Yonsei Med J.  2017 Sep;58(5):1018-1024. 10.3349/ymj.2017.58.5.1018.

Reduced Cortical Thickness in the Temporal Pole, Insula, and Pars Triangularis in Patients with Panic Disorder

• Kang EK
• Lee KS
• Lee SH

• KMID: 2418940
• DOI: http://doi.org/10.3349/ymj.2017.58.5.1018

Abstract

PURPOSE
Recent neuroimaging findings have revealed that paralimbic and prefrontal regions are involved in panic disorder (PD). However, no imaging studies have compared differences in cortical thickness between patients with PD and healthy control (HC) subjects.
MATERIALS AND METHODS
Forty-seven right-handed patients with PD who met the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders-4th edition-text revision, and 30 HC subjects were enrolled. We used the FreeSurfer software package for estimating the cortical thickness of regions of interest, including the temporal pole, insula, and pars triangularis (mid-ventrolateral prefrontal cortex).
RESULTS
Cortical thickness of the temporal pole (p=0.033, right), insula (p=0.017, left), and pars triangularis (p=0.008, left; p=0.025, right) in patients with PD was significantly lower, compared with HC subjects (Benjamini-Hochberg false discovery rate correction). Exploratory analysis revealed a significant negative correlation between the cortical thickness of the right temporal pole and Beck Depression Inventory scores (r=-0.333, p=0.027) in patients with PD and positive correlations between the cortical thickness of the left pars triangularis and Panic Disorder Severity Scale (r=0.429, p=0.004), Anxiety Sensitivity Index-Revised (r=0.380, p=0.011), and Beck Anxiety Inventory (r=0.421, p=0.004) scores using Pearson's correlation.
CONCLUSION
Ours study is the first to demonstrate cortical thickness reduction in the temporal pole, insula, and pars triangularis in patients with PD, compared with the HC subjects. These findings suggest that reduced cortical thickness could play an important role in the pathophysiology of PD.

Keyword

Panic disorder; cortical thickness; temporal pole; insula; pars triangularis

MeSH Terms

Adult
Broca Area/*pathology
Case-Control Studies
Cerebral Cortex/*pathology
Demography
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Panic Disorder/*pathology
Temporal Lobe/*pathology

Figure

• 

  Fig. 1 Cluster with significant differences in cortical thickness comparison between PD and HCs among the temporal pole (p=0.033, right), insula (p= 0.017, left), and pars triangularis (p=0.008, left; p=0.025, right) ROIs. All comparisons were made using independent t-tests with a significance level of p<0.05 after Benjamini-Hochberg FDR correction. The results were also visualized and verified by vertex-wised analysis. Blue and light blue in the up-per left quadrant of (A) and the upper right quadrant of (B) indicate the regions with a significantly reduced cortical thickness in the patients with PD. compared to the HCs. Scatter plots shows the positive correlation between PDSS (r=0.429, p=0.004), ASI-R (r=0.380, p=0.011), and BAI (r=0.421, p=0.004) scores with cortical thickness of the left pars triangularis (A) and negative correlation between BDI scores (r=-0.333, p=0.027) with cortical thickness of the right temporal pole (B) in the patients with PD. (A) Left Hemisphere, (B) Right Hemisphere. a, anterior; p, posterior; PD, panic disorder; HC, healthy control; ROIs, regions of interests; FDR, false discovery rate; PDSS, Panic Disorder Severity Scale; ASI-R, Anxiety Sensitivity Inventory-Revised; BAI, Beck Anxiety Inventory; BDI, Beck Depression Inventory.

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