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Cited by 61Neuroscience of respiration and sleepAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychosomatic Disorders and Their Treatments

Panic disorder: from respiration to the homeostatic brain

Perna, Giampaolo, Caldirola, Daniela, Bellodi, Laura·2004·Acta Neuropsychiatrica
DOI 10.1111/j.0924-2708.2004.0080.x
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Abstract

There is some experimental evidence to support the existence of a connection between panic and respiration. However, only recent studies investigating the complexity of respiratory physiology have revealed consistent irregularities in respiratory pattern, suggesting that these abnormalities might be a vulnerability factor to panic attacks. The source of the high irregularity observed, together with unpleasant respiratory sensations in patients with panic disorder (PD), is still unclear and different underlying mechanisms might be hypothesized. It could be the result of compensatory responses to abnormal respiratory inputs or an intrinsic deranged activity in the brainstem network shaping the respiratory rhythm. Moreover, since basic physiological functions in the organism are strictly interrelated, with reciprocal modulations and abnormalities in cardiac and balance system function having been described in PD, the respiratory findings might arise from perturbations of these other basic systems or a more general dysfunction of the homeostatic brain. Phylogenetically ancient brain circuits process physiological perceptions/sensations linked to homeostatic functions, such as respiration, and the parabrachial nucleus might filter and integrate interoceptive information from the basic homeostatic functions. These physiological processes take place continuously and subconsciously and only occasionally do they pervade the conscious awareness as ‘primal emotions’. Panic attacks could be the expression of primal emotion arising from an abnormal modulation of the respiratory/homeostatic functions.

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Crossref · 10.1111/j.0924-2708.2004.0080.x

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  • Possible explanations for the weaker anti-panic properties of fluvoxamine and imipramine are that fluvoxamine has the lowest in vitro anticholinergic effects and imipramine has the weakest effect on the serotonergic system.

    “Possible explanations are that fluvoxamine has the lowest in vitro anticholinergic effects, which are thought to be involved in respiratory aspects of anti-panic activity [50], whereas imipramine has the weakest effect on the serotonergic system, which plays a crucial role in the pathophysiology of panic–respiration connection [37, 51].”

    From Management of Treatment-Resistant Panic Disorder (2017) · cites this paper as [51]

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Authors
Perna, G., Caldirola, D., & Bellodi, L.
Affiliations
Vita-Salute San Raffaele University (IT)
Corresponding author
Perna, Giampaolo
ORCID
Venue
Acta Neuropsychiatrica
Publisher
Cambridge University Press (CUP)
Published
2004-04
Volume
16
Issue
2
Pages
57-67
ISSN
  • 0924-2708 (ISSN-L)
  • 1601-5215
DOI
10.1111/j.0924-2708.2004.0080.x
OpenAlex
W2036152614
Cited by
61
References
119
Citations by year
2026: 1 · 2025: 5 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 1 · 2018: 5 · 2017: 2 · 2016: 6 · 2014: 4 · 2013: 3 · 2012: 6
FWCI
0.94
Type
journal article
Language
en
Open access
closed
Licence
www.cambridge.org/core/terms (unspecified, 3736 d)
Locations
  • Acta Neuropsychiatrica (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords
panic disorder, panic attacks, respiration, respiratory irregularity, parabrachial nucleus, interoception, vulnerability factors

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