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The neurobiological basis of panic disorder: A review

14 December 1992


A large and divergent literature has emerged from the growing body of neurobiological research on panic disorder (PD). There have been few reviews of this literature, particularly in recent years. The present paper reviews the neurobiology of PD in the areas of genetic/familial transmission of PD, brain imaging studies, hyperventilation and· carbon dioxide inhalation, and studies of panic provoked by chemical means in the laboratory. Review of the literature suggests a widely held consensus among investigators that a neurobiological vulnerability to PD may be passed across generations, but there is no firm consensus regarding the site and specific nature of this presumed vulnerability. A noradrenergic dysregulation that implicates the locus ceruleus region of the brain remains a dominant model. Increasing interest 1n the role of neuroreceptors in PD has been brought about by the effectiveness of antipanic medications that seem to operate on these sites, as well as the development of methodology to provoke panic in the laboratory. A recent trend to evaluate the role of cognitive factors in the onset and maintenance of panic has led to efforts to incorporate psychological factors in both research designs and models of dysfunction in PD. These trends evident from the review of the literature of the neurobiology of PD are viewed in a historical context of development of interest in PD, as well as recent studies of the surprisingly high prevalence and morbidity of the phenomenon known as panic.


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