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- W2070694524 abstract "Panic attacks – a brief sense of impending doom accompanied by striking autonomic changes – is a relatively common disorder. It is often, but not necessarily, associated with PTSD (post traumatic stress disorder). The pathogenesis of the disorder is unknown. The fact that it sometimes occurs in TLE (temporal lobe epilepsy) offers a clue. Panic attacks may result from a malfunction of a phylogenetically ancient fight-flight response that is triggered accidentally [3]. When a person sees a terrifying or otherwise arousing scene, the visual input gets relayed via the fusiform gyrus to the amygdala. (The fusiform projects to the amygdala both directly and indirectly via the superior temporal sulcus) The amygdala – acting in concert with other ‘‘limbic’’ structures gauges the emotional significance (Predator? mate, something neutral?) of the sensory input and its output cascades into the hypothalamus. Hypothalamic activation results in the behavioral, affective as well as autonomic activation (increased heart rate, blood pressure, tidal volume; piloerection; sweating etc.) required to generate the fight flight response and to dissipate the heat of muscular exertion. These changes are usually induced by an identifiable external trigger to which they can be attributed; e.g., being chased by a lion. William James and Antonio Damasio have long championed the view that somatic changes resulting from autonomic arousal can in turn feedback into the brain, amplifying (or possibly even causing) subjectively experienced emotions. Now consider what would happen if the same cascade of changes were triggered by a mini-seizure in the temporal lobes. The entire cacade of events – including autonomic arousal and emotions – would be artificially set in motion but this time there is no identifiable external stimulus. Since the subject has no way of interpreting the arousal, the net result is a vague, inexplicable foreboding of terror which is even worse than an identifiable terror you can do something about. Indeed the sweating, accelerating heartbeat and breath rate resulting from the autonomic storm might be interpreted as a heart attack. This ‘‘treatment’’ – using false visual feedback – would be loosely analogous to our treatment of phantom pain [2] and stroke [1]." @default.
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- W2070694524 date "2009-09-01" @default.
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- W2070694524 title "Aborting panic attacks using false misattribution: A new treatment option" @default.
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- W2070694524 doi "https://doi.org/10.1016/j.mehy.2009.02.007" @default.
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