What fMRI can tell as about panic disorder: bridging the gap between neurobiology and psychotherapy.

Fifty years ago, when the effect of antidepressants on panic disorder was described, a significant progress in understanding this anxiety disorder has been made. Theoretical mechanisms and models of fear and panic disorder were proposed and tested in animal models and humans. With growing possibilities of non-invasive neuroimaging techniques, there is an increasing amount of information on the panic disorder. Unfortunately, a number of circumstances lead to inconsistent findings and its interpretations. In our review, we focused on functional MRI in panic disorder, limitations of current studies, possible interpretations and proposals for future direction. In our opinion, the current findings support the neuroanatomical model of panic disorder at the level of group data analysis. But at the same time, the results suggest significant inter-individual differences across the patients, which may be related to each patient's individual history, woven into their neural network and affecting the individual symptoms and response to therapy.