BRAIN IMAGINGIncreased brainstem volume in panic disorder: a voxel-based morphometric studyProtopopescu, Xeniaa b; Pan, Honga; Tuescher, Olivera; Cloitre, Marylenec; Goldstein, Martina; Engelien, Almuta; Yang, Yihonga; Gorman, Jackd; LeDoux, Josephe; Stern, Emilya; Silbersweig, Davida Author Information aFunctional Neuroimaging Laboratory, Department of Psychiatry, Weill Medical College of Cornell University, New York, New York, USA bThe Rockefeller University Laboratory of Neuroendocrinology, New York, New York, USA cNYU Child Studies Center, New York University School of Medicine, New York, New York, USA dMount Sinai School of Medicine, New York, New York, USA eCenter for Neural Science, New York University, New York, USA Correspondence and requests for reprints to Dr David Silbersweig, Functional Neuroimaging Laboratory, Department of Psychiatry, Box 140, Rm F1302, Weill Medical College of Cornell University, 1300 York Avenue, New York, NY 10021, USA Tel: +1 212 746 3762; fax: +1 212 746 5722; e-mail: [email protected] Sponsorship: This work was supported by NIMH grant 5-P50MH58911 ‘Center for Neural Systems of Fear and Anxiety,’ the DeWitt Wallace Fund of the New York Community Trust, and NIH MSTP grant GM07739 (to X.P.). Received 5 December 2005; revised 10 January 2006; accepted 11 January 2006 NeuroReport: March 20, 2006 - Volume 17 - Issue 4 - p 361-363 doi: 10.1097/01.wnr.0000203354.80438.1 Buy Metrics Abstract Neurocircuitry models of panic disorder have hypothesized that the panic attack itself stems from loci in the brainstem including the ascending reticular system and respiratory and cardiovascular control centers. Voxel-based morphometry with acobian modulation was used to examine gray matter volume changes in 10 panic disorder patients and 23 healthy controls. The panic disorder patients had a relatively increased gray matter volume in the midbrain and rostral pons of the brainstem. Increased ventral hippocampal and decreased regional prefrontal cortex volumes were also noted at a lower significance threshold. This finding has implications for pathophysiologic models of panic disorder, and provides structural evidence for the role of the brainstem in neurocircuitry models of panic disorder. © 2006 Lippincott Williams & Wilkins, Inc.