Panic disorder: the role of the balance system

Subtypes of panic attacks: a critical review of the empirical literature

“…Similar group differences were recently reported within patient samples that were not preselected for dizziness symptoms. [80,81] Approximately 50-85% of patients with panic disorder report the experience of dizziness during panic attacks, [82] relatively consistent with Jacob and colleagues' more objective findings for vestibular abnormalities [78][79][80][81] and supportive of the symptom's high frequency. Meuret et al's [16] factor analysis of DSM-IV panic symptomatology in a sizeable clinical sample indicated a ''mixed somatic'' factor comprised of symptoms of dizziness, nausea, trembling, sweating, and chills/hot flashes, and a prior analysis [20] also obtained a vestibular symptom factor.…”

Evidence for vestibular regulation of autonomic functions in a mouse genetic model

“…Because Brn-3.1 Ϫ/Ϫ mice show no neuronal aberrations in PB or any of the activated central regions as assessed by morphological analysis after thionin staining and calbindin immunohistochemistry (unpublished observations), our results suggest that information about the gravitational field is transmitted primarily by means of an activation of a cochleovestibulo-parabrachial pathway, which in turn leads to activation of multiple central structures governing the proper autonomic, endocrine, and emotional responses. Further, patients suffering from anxiety-related disorders and impaired stress response show increased incidence of vestibular dysfunction (11,37,38). This study contributes to the definition of mechanisms through which the vestibular system influences autonomic functions, an issue with important implications in space biology and psychiatric medicine.…”

“…For example, results from physiological studies have suggested a vestibulosympathetic ref lex regulating cardiovascular activity under changes in posture (10), but potential participation of putative somatic gravity receptors has remained ambiguous. Interestingly, a large proportion of patients suffering from anxietyrelated disorders show vestibular dysfunction compared with controls, and observations of correlations between vestibular dysfunction and stress and anxiety in humans have been noted for more than two millenniums (11,12).…”

Visually induced postural sway in anxiety disorders

“…About 30 percent of patients with vestibular disorders report persistent panic and agoraphobic symptoms or generalized anxiety (Eagger, et al, 1992;Stein, et al, 1994;. Conversely, vestibular dysfunction is common among patients with anxiety disorders (Jacob, Moller, et al, 1985;Sklare, et al, 1990;Hoffman, et al, 1994;Jacob Furman, Durrant, et al, 1996;Yardley, 1994Yardley, ,1995Perna, et al, 2001).…”