PMID- 17156152
OWN - NLM
STAT- MEDLINE
DCOM- 20070227
LR  - 20191210
IS  - 1398-5647 (Print)
IS  - 1398-5647 (Linking)
VI  - 8
IP  - 6
DP  - 2006 Dec
TI  - Panic comorbidity with bipolar disorder: what is the manic-panic connection?
PG  - 648-64
AB  - CONTEXT: Bipolar/panic comorbidity has been observed in clinical, community and 
      familial samples. As both are episodic disorders of affect regulation, the common 
      pathophysiological mechanism is likely to involve deficits in amygdala-mediated, 
      plasticity-dependent emotional conditioning. EVIDENCE: Neuronal genesis and 
      synaptic remodeling occur in the amygdala; bipolar and panic disorders have both 
      been associated with abnormality in the amygdala and related structures, as well 
      as in molecules that modulate plasticity, such as serotonin, norepinephrine, 
      brain-derived neurotrophic factor (BDNF) and corticotrophin releasing factor 
      (CRF). These biological elements are involved in behavioral conditioning to 
      threat and reward. MODEL: Panic attacks resemble the normal acute fear response, 
      but are abnormally dissociated from any relevant threat. Abnormal reward-seeking 
      behavior is central to both manic and depressive syndromes. Appetites can be 
      elevated or depressed; satisfaction of a drive may fail to condition future 
      behavior. These dissociations may be the result of deficits in 
      plasticity-dependent processes of conditioning within different amygdala 
      subregions. CONCLUSIONS: This speculative model may be a useful framework with 
      which to connect molecular, cellular, anatomic and behavioral processes in panic 
      and bipolar disorders. The primary clinical implication is that behavioral 
      treatment may be critical to restore function in some bipolar patients who 
      respond only partially to medications.
FAU - MacKinnon, Dean F
AU  - MacKinnon DF
AD  - Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School 
      of Medicine, Meyer 3-181, 600 N. Wolfe Street, Baltimore, MD 21287, USA. 
      dmackin@jhmi.edu
FAU - Zamoiski, Rachel
AU  - Zamoiski R
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Denmark
TA  - Bipolar Disord
JT  - Bipolar disorders
JID - 100883596
RN  - 0 (Brain-Derived Neurotrophic Factor)
RN  - 333DO1RDJY (Serotonin)
RN  - 9015-71-8 (Corticotropin-Releasing Hormone)
RN  - WI4X0X7BPJ (Hydrocortisone)
RN  - X4W3ENH1CV (Norepinephrine)
SB  - IM
MH  - Affect
MH  - Amygdala/metabolism/physiopathology
MH  - Bipolar Disorder/*epidemiology/metabolism/physiopathology
MH  - Brain-Derived Neurotrophic Factor/metabolism
MH  - Comorbidity
MH  - Conditioning, Psychological
MH  - Corticotropin-Releasing Hormone/metabolism
MH  - Fear
MH  - Humans
MH  - Hydrocortisone/metabolism
MH  - Hypothalamo-Hypophyseal System/physiopathology
MH  - Neuronal Plasticity/physiology
MH  - Norepinephrine/metabolism
MH  - Panic Disorder/*epidemiology/metabolism
MH  - Pituitary-Adrenal System/physiopathology
MH  - Serotonin/metabolism
MH  - Stress, Psychological/epidemiology/psychology
MH  - Synapses/physiology
RF  - 268
EDAT- 2006/12/13 09:00
MHDA- 2007/02/28 09:00
CRDT- 2006/12/13 09:00
PHST- 2006/12/13 09:00 [pubmed]
PHST- 2007/02/28 09:00 [medline]
PHST- 2006/12/13 09:00 [entrez]
AID - BDI356 [pii]
AID - 10.1111/j.1399-5618.2006.00356.x [doi]
PST - ppublish
SO  - Bipolar Disord. 2006 Dec;8(6):648-64. doi: 10.1111/j.1399-5618.2006.00356.x.