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Eric M. Reiman, MD; Marcus E. Raichle, MD; Eli Robins, MD; Mark A. Mintun, MD; Maureen J. Fusselman, RN, MS; Peter T. Fox, MD; Joseph L. Price, PhD; Kathryn A. Hackman

Arch Gen Psychiatry. 1989;46(6):493-500.

Abstract
• Positron emission tomographic measurements of regional blood flow were used to assess local neuronal activity in patients with panic disorder and in normal control subjects before and during the infusion of sodium lactate. A new technique for the analysis of positron emission tomographic data was employed to identify significant changes in regional blood flow associated with lactate infusion in the panicking patients, nonpanicking patients, and controls. Lactate-induced panic was associated with significant blood flow increases bilaterally in the temporal poles; bilaterally in insular cortex, claustrum, or lateral putamen; bilaterally in or near the superior colliculus; and in or near the left anterior cerebellar vermis. Lactate infusion was not associated with significant changes in regional blood flow in the nonpanicking patients or control subjects. Thus, the identified regions seemed to be involved in an anxiety attack.

Author Affiliations
From the Departments of Psychiatry (Drs Reiman, Robins, and Fusselman), Neurology and Neurological Surgery (Drs Raichle, Mintun, and Fox), and Anatomy and Neurobiology (Dr Price), the Mallinckrodt Institute of Radiology (Drs Raichle, Mintun, and Fox and Ms Hackman), and the McDonnell Center for Studies of Higher Brain Function (Drs Reiman and Raichle), the Washington University School of Medicine, St Louis, Mo.

Footnotes
Accepted for publication February 3, 1989.

Presented at the 141st Annual Meeting of the American Psychiatric Association, Montreal, Canada, May 10, 1988.

Reprints requests to The Division of Radiation Sciences, Mallinckrodt Institute of Radiology, 510 S Kingshighway, St Louis, MO 63110 (Dr Reiman).

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