{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T09:49:25Z","timestamp":1791625765726,"version":"4.3.4"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Purpose<\/jats:bold>\n                    : Panic disorder (PD) is characterized by recurrent, unexpected panic attacks and impaired top\u2010down modulation of the fear circuitry, notably left dorsolateral prefrontal cortex (DLPFC) hypoactivity and dysregulation of respiratory\u2010panic pathways. Transcranial direct current stimulation (tDCS) is a non\u2010invasive brain stimulation technique that modulates cortical excitability by delivering low\u2010intensity electrical currents through scalp electrodes. Chronic rhinosinusitis (CRS) and nasal septum deviation (NSD) commonly disrupt nasal breathing and sleep while increasing anxiety vulnerability. This study evaluated the efficacy and long\u2010term stability of anodal tDCS over the left DLPFC in reducing panic severity in PD patients with versus without comorbid CRS or NSD.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods<\/jats:bold>\n                    : Sixty\u2010six adults with DSM\u20105 PD were purposively allocated to PD\u2010only (\n                    <jats:italic>n<\/jats:italic>\n                    = 27), PD + CRS (\n                    <jats:italic>n<\/jats:italic>\n                    = 26), and PD + NSD (\n                    <jats:italic>n<\/jats:italic>\n                    = 13) groups. All received 25 sessions of anodal tDCS (2\u00a0mA, 20\u00a0min; anode F3, cathode FP2). Panic severity was assessed with the Panic Disorder Severity Scale (PDSS) at baseline, post\u2010treatment, and 6\u2010 and 12\u2010month follow\u2010ups. The data were analyzed using mixed ANOVA with Bonferroni\u2010corrected post\u2010hoc tests.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Finding<\/jats:bold>\n                    : A significant time \u00d7 group interaction was observed (\n                    <jats:italic>F<\/jats:italic>\n                    = 7.65,\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001,\n                    <jats:italic>\n                      \u03b7\n                      <jats:sub>p<\/jats:sub>\n                    <\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    = 0.20). All groups showed large, immediate reductions in PDSS scores (57%\u201365%,\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001). Treatment gains were fully maintained at 12 months in the PD\u2010only and PD + CRS groups, whereas the PD + NSD group exhibited statistically and clinically significant partial relapse by 12 months (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.022 versus both other groups).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion<\/jats:bold>\n                    : Anodal left\u2010DLPFC tDCS is highly effective and generally durable for panic disorder. However, untreated nasal septum deviation substantially compromises long\u2010term stability, probably via persistent interoceptive stress and respiratory dysregulation. Systematic screening and management of upper\u2010airway patency are recommended to optimize sustained outcomes.\n                  <\/jats:p>","DOI":"10.1002\/brb3.71508","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T05:59:48Z","timestamp":1779688788000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Anodal Left DLPFC tDCS on Panic Severity in Panic Disorder Patients With and Without Comorbid Rhinosinusitis and Nasal Septum Deviation"],"prefix":"10.1002","volume":"16","author":[{"given":"Roghayeh","family":"Mohammadi","sequence":"first","affiliation":[{"name":"Department of Psychology Payame Noor University  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Alipour","sequence":"additional","affiliation":[{"name":"Department of Psychology Payame Noor University  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Alipour","sequence":"additional","affiliation":[{"name":"Department of Psychology Roudehen Campus, Islamic Azad University  Roudehen 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