What is the clinical evidence from this study?

Study design: Observational. Population: Panic disorder and social anxiety disorder (n=90). Intervention: Panic disorder vs. Social anxiety disorder and healthy controls. Primary outcome: Intraindividual coupling of unconditioned cortico-cardiac responses (N100 magnitude predicting cardiac acceleration).

What question did this study set out to answer?

The study investigates how brain responses to threats relate to heart activity in individuals with panic disorder and social anxiety disorder compared to healthy controls.

September 6, 2025Journal of Anxiety DisordersOpen Access

Brain-heart coupling in response to imminent threat in panic disorder, social anxiety disorder, and healthy controls

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Key result

Panic disorder shows enhanced cortico-cardiac coupling to aversive noise versus social anxiety and healthy controls.

n=90

Why the study?

Within-subject associations between central markers of attentional stimulus processing and peripheral defensive activation, such as cardiac acceleration, are not well understood.

Does cortico-cardiac coupling in response to threat differ among individuals with panic disorder, social anxiety disorder, and healthy controls?

Key Points

The study investigates how brain responses to threats relate to heart activity in individuals with panic disorder and social anxiety disorder compared to healthy controls.
Analyzed data from N = 90 participants across panic disorder, social anxiety disorder, and healthy controls.
Participants underwent a threat conditioning paradigm involving face stimuli and an aversive noise burst.
Calculated intraindividual coupling of cortico-cardiac responses using EEG and heart period data.
The noise burst triggered significant cardiac acceleration and a pronounced N100 event-related potential.
Cortico-cardiac coupling was stronger in individuals with panic disorder compared to those with social anxiety disorder.
Healthy controls showed intermediate levels of cortico-cardiac coupling during the response.

Study Design

Type

Observational (n=90)

Structured PICO

Does cortico-cardiac coupling in response to threat differ among individuals with panic disorder, social anxiety disorder, and healthy controls?

Population

90 participants with panic disorder, social anxiety disorder, and healthy controls who completed a threat conditioning paradigm.

Exposure

Threat conditioning paradigm with face stimuli as conditioned stimuli and an aversive white noise burst as unconditioned stimulus

Comparator

Comparisons between panic disorder, social anxiety disorder, and healthy control groups

Outcome

Intraindividual coupling of unconditioned cortico-cardiac responses (single-trial EEG N100 magnitude predicting single-trial cardiac acceleration)surrogate

Cortico-cardiac defensive responses (EEG N100 predicting cardiac acceleration) are specifically enhanced in individuals with panic disorder compared to those with social anxiety disorder or healthy controls.

Discussion

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Implication

Does not support clinical adoption of cortico-cardiac measures; leaves open specificity as a panic disorder biomarker.

Cite This Study

Unterschemmann et al. (2025) conducted an observational in Panic disorder and social anxiety disorder (n=90). Panic disorder vs. Social anxiety disorder and healthy controls was evaluated on Intraindividual coupling of unconditioned cortico-cardiac responses (N100 magnitude predicting cardiac acceleration). Cortico-cardiac coupling in response to an aversive noise burst was enhanced in individuals with panic disorder compared to social anxiety disorder and healthy controls.

synapsesocial.com/papers/6a1fe9ff91899344c12e52cc https://doi.org/10.1016/j.janxdis.2025.103069

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Brain-heart coupling in response to imminent threat in panic disorder, social anxiety disorder, and healthy controls

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Brain-heart coupling in response to imminent threat in panic disorder, social anxiety disorder, and healthy controls

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider