Evidence map›Paper›PMID 27045843›Full record

ArticleTranslational psychiatry2016

MAOA gene hypomethylation in panic disorder-reversibility of an epigenetic risk pattern by psychotherapy.

C Ziegler, J Richter, M Mahr, A Gajewska, M A Schiele, A Gehrmann, B Schmidt, K-P Lesch, T Lang, S Helbig-Lang and 10 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Translational psychiatry, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04029740 (Searching for Exosomal microRNAs and Cellular Biomarkers and Mechanisms Underlying the Differences Between Panic Disorder Patients Who Are Responders and Non-responders to Cognitive Behavior Therapy), which is not on this map. Cited by 75 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
75citing papers in PubMed, 3 pooled it
30.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04029740 naunknown statusnot on this mapstarted 2019, after this paper: background citation

Searching for Exosomal microRNAs and Cellular Biomarkers and Mechanisms Underlying the Differences Between Panic Disorder Patients Who Are Responders and Non-responders to Cognitive Behavior Therapy

TypeinterventionalSponsorHebrew University of JerusalemRan2019 to 2021Enrolled80ConditionsPanic DisorderArmsCBT- both internet and face to face, No intervention
3 · Its place in the literature

Who cites it

75 citing papers in PubMed, 3 syntheses or guidelines pooled it, 181 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Epigenetic markers of response to psychotherapy in obsessive-compulsive disorder.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026
    Article
  6. Article
  7. Article
  8. Article
  9. Review
  10. Type A monoamine oxidase; its unique role in mood, behavior and neurodegeneration.Journal of neural transmission (Vienna, Austria : 1996) · 2025
    Review
  11. Article
  12. Review
  13. Article
  14. Review
  15. Article
  16. The role of epigenetics in anxiety disorders.Molecular biology reports · 2023
    Review
  17. Review
  18. Review
  19. Review
  20. Article

15 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 8 institutions in 1 country.

C ZieglerDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany.
J RichterInstitute of Psychology, University of Greifswald, Greifswald, Germany.
M MahrDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany.
A GajewskaDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany.
M A SchieleDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany.
A GehrmannDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany.
B SchmidtDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany.
K-P LeschDivision of Molecular Psychiatry, Department of Psychiatry, University of Würzburg, Würzburg, Germany.
T LangChristoph-Dornier-Foundation for Clinical Psychology, Bremen, Germany.
S Helbig-LangDepartment of Clinical Psychology and Psychotherapy, University of Hamburg, Hamburg, Germany.
P PauliDepartment of Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany.
T KircherDepartment of Psychiatry, Marburg University, Marburg, Germany.
A ReifDepartment of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt, Germany.ORCID http://orcid.org/0000-0002-0992-634X
W RiefSection for Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany.
A N Vossbeck-ElsebuschInstitute of Psychology, University of Münster, Münster, Germany.
V AroltDepartment of Psychiatry and Psychotherapy, University of Münster, Münster, Germany.
H-U WittchenDepartment of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany.
A O HammInstitute of Psychology, University of Greifswald, Greifswald, Germany.
J DeckertDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany.
K DomschkeDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany.
University of Würzburg · DEPhilipps University of Marburg · DEUniversität Greifswald · DEUniversity of Münster · DEDornier Flugzeugwerke (Germany) · DEGoethe University Frankfurt · DETechnische Universität Dresden · DEUniversität Hamburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Epigenetic signatures such as methylation of the monoamine oxidase A (MAOA) gene have been found to be altered in panic disorder (PD). Hypothesizing temporal plasticity of epigenetic processes as a mechanism of successful fear extinction, the present psychotherapy-epigenetic study for we believe the first time investigated MAOA methylation changes during the course of exposure-based cognitive behavioral therapy (CBT) in PD. MAOA methylation was compared between N=28 female Caucasian PD patients (discovery sample) and N=28 age- and sex-matched healthy controls via direct sequencing of sodium bisulfite-treated DNA extracted from blood cells. MAOA methylation was furthermore analyzed at baseline (T0) and after a 6-week CBT (T1) in the discovery sample parallelized by a waiting time in healthy controls, as well as in an independent sample of female PD patients (N=20). Patients exhibited lower MAOA methylation than healthy controls (P<0.001), and baseline PD severity correlated negatively with MAOA methylation (P=0.01). In the discovery sample, MAOA methylation increased up to the level of healthy controls along with CBT response (number of panic attacks; T0-T1: +3.37±2.17%), while non-responders further decreased in methylation (-2.00±1.28%; P=0.001). In the replication sample, increases in MAOA methylation correlated with agoraphobic symptom reduction after CBT (P=0.02-0.03). The present results support previous evidence for MAOA hypomethylation as a PD risk marker and suggest reversibility of MAOA hypomethylation as a potential epigenetic correlate of response to CBT. The emerging notion of epigenetic signatures as a mechanism of action of psychotherapeutic interventions may promote epigenetic patterns as biomarkers of lasting extinction effects.

Indexed as

Cognitive Behavioral TherapyDNA MethylationEpigenesis, GeneticAdultCase-Control StudiesFemaleHumansMonoamine OxidasePanic DisorderSequence Analysis, DNAMonoamine Oxidasemonoamine oxidase A, human

Identifiers

PMID27045843
PMCPMC4872399
OpenAlexW2328700233

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.