This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (66)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Panic Disorder  • Alert me on articles by topic

Georg Wiedemann, MD; Paul Pauli, PhD; Wilhelm Dengler, MD; Wemer Lutzenberger, PhD; Niels Birbaumer, PhD; Gerhard Buchkremer, MD

Arch Gen Psychiatry. 1999;56:78-84.

Background  Right frontal hemisphere activation, as indicated by reduced frontal alpha amplitude, seems to represent activation of an avoidance-withdrawal system and seems to be associated with negative emotions. Since patients with panic disorder are characterized by both negative emotions and avoidance-withdrawal behavior, we expected them to show greater right than left frontal hemisphere activation.

Methods  Spontaneous electroencephalography was recorded from the left and right frontal and parietal scalp regions of 23 patients with panic disorder patients without a diagnosis of depression and from 25 healthy control participants during the following conditions: rest, confrontation with neutral, panic-relevant, anxiety-relevant but panic-irrelevant, or anxiety-irrelevant but emotionally relevant stimuli, and performance of a motor task. Their emotional state during these conditions was assessed by the Self-Assessment Manikin.

Results  In patients with panic disorders, there were asymmetries in frontal hemisphere activation during resting phases and when confronted with anxiety-relevant stimuli. Their right frontal alpha power was significantly decreased compared with the left, while control participants did not show frontal brain asymmetry during these phases. There was no frontal brain asymmetry when patients observed an emotionally neutral picture or performed a motor task. Under these conditions, left and right frontal hemisphere alpha activation of patients with panic disorder and healthy participants were comparable.

Conclusions  These data support the hypothesis that patients with panic disorder are characterized by greater activation of a right frontal avoidance-withdrawal system in negatively valenced situations. The findings are interpreted as biological evidence for a disturbed cortical processing in patients with panic disorder.

From the University Hospital of Psychiatry and Psychotherapy (Drs Wiedemann, Dengler, and Buchkremer) and the Institute of Medical Psychology and Behavioral Neurobiology, University of Tuebingen, Tuebingen, Germany (Drs Pauli, Lutzenberger, and Birbaumer).

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Changes in Brain Electrical Activity After Cognitive Behavioral Therapy for Posttraumatic Stress Disorder in Patients Injured in Motor Vehicle Accidents
Rabe et al.
Psychosom. Med. 2008;70:13-19.
ABSTRACT | FULL TEXT  

Exaggerated Differences in Pulse Wave Velocity Between Left and Right Sides Among Patients With Anxiety Disorders and Cardiovascular Disease
Yeragani et al.
Psychosom. Med. 2007;69:717-722.
ABSTRACT | FULL TEXT  

Left Hemisphere Dysfunction During Verbal Dichotic Listening Tests in Patients Who Have Social Phobia With or Without Comorbid Depressive Disorder
Bruder et al.
Am. J. Psychiatry 2004;161:72-78.
ABSTRACT | FULL TEXT  

The effect of brain tumour laterality on anxiety levels among neurosurgical patients
Mainio et al.
J. Neurol. Neurosurg. Psychiatry 2003;74:1278-1282.
ABSTRACT | FULL TEXT  

The neural circuitry of emotion and affective style: prefrontal cortex and amygdala contributions
Davidson
Social Science Information 2001;40:11-37.
ABSTRACT