Angst und Panik

ZUSAMMENFASSUNG

Gegenstand und Ziel: Die Forschung zu den neuronalen Korrelaten von Angst und Panik hat sich im letzten Jahrzehnt weiterentwickelt. Seit 1989 Gormans Hypothese zur Neuroanatomie der Panikstörung erschien, wurden viele Studien in den Bereichen Bildgebung und Neurochemie durchgeführt.

Material und Methoden: Wir geben eine Übersicht über die Datenlage zu funktionellen Netzwerken bei Angst und Panik mit einem Schwerpunkt auf funktionellen Bildgebungsstudien.

Ergebnisse: Für das Verständnis der Panikstörung ist von einem komplexen Modell multipler neuronaler Netzwerke mit Beteiligung von weitaus mehr Hirnregionen als zunächst angenommen auszugehen. Ein mögliches erweitertes neuro­anatomisches Netzwerkmodell der Panikstörung umfasst den präfrontalen Kortex, den zingulären Kortex, Thalamus, Hypothalamus, Insel, Hirnstamm, Hippocampus, Amygdala und den Bed Nucleus der Stria Terminalis. Neurochemisch ist eine Vielzahl von Neurotransmittern an der Entstehung der Panikstörung beteiligt.

Schlussfolgerungen: Für das Verständnis der funktionellen Netzwerke bei Angst und Panik sind interdisziplinäre Forschung sowie eine dimensionale und transdiagnostische Herangehensweise essenziell.

ABSTRACT

Objective: Research on the neuronal correlates of anxiety and panic has significantly evolved in the last decade. A wide range of studies regarding neuroimaging and neurochemistry have been conducted since Gorman published his neuroanatomical hypothesis of panic disorder in 1989.

Materials and method: We will give an overview on data on functional networks in anxiety and panic. An emphasis is put on functional neuroimaging studies.

Results: A complex model of multiple neuronal networks is an approach to understanding anxiety disorders in general and panic disorder in particular. More regions than assumed earlier are involved in this multiple network model. A possible network model for understanding panic disorder includes the prefrontal cortex, the cingular cortex, thalamus, hypothalamus, insula, brainstem, amygdala and the bed nucleus striae terminalis. From a neurochemical perspective a multitude of neurotransmitters is involved in the genesis of panic disorder.

Conclusions: Interdisciplinary research as well as a dimensional and transdiagnostic perspective are essential to improve the understanding of neuronal correlates of anxiety and panic.

Schlüsselwörter

Angst - Panikstörung - funktionelle Bildgebung - Furchtnetzwerk

Key Words

Anxiety - panic - functional neuroimaging - fear network

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