Psychiatry and Clinical Psychopharmacology
Systematic Review

Gray Matter Alterations in Panic Disorder: A Voxel-Wise Meta-Analysis


Department of Radiology, Xishan Hospital, the Seventh People’s Hospital of Wenzhou, Wenzhou, Zhejiang, China


Hainan Province’s Capital City Compulsory Isolation Drug Rehabilitation Center Hospital, Haikou, Hainan, China


Nuclear Magnetic Resonance, Wulanchabu Central Hospital, Wulanchabu, Inner Mongolia, China


Department of Neurology, General Hospital of Central Theater Command, Wuhan, Hubei, China

Psychiatry and Clinical Psychopharmacology 2023; 33: 229-237
DOI: 10.5152/pcp.2023.23684
Read: 851 Downloads: 392 Published: 25 August 2023

Background: Gray matter alterations play a role in the panic disorder’s pathophysiology origin. However, the current literature seemed inadequate to reach a consistent conclusion. Therefore, we conducted this gray matter meta-analysis on panic disorder.

Methods: A systematic review and a voxel-wise meta-analysis based on voxel-based morphometry were conducted for the gray matter studies in patients with panic disorder. The Seed-based d Mapping toolbox was applied for the voxel-wise meta-analysis. Fourteen gray matter studies (954 subjects) were enrolled in the current meta-analysis. The subgroup analysis of typical-onset versus late-onset patients was also performed. At last, the clinical severity was meta-regressed with gray matter alterations.

Results: Significant gray matter alterations were found in the left para-cingulate gyrus and the right amygdala of panic disorder patients. The subgroup analysis of typical-onset panic disorder patients showed a similar pattern. However, gray matter alterations were demonstrated in the bilateral opercular cortex of late-onset panic disorder patients. A significant association between the clinical severity and the gray matter alterations was found in the fronto-cingulate regions of panic disorder patients.

Conclusion: Gray matter alterations might represent a significant pillar of panic disorder’s neurobiology, especially for the amygdala, cingulate, and frontal regions. Future gray matter studies in panic disorder should be needed to reconfirm this pattern of gray matter alterations.

Cite this article as: Pan A, Liu S, Hu S, Dai J, Yi J. Gray matter alterations in panic disorder: A voxel-wise meta-analysis. Psychiatry Clin Psychopharmacol. 2023;33(3):229-237.

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