Decreased hypothalamus volumes in generalized anxiety disorder but not in panic disorder

Robert Terlevic, Miriam Isola, Maria Ragogna, Martina Meduri, Francesca Canalaz, Laura Perini, Gianluca Rambaldelli, Luciana Travan, Enrico Crivellato, Stefania Tognin, Giuseppe Como, Chiara Zuiani, Massimo Bazzocchi, Matteo Balestrieri, Paolo Brambilla

Research output: Contribution to journalArticlepeer-review


Background: The hypothalamus is a brain structure involved in the neuroendocrine aspect of stress and anxiety. Evidence suggests that generalized anxiety disorder (GAD) and panic disorder (PD) might be accompanied by dysfunction of the hypothalamus-pituitary-adrenal axis (HPA), but so far structural alterations were not studied. We investigated hypothalamic volumes in patients with either GAD or PD and in healthy controls. Methods: Twelve GAD patients, 11 PD patients and 21 healthy controls underwent a 1.5T MRI scan. Hypothalamus volumes were manually traced by a rater blind to subjects' identity. General linear model for repeated measures (GLM-RM) was used to compare groups on hypothalamic volumes, controlling for total intracranial volume, age and sex. Results: The hypothalamus volume was significantly reduced (p=0.04) in GAD patients, with significant reductions in both the left (p=0.02) and right side (p=0.04). Patients with PD did not differ significantly (p=0.73). Anxiety scores were inversely correlated with hypothalamic volumes. Limitations: The small sample size could reduce the generalizability of the results while the lack of stress hormone measurements renders functional assessment of the hypothalamus-pituitary-adrenal axis not feasible. Conclusions: The present study showed decreased hypothalamic volumes in GAD patients but not in those with PD. Future longitudinal studies should combine volumetric data with measurements of stress hormones to better elucidate the role of the HPA axis in GAD.

Original languageEnglish
Pages (from-to)390-394
Number of pages5
JournalJournal of Affective Disorders
Issue number3
Publication statusPublished - Apr 25 2013


  • Generalized anxiety disorder
  • Hypothalamus
  • Panic disorder
  • Structural magnetic resonance imaging

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology


Dive into the research topics of 'Decreased hypothalamus volumes in generalized anxiety disorder but not in panic disorder'. Together they form a unique fingerprint.

Cite this