A breakthrough discovery could lead to new drugs that prevent people from suffering panic attacks.
People suffering from panic disorder experience frequent and unexpected attacks which trigger symptoms of overwhelming fear, sweaty palms, shortness of breath and a rapid heart rate.
Now, researchers in the US observing panic attacks in mice identified a brain circuit of specialised neurons that could be controlled to mediate panic disorder.
The scientists located an area of the brain involved in generating panic and bringing about emotional and physical changes.
The research team, from the Salk Institute for Biological Studies, also found that by inhibiting certain signals they could reduce panic symptoms – offering hope for the development of drugs to alleviate panic disorder.
The Salk scientists, based in California, set out to map the regions and connections of the brain that cause panic attacks.
To begin drawing their map, the researchers looked at a part of the brain called the lateral parabrachial nucleus (or PBL, slightly easier), located in part of the brain stem known as its ‘alarm centre’.
This small brainstem area, called the pons, also controls our breathing, heart rate, and body temperature.
The scientists found the PBL was implicated in generating panic and bringing about emotional and physical changes.
They also discovered that this area of the brain produces the neuropeptide PACAP (pituitary adenylate cyclase-activating polypeptide), known as the master regulator of stress responses.
What is a panic attack?
A panic attack is one symptom of panic disorder, where sufferers regularly have sudden attacks of panic or fear.
During a panic attack you get a rush of intense mental and physical symptoms. It can come on very quickly and for no apparent reason.
A panic attack can be very frightening and distressing – but are not dangerous.
Most panic attacks last between five and 20 minutes.
Symptoms include:
- a racing heartbeat
- feeling faint
- sweating
- nausea
- chest pain
- shortness of breath
- trembling
- hot flushes
- chills
- shaky limbs
- a choking sensation
- dizziness
- numbness or pins and needles
- dry mouth
- a feeling of dread or a fear of dying
- a churning stomach
- a tingling in your fingers
- feeling like you’re not connected to your body
Source: The NHS
However, the link between these elements was still unclear, so the team turned to experiments in mice to confirm and expand their proposed map.
Sukjae Kang, a senior research associate at Salk and co-first author of the study, said: ‘Emotional and stress-related behaviors have been associated with PACAP-expressing neurons in the past.
‘By mimicking panic attacks in the mice, we were able to watch those neurons’ activity and discover a unique connection between the PACAP brain circuit and panic disorder.’
In observing the brains of mice during panic attacks, the researchers found that PACAP-expressing neurons became activated.
Once activated, they release the messenger molecule to another part of the brain called the dorsal raphe. Here, they activate receptor neurons, producing panic-associated behavioral and physical symptoms in the mice.
This newly discovered connection between panic disorder and the PACAP brain circuit was an important step in mapping panic disorder in the brain.
The team also found that by inhibiting PACAP signalling, they could disrupt the flow of PACAP neuropeptides and reduce panic symptoms – a promising finding for the future development of panic disorder-specific drugs.
Dr Sung Han, senior author of the study and an associate professor at Salk, says that despite panic disorder’s categorisation as an anxiety disorder, there are many ways in which anxiety and panic differ.
Panic, for example, induces physical symptoms such as shortness of breath, a rapid heart rate, sweating and nausea – whereas anxiety does not induce these symptoms.
Panic attacks are also uncontrollable and often spontaneous, while other anxiety disorders such as post-traumatic stress disorder (PTSD) are more memory-based and have predictable triggers.
Dr Han explains that these differences are why it is crucial to construct this panic disorder brain map, so researchers can create therapeutics specially tailored to panic disorder.
The team now hopes to explore PACAP-expressing neurons and PACAP neuropeptides as druggable targets for panic disorder.
The study is published in the journal Nature Neuroscience.
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