Neurological bases for balance–anxiety links

• Published in: Journal of anxiety disorders 2001, Vol.15 (1), p.53-79
• Main Authors: Balaban, Carey D, Thayer, Julian F
• Format: Article
• Language: English
• Subjects: Agoraphobia; Anxiety disorder; Anxiety Disorders - complications; Anxiety Disorders - drug therapy; Autonomic Nervous System - drug effects; Autonomic Nervous System - physiopathology; Balance disorder; Emotions; Humans; Models, Neurological; Monoamines; Neurotransmitter Agents - metabolism; Neurotransmitter Agents - pharmacology; Postural Balance; Space life sciences; Vertigo; Vestibular Diseases - complications; Vestibular Diseases - drug therapy; Vestibular system
• ISSN: 0887-6185; 1873-7897
• DOI: 10.1016/S0887-6185(00)00042-6

This review paper examines neurologic bases of links between balance control and anxiety based upon neural circuits that are shared by pathways that mediate autonomic control, vestibulo-autonomic interactions, and anxiety. The core of this circuitry is a parabrachial nucleus network, consisting of the parabrachial nucleus and its reciprocal relationships with the extended central amygdaloid nucleus, infralimbic cortex, and hypothalamus. Specifically, the parabrachial nucleus is a site of convergence of vestibular information processing and somatic and visceral sensory information processing in pathways that appear to be involved in avoidance conditioning, anxiety, and conditioned fear. Monoaminergic influences on these pathways are potential modulators of both effects of vigilance and anxiety on balance control and the development of anxiety and panic. This neurologic schema provides a unifying framework for investigating the neurologic bases for comorbidity of balance disorders and anxiety.