BRAIN IMAGINGFunctional MRI changes during panic anticipation and imagery exposureBystritsky, AlexanderCA; Pontillo, Deborah1; Powers, Mark; Sabb, Fred W.2; Craske, Michelle G.1; Bookheimer, Susan Y.2Author Information Departments of Psychiatry, and 1Psychology, UCLA/NPI, 300 UCLA Medical Plaza, 2335 Los Angeles, CA 90095, USA CACorresponding Author Received 5 September 2001; accepted 15 October 2001 Neuroreport: December 21st, 2001 - Volume 12 - Issue 18 - p 3953-3957 Buy SDC Abstract While undergoing fMRI, six patients with DSM IV diagnosis of panic disorder and six normal controls performed directed imagery of neutral, moderate and high anxiety situations based on an individually determined behavioral hierarchy. Brain activity was compared during high vs neutral anxiety blocks for each group of subjects using SPM99b. Panic patients showed increased activity in inferior frontal cortex, hippocampus and throughout the cingulate both anterior and posterior, extending into the orbitofrontal cortex and encompassing both hemispheres. These areas may constitute the important circuit in the psychopathology of panic disorder. We propose that this pattern of activity may enhance the encoding and retrieval of strong emotional events, facilitating the recapitulation of traumatic experiences and leading to panic disorder in vulnerable individuals. © 2001 Lippincott Williams & Wilkins, Inc.