Impact of loudness dependency of auditory evoked potentials on the panic response to CCK-4.

Abstract

RATIONALE:

Experimental panic induction with cholecystokinin-tetrapeptide (CCK-4) has been established as a model to study the pathophysiology of panic disorder. In line with the serotonin (5-HT)-hypothesis of panic disorder it has been suggested that the panicogenic effects of CCK-4 are mediated in part through the 5-HT system. The analysis of the loudness dependency of the auditory evoked potentials (LDAEP) is a valid non-invasive indicator of central serotonergic activity.

METHODS:

We investigated the correlation between LDAEP and behavioral, cardiovascular and neuroendocrine panic responses to CCK-4in 77 healthy volunteers and explored whether differences in LDAEP paralleled subjective panic severity. Behavioral panic responses were measured with the panic symptom scale (PSS). Heart rate and ACTH/cortisol plasma concentrations were assessed concomitantly.

RESULTS:

LDAEP did not differ between panickers and nonpanickers. Furthermore, LDAEP did not correlate with the behavioral panic response. However, a significant positive correlation between LDAEP and CCK-4 induced HPA-axis activation, which was uniform in panickers and nonpanickers, could be detected.

CONCLUSIONS:

The psychological effects of CCK-4 rather are mediated by neurotransmitters others than the endogenous 5-HT system. However, the extent of the neuroendocrine activation related to the CCK-4 panic provocation was correlated with the LDAEP, thereby suggesting that central 5-HT mechanisms are involved in the HPA-axis activation during this challenge paradigm.

• Authors: Daniela Eser, Gregor Leicht, Thomas Baghai, Oliver Pogarell, Cornelius Schüle, Susanne Karch, Caroline Nothdurfter, Rainer Rupprecht, Christoph Mulert
• Journal: Journal of psychiatric research (J Psychiatr Res) Vol. 43 Issue 4 Pg. 393-400 (Jan 2009) ISSN: 0022-3956 [Print] England
• PMID: 18534623 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Tetragastrin
• Adrenocorticotropic Hormone
• Hydrocortisone

Topics

• Acoustic Stimulation (methods)
• Adrenocorticotropic Hormone (biosynthesis, blood)
• Adult
• Electroencephalography
• Evoked Potentials, Auditory (drug effects)
• Heart Rate (drug effects)
• Humans
• Hydrocortisone (biosynthesis, blood)
• Hypothalamo-Hypophyseal System (drug effects, physiopathology)
• Loudness Perception (drug effects)
• Male
• Panic (physiology)
• Pituitary-Adrenal System (drug effects, physiopathology)
• Radioimmunoassay
• Severity of Illness Index
• Statistics as Topic
• Tetragastrin (administration & dosage, toxicity)