Differential activity of subgenual cingulate and brainstem in panic disorder and PTSD

Oliver Tuescher, Xenia Protopopescu, Hong Pan, Marylene Cloitre, Tracy Butler, Martin Goldstein, James C. Root, Almut Engelien, Daniella Furman, Michael Silverman, Yihong Yang, Jack Gorman, Joseph LeDoux, David Silbersweig, Emily Stern

Research output: Contribution to journalArticlepeer-review


Most functional neuroimaging studies of panic disorder (PD) have focused on the resting state, and have explored PD in relation to healthy controls rather than in relation to other anxiety disorders. Here, PD patients, posttraumatic stress disorder (PTSD) patients, and healthy control subjects were studied with functional magnetic resonance imaging utilizing an instructed fear conditioning paradigm incorporating both Threat and Safe conditions. Relative to PTSD and control subjects, PD patients demonstrated significantly less activation to the Threat condition and increased activity to the Safe condition in the subgenual cingulate, ventral striatum and extended amygdala, as well as in midbrain periaquaeductal grey, suggesting abnormal reactivity in this key region for fear expression. PTSD subjects failed to show the temporal pattern of activity decrease found in control subjects.

Original languageEnglish (US)
Pages (from-to)251-257
Number of pages7
JournalJournal of Anxiety Disorders
Issue number2
StatePublished - Mar 2011


  • Anxiety disorders
  • Brainstem
  • Extended amygdala
  • Neuroimaging
  • Panic disorder
  • Posttraumatic stress Disorder
  • Subgenual cingulate cortex
  • Ventral striatum

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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