Neural Probes of Respiratory Control and Interoception in Panic Disorder

惊恐障碍中呼吸控制和内感受的神经探针：NIMH的应用 以患者为导向的研究关怀发展奖（K23）。候选人已经完成了神经成像 奖学金培训，并寻求高级培训，以促进未来独立神经成像的目标 情绪和焦虑症的研究项目。老年人呼吸内感受的影像学研究 恐慌症将作为拟议的项目。恐慌症是一种严重的精神疾病， 严重的社会经济负担，因为其在总人口中的流行率为2-4%， （>50%）的治疗无应答和复发。惊恐障碍的病理生理学基础尚不清楚， 尽管流行的模型反映了皮质边缘脑功能障碍和异常呼吸的作用。的 候选人提出测试一个新的皮质边缘/边缘脑模型，重点是岛皮质及其作用， 内感受（对身体生理状况的感觉）。完整的内感受对于 生存作为一个报警的稳态失衡，并认为主要是在岛屿内处理 皮层虽然岛叶皮层在以前的恐慌神经成像研究中有牵连，但一个统一的模型 对于具有孤立焦点的恐慌神经回路还有待测试和解释。所提出的神经回路 模型将岛叶皮层功能障碍归因于对身体症状的误解 （内感受性线索），进而导致夸张的行为/恐惧反应，沿着最终的共同恐慌 电路呼吸内感受性激发过程中的功能磁共振成像（fMRI）研究 将被用来测试候选人的神经回路模型恐慌症，集中在岛叶皮层， 它在内感受中的作用。酸/碱生理学和呼吸心理生理学的额外测试将 补充神经影像学研究，以区分惊恐障碍的呼吸亚型， 据报道，占恐慌症患者的50%以上。总的来说，该项目代表了第一个 惊恐障碍与呼吸激发和控制的综合神经系统研究该项目将 测试恐慌神经回路的统一模型，同时承诺为焦虑回路的一般模型提供信息。 相关性（参见说明）： 恐慌症（一种以频繁、自发的恐慌发作为特征的病症）的病因尚不清楚 并且目前的治疗不能使大多数患者保持缓解。目前的项目旨在描绘 与恐慌症有关的功能失调的大脑回路，以便开发出更好的治疗方法。

Neural Probes of Respiratory Control and Interoception in Panic Disorder," an application for an NIMH Patient Oriented Research Caree r Development Award (K23). The candidate has completed neuroimaging fellowship training and seeks advanced training to facilitate objectives for future independent neuroimaging research programs in the mood and anxiety disorders. A neuroimaging study of respiratory interoception in panic disorder will serve as the proposed project. Panic disorder is a serious psychiatric illness that imposes significant social-economic burden given its prevalence of 2-4% in the general population, and high rates (>50%) of treatment non-response and relapse. The pathophysiological basis of panic disorder is unknown, although prevailing models reflect roles for cortico-limbic brain dysfunction and abnormal respiration. The candidate proposes to test a new cortico-limbic/paralimbic model focused on the insularcortex and its role in interoception (the sense of the physiological condition of the body). Intact interoception is essential to survival as an alarm for homeostatic imbalance, and thought to be primarily processed within the insular cortex. While the insular cortex has been implicated in previous panic neuroimaging studies, a unified model for panic neural circuitry with an insular focus has yet to be tested and explained. The proposed neural circuit model attributes dysfunction within insular cortex to trigger the misinterpretation of physical symptoms (interoceptive cues), that in turn lead to exaggerated behavioral/fear responses along a final common panic circuitry. Functional magnetic resonance imaging (fMRI) studies during respiratory interoceptive provocation will be used to test the candidate's neural circuit model for panic disorder, centered on the insular cortex and its role in interoception. Additional tests of acid/base physiology and respiration psychophysiology will complement the neuroimaging studies in order to differentiate a respiratory subtype of panic disorder, reported to account for greater than 50% of panic patients. Taken together, the project represents the first integrated neural systems study of panic disorder with respiratory provocation and control. The project will test a unified model for panic neural circuitry while promising to inform general models of anxiety circuitry. RELEVANCE (See instructions): The cause of panic disorder (a condition characterized by frequent, spontaneous panic attacks) is unknown and current treatments fail to keep most patients in remission. The current project aims to delineate the dysfunctional brain circuits involved in panic disorder so that better treatments may be developed.