Abstract：
Abnormal functional connectivity (FC) within the fear network model (FNM) has been identified in panic disorder (PD) patients, but the specific local structural and functional properties, as well as effective connectivity (EC), remain poorly understood in PD. The purpose of this study was to investigate the structural and functional patterns of the FNM in PD. Magnetic resonance imaging data were collected from 33 PD patients and 35 healthy controls (HCs). Gray matter volume (GMV), degree centrality (DC), regional homogeneity (ReHo), and amplitude of low-frequency fluctuation (ALFF) were used to identify the structural and functional characteristics of brain regions within the FNM in PD. Subsequently, FC and EC of abnormal regions, based on local structural and functional features, and their correlation with clinical features were further examined. PD patients exhibited preserved GMV, ReHo, and ALFF in the brain regions of the FNM compared with HCs. However, increased DC in the bilateral amygdala was observed in PD patients. The amygdala and its subnuclei exhibited altered EC with rolandic operculum, insula, medial superior frontal gyrus, supramarginal gyrus, opercular part of inferior frontal gyrus, and superior temporal gyrus. Additionally, Hamilton Anxiety Scale score was positively correlated with EC from left lateral nuclei (dorsal portion) of amygdala to right rolandic operculum and left superior temporal gyrus. Our findings revealed a reorganized functional network in PD involving brain regions regulating exteroceptive-interoceptive signals, mood, and somatic symptoms. These results enhance our understanding of the neurobiological underpinnings of PD, suggesting potential biomarkers for diagnosis and targets for therapeutic intervention.
摘要：
恐惧网络模型（FNM）中的异常功能连接（FC）已在惊恐障碍（PD）患者中被识别，但是特定的局部结构和功能特性，以及有效连接(EC)，在PD中仍然知之甚少。这项研究的目的是研究PD中FNM的结构和功能模式。从33名PD患者和35名健康对照（HC）收集磁共振成像数据。灰质体积（GMV），度中心性(DC)，区域同质性(ReHo)，和低频波动幅度（ALFF）用于鉴定PD中FNM内脑区域的结构和功能特征。随后，异常区域的FC和EC，基于局部结构和功能特征，并进一步检查其与临床特征的相关性。PD患者表现出保留的GMV，ReHo,与HC相比，FNM的大脑区域和ALFF。然而,PD患者双侧杏仁核DC增加。杏仁核及其亚核显示出罗兰管壳的EC改变，脑岛,内侧额上回，颈上回，下额回的眼部,和颞上回.此外,汉密尔顿焦虑量表评分与从杏仁核左外侧核（背侧）到右罗兰骨和左颞上回的EC呈正相关。我们的发现揭示了PD中重组的功能网络，涉及调节外感受-感觉信号的大脑区域，心情,和躯体症状。这些结果增强了我们对PD的神经生物学基础的理解，提示诊断的潜在生物标志物和治疗干预的目标。
