Recognition of happy facial affect in panic disorder: an fMRI study.

BACKGROUND This study investigated activation of the anterior cingulate cortex (ACC) and amygdala during the presentation of happy facial affect images in patients with panic disorder (PD) as measured by blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI). METHODS Eight patients with PD and eight sex-matched controls were recruited for the study. Scanning was performed on a general electric (GE) Signa 1.5T scanner retrofitted with a whole body echo planar coil. Using a quadrature head coil, echo planar images and high-resolution MR images were acquired. RESULTS After covarying for age, examination of group differences revealed greater ACC activation bilaterally in patients with PD compared to controls in response to happy faces. However, there were no differences in amygdala activation between the groups. These findings contrasted with regional brain activation in response to neutral faces where there were was also greater bilateral ACC activation in the PD group, but only 44 ACC voxels showed significant increases as opposed to 509 voxels for the happy condition. There were no between group differences in activation in the amygdala. CONCLUSION This is the first fMRI study to our knowledge that demonstrates ACC abnormalities in response to happy facial affect recognition in PD.