The Renaissance Eye

Somatic Memory and Peripheral Signal Dysregulation in Panic Attacks and PTSD (Margo Neely, 2025)

Overview

Panic attacks and post-traumatic stress disorder (PTSD) are currently classified as psychiatric disorders, conceptualized primarily as dysfunctions of cognition and cortical networks. This framing limits research and treatment to the brain and often neglects the body’s role as a storehouse and generator of memory. Yet converging evidence suggests that the autonomic nervous system (ANS)—including vagal, sympathetic, and parasympathetic pathways—encodes and replays trauma outside of cortical memory. Heart rate variability (HRV) studies show that autonomic dysregulation precedes PTSD development, while predictive interoceptive models suggest panic symptoms are replayed patterns of visceral and autonomic input. In parallel, somatic therapy literature and ethological studies (e.g., the “shake-off” discharge observed in prey animals after acute stress) indicate that uncompleted bodily responses become somatic imprints, resurfacing as panic and flashbacks.

By reframing panic/PTSD as somatic illnesses, not solely mental ones, we open new pathways for diagnosis and intervention that address the root in body-stored memory and signals.

Sources: Minassian et al., JAMA Psychiatry (HRV→PTSD risk); Barrett & Simmons, Nat Rev Neurosci (predictive interoception); Schneider et al., meta-analysis of autonomic dysfunction in PTSD; Gentsch et al., “body memories” clinical manifestations; Engelen et al., interoceptive rhythms; and tcVNS studies reducing autonomic reactivity in PTSD

Vision

As Leonardo looked to nature to uncover the secrets of the body, so too do we turn to the body to ask where panic and PTSD truly live.

We hypothesize that these conditions are not disorders of thought, but somatic illnesses encoded in the autonomic nervous system—signals the body stores and replays, waiting to be understood, as Da Vinci once sought truth through the patient study of anatomy and the natural world.

This program will:

Redefine panic/PTSD as somatic signal disorders.
Deliver new diagnostic tools that give psychiatry its long-missing “lab tests.”
Develop non-drug interventions that work in real time, in hospitals and in the field.
Transform patient experience from self-blame and invisibility into embodied understanding and technological support.

Mission

Aim 1 Aim 2 Aim 3

Define panic/PTSD as disorders of somatic memory

• Hypothesis: Panic and PTSD episodes emerge from maladaptive reactivation of autonomic “engrams” stored in peripheral nervous system circuits, not solely cortical recall.

• Approach: Use multi-modal monitoring (HRV, electrodermal activity, respiratory variability, tremor analysis) to map recurring body-based signatures of panic/PTSD episodes.

Characterize the dynamics of signal replay and bodily triggers

• Hypothesis: Panic/PTSD episodes are precipitated by bottom-up peripheral cues (cardio-respiratory, proprioceptive, vestibular) that trigger full autonomic pattern replays.

• Approach: Combine ecological momentary assessment (EMA) with lab-based stress induction to capture trigger→response sequences; apply computational modeling of somatic prediction errors.

Pilot body-based interventions that “rewrite” autonomic patterns

• Hypothesis: Somatic interventions (HRV biofeedback, paced breathing, tremor discharge, interoceptive exposure, vagus nerve stimulation) reduce panic/PTSD symptoms by reprogramming maladaptive autonomic loops.

• Approach: Conduct small-scale randomized pilot trials comparing body-based methods to conventional cognitive interventions, measuring changes in autonomic markers and symptom recurrence.

Expanded Goals: Somatic Research + Technology Development

1 2 3 4 5

Develop a Somatic Signal Capture Platform

Objective: Create a wearable or clinical device that continuously records and identifies the physiological markers of panic/PTSD at their source: the autonomic nervous system.

Features:
◦ Multi-sensor integration: HRV, electrodermal activity (EDA), respiratory variability, tremor/muscle discharge, micro-movements, and vagal tone.
◦ Machine learning algorithms to detect “somatic replay patterns” that precede or constitute panic/PTSD episodes.
◦ Portable for both hospital/ER deployment and daily-life monitoring for high-risk populations (e.g., veterans, EMTs, survivors of trauma).

Impact: Provides real-time biomarker detection, allowing clinicians to “see” panic/PTSD as body-stored events rather than waiting for patient self-report.

Create a Somatic Index of Trauma (SIT)

Objective: Establish a standardized system of measurement for panic/PTSD responses based on peripheral nervous system signals.

Design:
◦ Define composite metrics (e.g., HRV entropy, tremor frequency, vagal engagement) into a quantifiable score.
◦ Use AI pattern recognition to map “panic loops” or “trauma replays” distinct from normal stress arousal.

Outcome: A reproducible Somatic Index that can be used in both research and clinical settings—analogous to blood pressure in cardiology—giving psychiatry a measurable somatic biomarker for trauma.

Non-Pharmacological Somatic Intervention Device

Objective: Develop technology to facilitate physiological release of stored panic/trauma responses—without reliance on drugs or cognitive effort (e.g., controlled breathing, which can be impossible mid-panic).

Possible Approaches:
◦ Adaptive vibration/tremor induction: Gentle, rhythmic stimulation prompting the “shake-off” discharge seen in animal models.
◦ Closed-loop vagal nerve stimulation (VNS): A device that detects panic replay onset and automatically applies non-invasive VNS to reset autonomic balance.
◦ Bio-acoustic/sonic entrainment: Use of sound or low-frequency vibration targeted at visceral/autonomic systems to entrain parasympathetic dominance.

Impact: Empowers patients to achieve autonomic reset through technology-assisted, body-first interventions—restoring equilibrium without cognitive control or pharmacology.

Integrative Clinical Platform for Post-Trauma Care

Objective: Deploy these technologies in hospitals, emergency rooms, and mental health centers for immediate post-trauma intervention.

Protocol:
◦ Upon arrival after a traumatic event (accident, combat, assault), patients are monitored via the Somatic Signal Capture device.
◦ If dysregulation patterns emerge, non-pharmacological intervention is applied immediately to release stored signals before they crystallize into chronic PTSD.
◦ Longitudinal monitoring tracks patients over weeks, preventing the “replay loop” from becoming embedded.

Outcome: A paradigm shift in trauma care—where intervention begins at the body level in real time, rather than months later in psychotherapy.

Data + Narrative Integration for Research and Healing

Objective: Combine objective data (biosignals, Somatic Index scores) with subjective somatic narratives to deepen understanding of how panic/PTSD live in the body.

Design:
◦ Pair sensor data with patient self-reports of somatic experience (“tight chest,” “buzzing limbs,” “freeze”).
◦ Use this integration for personalized treatment mapping: tailoring interventions to an individual’s unique somatic replay profile.

Outcome: A rich interdisciplinary data set that merges medicine, engineering, and humanities—transforming panic/PTSD from an invisible mental construct into a visible, measurable, embodied phenomenon.

Data + Statistics

Presented below are comparative statistics on the prevalence of PTSD and panic disorders among three key subgroups: the general U.S. population, first responders, and military veterans

General Population

In the United States, 3.6% of adults experienced PTSD in the past year, 2.7% were diagnosed with panic disorder, and 11.2% reported at least one panic attack

Sources: NIMH – PTSD Statistics | NIMH – Panic Disorder Statistics | JAMA Psychiatry – Panic Attacks

First Responders

In U.S. cohorts, 15% of male and 18% of female police officers screened positive for probable PTSD, 13% of firefighters in a U.S. municipal department screened positive for PTSD, and among New York EMS clinicians (EMTs/paramedics) during COVID-19 25% met presumptive PTSD criteria (33% reported PTSD symptoms)

Sources: CDC Stacks (BCOPS police, 2013) | NIOSH HHE (Firefighters, 2017) | Air Medical Journal (EMS clinicians, NY, 2024)

Military and Veterans

Studies estimate that 10–18% of U.S. service members returning from Iraq and Afghanistan developed PTSD, while surveys show 4.8% of veterans with current PTSD and 8% lifetime, and VA data indicate 14% of male and 24% of female veterans in care were diagnosed in FY2024. Although national estimates are limited, one VA clinic study found that 37.4% of veterans with PTSD also had panic disorder

Sources: VA – PTSD in Veterans | PMC – Survey | PMC – Panic Disorder in Veterans

Toward a Paradigm Shift

Reframing panic and PTSD as somatic illnesses rooted in the body opens the door to new diagnostics, technologies, and treatments. Real breakthroughs will come through collaboration: scientists mapping autonomic pathways, engineers building sensing and intervention devices, clinicians applying real-world insight, and artists creating visualizations that let us see and feel what has long been hidden. Together, this interdisciplinary team can transform panic and trauma from invisible “mental” afflictions into measurable, treatable somatic signals—bringing forward a new era of understanding, healing, and resilience.