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Brain blood flow in anxiety disorders

OCD, panic disorder with agoraphobia, and post-traumatic stress disorder on 99m TcHMPAO single photon emission tomography (SPET)

Published online by Cambridge University Press:  03 January 2018

J. V. Lucey*
Affiliation:
St Bartholomew's and The Royal London School of Medicine and Dentistry, and Institute of Psychiatry
Durval C. Costa
Affiliation:
Institute of Nuclear Medicine
Gwen Adshead
Affiliation:
Institute of Psychiatry
Martin P. Deahl
Affiliation:
St Bartholomews and the Royal London School of Medicine and Dentistry
Geraldo Busatto
Affiliation:
Institute of Psychiatry
Sveto Gacinovic
Affiliation:
Institute of Nuclear Medicine
Michael Travis
Affiliation:
Institute of Psychiatry
Lyn S. Pilowsky
Affiliation:
Institute of Psychiatry
Peter J. Ell
Affiliation:
Institute of Nuclear Medicine
Isaac M. Marks
Affiliation:
Institute of Psychiatry, London
Robert W. Kerwin
Affiliation:
Institute of Psychiatry, London
*
Dr J. V. Lucey, Senior Lecturer, Department of Psychological Medicine, St Bartholomew's Hospital, West Smithfield, London ECIA 7BE. e-mail: [email protected]

Abstract

Background

We compared regional cerebral blood flow (rCBF) in three groups of patients with DSM–III–R anxiety disorders.

Method

Fifteen patients with obsessive–compulsive disorder (OCD), 15 with panic disorder with agoraphobia (PA), and 16 with post-traumatic stress disorder (PTSD) and a similar group of healthy controls were assessed on brain-dedicated high-resolution SPET.

Results

MANOVA revealed significant rCBF differences between diagnostic groups (F=4.4; d.f.=3, 57; P=0.007) and between cerebral regions (F=6.4; d.f.=1, 57; P=0.01) in OCD and PTSD compared with PA and healthy controls, limited to bilateral superior frontal cortices and right caudate nuclei. Whole brain blood flow correlated positively with anxiety (r=0.24, n=46, P=0.05). Beck depression scores correlated significantly negatively with left caudate rCBF (r= –0.24, n=46, P=0.05) and right caudate rCBF (r= –0.31, n=46, P=0.02). PTSD syndrome severity correlated significantly negatively with the left caudate (r=-0.49, n=16. P=0.03) and with right caudate rCBF (r=-0.7, n=16, P=0.001)

Conclusions

Functional rCBF differences in anxiety disorders could relate to repetitive, intrusive, distressing mental activity, prominent in both OCD and PTSD.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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