Assessing Panic: Bridging the Gap Between Fundamental Mechanisms and Daily Life Experience

Nicole K. Leibold*, Koen R. Schruers

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

Panic disorder (PD) is one of the most common psychiatric disorders. Recurrent, unexpected panic attacks (PAs) are the primary symptom and strongly impact patients' quality of life. Clinical manifestations are very heterogeneous between patients, emphasizing the need for a dimensional classification integrating various aspects of neurobiological and psychological circuits in line with the Research Domain Criteria (RDoC) proposed by the US National Institute of Mental Health. To go beyond data that can be collected in the daily clinical situation, experimental panic provocation is widely used, which has led to important insights into involved brain regions and systems. Genetic variants can determine the sensitivity to experimental models such as carbon dioxide (CO2) exposure and can increase the risk to develop PD. Recent developments now allow to better assess the dynamic course of PAs outside the laboratory in patients' natural environment. This can provide novel insights into the underlying mechanisms and the influence of environmental factors that can alter gene regulation by changing DNA methylation. In this mini review, we discuss assessment of PAs in the clinic, in the laboratory using CO2 exposure, genetic associations, and the benefits of real-life assessment and epigenetic research.
Original languageEnglish
Article number785
Number of pages10
JournalFrontiers in Neuroscience
Volume12
DOIs
Publication statusPublished - 24 Oct 2018

Keywords

  • panic attacks
  • CO2 exposure
  • genetics
  • DNA methylation
  • ambulatory assessment
  • 35-PERCENT CARBON-DIOXIDE
  • GENERALIZED ANXIETY DISORDER
  • SEROTONIN TRANSPORTER GENE
  • MAJOR DEPRESSION
  • DNA METHYLATION
  • PHYSIOLOGICAL-CHANGES
  • RESPIRATORY CONTROL
  • EXPERIMENTAL-MODEL
  • MONOAMINE-OXIDASE
  • REGULATORY REGION

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