Regional cerebral metabolic asymmetries replicated in an independent group of patients with panic disorder

Thomas E Nordahl, Murray B. Stein, Chawki Benkelfat, William E. Semple, Paul Andreason, Allen Zametkin, Thomas W. Uhde, Robert M. Cohen

Research output: Contribution to journalArticlepeer-review

77 Scopus citations


Background: Abnormal left/right (L/R) hemispheric ratios of regional cerebral glucose metabolic rates (rCMRglc) (hippocampus and inferior prefrontal cortex) have been noted in unmedicated panic disorder patients. Methods: An independent group of panic disorder patients placed on imipramine was studied with positron-emission tomography, testing for evidence of normalization versus persistence of the abnormal rCMRglc ratios. Differences in orbital frontal rCMRglc values between the imipramine-treated and the previously reported unmedicated panic disorder patients were tested examining for evidence that the differences would resemble those noted in obsessive- compulsive disorder (OCD) patients treated with clomipramine. Results: We found the same abnormally low L/R hippocampal and posterior inferior prefrontal rCMRglc ratios in the imipramine-treated panic disorder patients. In addition, we found posterior orbital frontal rCMRglc decreases in the imipramine-treated panic disorder patients compared with the unmedicated panic disorder patients. Conclusions: These abnormal asymmetries found in unmedicated panic disorder patients and now in imipramine-treated panic disorder patients may reflect a trait abnormality. The orbital frontal rCMRglc differences between the imipramine-treated and unmedicated patients are similar to changes noted in OCD patients treated with clomipramine and may reflect direct or indirect effects of imipramine treatment in panic disorder patients.

Original languageEnglish (US)
Pages (from-to)998-1006
Number of pages9
JournalBiological Psychiatry
Issue number10
StatePublished - Nov 15 1998


  • Hemispheric asymmetries
  • Panic disorder
  • Regional cerebral glucose metabolism

ASJC Scopus subject areas

  • Biological Psychiatry


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