BACKGROUND
Panic disorder is a common and important disease in clinical practice. It causes a reduction in individual productivity and an increase in health care use. It can be treated with several medications and cognitive behavioral therapy. However, because of adverse medication effects and poor treatment compliance, new therapeutic modules will be needed.
OBJECTIVE
We hypothesized that digital therapy for panic disorder may improve panic disorder symptoms. Treatment response would be associated with changes in brain activities assessed via functional near-infrared spectroscopy (fNIRS)
METHODS
A cohort of individuals (n=50) with a history of panic attacks were recruited. Symptoms were assessed before and after the application of Restee®, which is a smartphone-based program for treating the clinical symptoms of panic disorder, panic symptoms, depressive symptoms, and anxiety were assessed. The hemodynamics in the frontal cortex during the resting state were measured via fNIRS. Restee ® consists of four categories: diary, education, quest, and serious games. The study trial was approved by institutional review board of Chung-Ang University Hospital and the written informed consent was applied to all participants. (1041078-202112-HR-349-01)
RESULTS
The number (n=20, 80%) of participants with improved panic symptoms in the Restee group was greater than that in the control group (n=6, 28.6%; χ 2 =12.3, p<0.01). During the treatment, the improvement in the panic disorder severity scale (PDSS) scores in the Restee group was greater than that in the control group (F=7.03, p=0.01). In the Restee group, 42.5% of the PDSS score (14.3±6.5 at baseline and 7.2±3.6 after intervention) improved, whereas 14.6% of the PDSS score (12.4±5.2 at baseline and 9.8±7.9 after intervention) improved in the control group. During the treatment, the reduction in accHbO 2 within the right VLPFC (F=8.22, p=0.006) and the right OFC (F=8.88, p=0.005) was greater in the Restee group than in the control group. In the Restee group, changes in PDSS scores and accHbO 2 in the right VLPFC were positively correlated (r=0.42, p=0.04)
CONCLUSIONS
Restee® would effectively reduce the symptoms and brain activities in the ventrolateral prefrontal and orbitofrontal cortices of patients with panic disorder. The improvement of panic disorder symptoms was positively correlated with decreased brain activities in ventrolateral prefrontal and orbitofrontal cortices at the resting state
CLINICALTRIAL
Clinical Trial registration number: KCT0007280