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Shevorykin A, Hyland BM, Robles D, Ji M, Vantucci D, Bensch L, Thorner H, Marion M, Liskiewicz A, Carl E, Ostroff JS, Sheffer CE. Tobacco use, trauma exposure and PTSD: a systematic review. Health Psychol Rev 2024:1-32. [PMID: 38711288 DOI: 10.1080/17437199.2024.2330896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/11/2024] [Indexed: 05/08/2024]
Abstract
Tobacco use remains one of the most significant preventable public health problems globally and is increasingly concentrated among vulnerable groups, including those with trauma exposure or diagnosed with PTSD. The goal of this systematic review was to update and extend previous reviews. Of the 7224 publications that met the initial criteria, 267 were included in the review. Summary topic areas include conceptual frameworks for the relation between trauma or PTSD and tobacco use; associations between trauma exposure or PTSD and tobacco use; number and type of trauma exposures and tobacco use; PTSD symptoms and tobacco use; Treatment-related studies; and the examination of causal relations. Evidence continues to indicate that individuals exposed to trauma or diagnosed with PTSD are more likely to use tobacco products, more nicotine dependent and less likely to abstain from tobacco even when provided evidence-based treatments than individuals without trauma. The most commonly cited causal association proposed was use of tobacco for self-regulation of negative affect associated with trauma. A small proportion of the studies addressed causality and mechanisms of action. Future work should incorporate methodological approaches and measures from which we can draw causal conclusions and mechanisms to support the development of viable therapeutic targets.
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Affiliation(s)
- Alina Shevorykin
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Bridget M Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Daniel Robles
- Department of Psychology, Faculty of Science, University of Alberta, Edmonton, Canada
| | - Mengjia Ji
- Department of Psychology, The City College of New York (CUNY), New York, NY, USA
| | - Darian Vantucci
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Lindsey Bensch
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Hannah Thorner
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Matthew Marion
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Amylynn Liskiewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Ellen Carl
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Jamie S Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Pineles SL, Ni P, Pandey S, Japuntich SJ, Cesare N, Shor R, Carpenter JK, Gregor K, Joos CM, Blumenthal TD, Rasmusson AM. Tobacco withdrawal-induced changes in sensorimotor filtering as a predictor of smoking lapse in trauma-exposed individuals. Addict Behav 2024; 148:107868. [PMID: 37774527 DOI: 10.1016/j.addbeh.2023.107868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/17/2023] [Accepted: 09/21/2023] [Indexed: 10/01/2023]
Abstract
Prepulse inhibition (PPI) is a measure of sensorimotor filtering thought to shield the processing of initial weaker auditory stimuli from interruption by a later startle response. Previous studies have shown smoking withdrawal to have a negative impact on sensorimotor filtering, particularly in individuals with psychopathology. Because tobacco use may alleviate sensory and sensorimotor filtering deficits, we examined whether smoking withdrawal-induced changes in PPI were associated with maintenance of smoking abstinence in trauma-exposed individuals with and without PTSD who were attempting to quit smoking. Thirty-eight individuals (n = 24 with current or past PTSD; 14 trauma-exposed healthy controls) made an acute biochemically-verified smoking cessation attempt supported by 8 days of contingency management (CM) and cognitive behavioral therapy (CBT) for smoking. Participants completed a PPI task at the pre-quit baseline, 2 days post-quit, and 5 days post-quit. Post-quit changes in PPI were compared between those who remained abstinent for the first 8-days of the quit attempt and those who lapsed back to smoking. PPI changes induced by biochemically-verified smoking abstinence were associated with maintenance of abstinence across the 8-day CM/CBT-supported quit attempt. As compared to those who maintained tobacco abstinence, participants who lapsed to smoking had significantly lower PPI at 2 and 5 days post-quit relative to baseline. Thus, among trauma-exposed individuals, decreases in PPI during acute smoking cessation supported by CM/CBT are associated with lapse back to smoking. Interventions that improve PPI during early smoking abstinence may facilitate smoking cessation among such individuals who are at high risk for chronic, refractory tobacco use.
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Affiliation(s)
- Suzanne L Pineles
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, United States; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, United States.
| | - Pengsheng Ni
- Health Law, Policy & Management Department, Boston University School of Public Health, United States; Biostatistics & Epidemiology Data Analytic Center, Boston University School of Public Health, United States
| | - Shivani Pandey
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, United States
| | - Sandra J Japuntich
- Behavioral Health Equity Research Group, Hennepin Healthcare, United States; Department of Medicine, University of Minnesota Medical School, United States
| | - Nina Cesare
- Biostatistics & Epidemiology Data Analytic Center, Boston University School of Public Health, United States
| | - Rachel Shor
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, United States
| | - Joseph K Carpenter
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, United States; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, United States
| | - Kristin Gregor
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, United States; Mental Health Service, VA Boston Healthcare System, United States
| | - Celina M Joos
- Psychology Department, Pennsylvania State University, United States
| | | | - Ann M Rasmusson
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, United States; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, United States
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Santos-Carrasco D, De la Casa LG. Prepulse inhibition deficit as a transdiagnostic process in neuropsychiatric disorders: a systematic review. BMC Psychol 2023; 11:226. [PMID: 37550772 PMCID: PMC10408198 DOI: 10.1186/s40359-023-01253-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 07/18/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Psychopathological research is moving from a specific approach towards transdiagnosis through the analysis of processes that appear transversally to multiple pathologies. A phenomenon disrupted in several disorders is prepulse inhibition (PPI) of the startle response, in which startle to an intense sensory stimulus, or pulse, is reduced if a weak stimulus, or prepulse, is previously presented. OBJECTIVE AND METHODS The present systematic review analyzed the role of PPI deficit as a possible transdiagnostic process for four main groups of neuropsychiatric disorders: (1) trauma-, stress-, and anxiety-related disorders (2) mood-related disorders, (3) neurocognitive disorders, and (4) other disorders such as obsessive-compulsive, tic-related, and substance use disorders. We used Web of Science, PubMed and PsycInfo databases to search for experimental case-control articles that were analyzed both qualitatively and based on their potential risk of bias. A total of 64 studies were included in this systematic review. Protocol was submitted prospectively to PROSPERO 04/30/2022 (CRD42022322031). RESULTS AND CONCLUSION The results showed a general PPI deficit in the diagnostic groups mentioned, with associated deficits in the dopaminergic neurotransmission system, several areas implied such as the medial prefrontal cortex or the amygdala, and related variables such as cognitive deficits and anxiety symptoms. It can be concluded that the PPI deficit appears across most of the neuropsychiatric disorders examined, and it could be considered as a relevant measure in translational research for the early detection of such disorders.
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Acheson DT, Baker DG, Nievergelt CM, Yurgil KA, Geyer MA, Risbrough VB. Prospective longitudinal assessment of sensorimotor gating as a risk/resiliency factor for posttraumatic stress disorder. Neuropsychopharmacology 2022; 47:2238-2244. [PMID: 36192631 PMCID: PMC9630259 DOI: 10.1038/s41386-022-01460-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/02/2022] [Accepted: 09/13/2022] [Indexed: 01/18/2023]
Abstract
Little is understood about cognitive mechanisms that confer risk and resiliency for posttraumatic stress disorder (PTSD). Prepulse Inhibition (PPI) is a measure of pre-attentional response inhibition that is a stable cognitive trait disrupted in many neuropsychiatric disorders characterized by poor behavioral or cognitive inhibition, including PTSD. Differentiating between PTSD-related phenotypes that are pre-existing factors vs. those that emerge specifically after trauma is critical to understanding PTSD etiology and can only be addressed by prospective studies. This study tested the hypothesis that sensorimotor gating performance is associated with risk/resiliency for combat-related PTSD. As part of a prospective, longitudinal study, 1226 active duty Marines and Navy Corpsman completed a PPI test as well as a clinical interview to assess PTSD symptoms both before, and 3 and 6 months after a combat deployment. Participants that developed PTSD 6 months following deployment (N=46) showed lower PPI across pre and post-deployment time points compared to participants who did not develop PTSD (N=1182) . Examination of the distribution of PTSD across PPI performance revealed a lower than expected number of cases in the highest performing quartile compared to the rest of the distribution (p < 0.04). When controlling for other factors that predict PTSD in this population, those in the top 25% of PPI performance showed a >50% reduction in chance to develop PTSD (OR = 0.32). Baseline startle reactivity and startle habituation were not significantly different between PTSD risk and control groups. These findings suggest that robust sensorimotor gating may represent a resiliency factor for development of PTSD following trauma.
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Affiliation(s)
- Dean T Acheson
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center for Excellence in Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | - Dewleen G Baker
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center for Excellence in Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | - Caroline M Nievergelt
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center for Excellence in Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | - Kate A Yurgil
- Center for Excellence in Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychological Sciences, Loyola University New Orleans, New Orleans, LA, USA
| | - Mark A Geyer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Mental Illness Research, Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
| | - Victoria B Risbrough
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
- Center for Excellence in Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA.
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Berryman C, Wallwork SB, Heredia-Rizo AM, Knight E, Camfferman D, Russek L, Moseley GL. Are You Listening? Facilitation of the Auditory Blink Response in People with Fibromyalgia. THE JOURNAL OF PAIN 2021; 22:1072-1083. [PMID: 33757876 DOI: 10.1016/j.jpain.2021.03.141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 01/21/2023]
Abstract
The purpose of the current study was to determine whether auditory prepulse inhibition (PPI) and/or prepulse facilitation (PPF) were altered in people with fibromyalgia (FM) when compared with controls. Eyeblink responses were recorded from 29 females with FM and 27 controls, while they listened to 3 blocks of auditory stimuli that delivered pulses with either PPI or PPF. Using a linear mixed model, our main findings were that there was a GROUP*CONDITION interaction (F4, 1084 = 4.01, P= .0031) indicating that the difference in amplitude between FM group and control group changed depending on the condition (PPI or PPF). Post hoc tests revealed no differences between the groups in response to PPI. The FM group showed a greater reactivity of response to the PPF conditioned stimulus than the control group did (t(39.7) = 2.03, P= .0494). Augmentation of PPF, as demonstrated by the FM group is thought to be linked to alterations in information processing mediated by an autonomically driven general orienting process. Activities that decrease autonomic drive or rebalance autonomic and parasympathetic tone such as vagal stimulation might be pursued as effective interventions for people with FM. PERSPECTIVE: This article presents evidence of preservation of neural circuitry that underpins response suppression and evidence of neural circuit disturbance mediated by autonomic drive-in people with FM. These results are important because intact circuitry underpins the effectiveness of therapies and may be harnessed, and rebalancing autonomic drive may be indicated.
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Affiliation(s)
- Carolyn Berryman
- Faculty of Health and Medical Science, The University of Adelaide, North Terrace, Adelaide, Australia; IIMPACT in Health, University of South Australia, North Terrace, Adelaide, Australia.
| | - Sarah B Wallwork
- IIMPACT in Health, University of South Australia, North Terrace, Adelaide, Australia
| | - Alberto Marcos Heredia-Rizo
- Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - Emma Knight
- Faculty of Health and Medical Science, The University of Adelaide, North Terrace, Adelaide, Australia
| | | | - Leslie Russek
- Physical Therapy Department, Clarkson University, Potsdam, New York
| | - G Lorimer Moseley
- IIMPACT in Health, University of South Australia, North Terrace, Adelaide, Australia
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Li W, Mao Z, Bo Q, Sun Y, Wang Z, Wang C. Pre-pulse inhibition deficits in individuals at clinical high-risk for psychosis: A systematic review and meta-analysis. Early Interv Psychiatry 2021; 15:794-806. [PMID: 32705810 DOI: 10.1111/eip.13015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 06/15/2020] [Accepted: 06/24/2020] [Indexed: 11/29/2022]
Abstract
AIM Neurophysiological markers of schizophrenia may help identify individuals who are at an increased risk of developing psychosis. As an operational measure of sensorimotor gating, pre-pulse inhibition (PPI) deficit has been investigated in clinical high-risk (CHR) individuals. In this study, we performed a systematic review and meta-analysis of studies that investigated PPI in CHR individuals. METHODS Relevant studies published as of July 2019 were retrieved from the PubMed, Cochrane, Embase, PscyINFO, EBSCO and Chinese databases. PPI was evaluated by calculating the standard mean differences (SMDs) between CHR individuals and healthy controls (HC) in meta-analysis. Quality of studies was assessed using the Newcastle-Ottawa Scale. I2 index was used to assess heterogeneity and Egger's test was used to assess publication bias. RESULTS Eight studies were found to be eligible. The meta-analysis included five studies with a combined study population of 184 CHR subjects and 161 HC. CHR individuals showed lower PPI levels compared to HC in 120 ms inter-stimulus interval or stimulus onset asynchrony paradigm (P = .491, SMD = -0.62). No significant heterogeneity was observed in 120 ms PPI paradigm (χ2 = 3.41, P = .491, I2 = 0.0%). CONCLUSION CHR individuals had lower PPI level compared to HC in 120 ms paradigm, which were relatively stable and significant. The results indicate the presence of information processing and inhibitory problems prior to the development of full-blown psychosis. PPI may be clinically used as an objective indicator to supplement the understanding of CHR individuals.
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Affiliation(s)
- Weidi Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhen Mao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Qijing Bo
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yue Sun
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhimin Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Chuanyue Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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Schleyken S, Baldermann J, Huys D, Franklin J, Visser-Vandewalle V, Kuhn J, Kohl S. Deep brain stimulation and sensorimotor gating in tourette syndrome and obsessive-compulsive disorder. J Psychiatr Res 2020; 129:272-280. [PMID: 32829082 DOI: 10.1016/j.jpsychires.2020.07.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/05/2020] [Accepted: 07/17/2020] [Indexed: 12/11/2022]
Abstract
Recent translational data suggest that deep brain stimulation (DBS) of the cortico-striato-thalamo-cortical (CSTC) loops improves sensorimotor gating in psychiatric disorders that show deficient prepulse inhibition (PPI), a robust operational measure of sensorimotor gating. To our knowledge we are the first to investigate this effect in patients with Tourette syndrome (TS). We measured PPI of the acoustic startle reflex in patients with TS (N = 10) or Obsessive-Compulsive Disorder (OCD) (N = 8) treated with DBS of the centromedian and ventro-oral internal thalamic nucleus and the anterior limb of internal capsule-nucleus accumbens area respectively, and aged- and gender-matched healthy controls (HC). PPI of the DBS groups was measured in randomized order in the ON and OFF stimulation condition. Statistical analysis revealed no significant difference in PPI (%) of patients with TS between ON (M = 20.5, SD = 14.9) and OFF (M = 25.2, SD = 29.7) condition. There were significantly reduced PPI levels in patients with TS in the ON condition compared to HC (M = 49.2, SD = 10.7), but no significant difference in PPI between TS in the OFF condition and HC. Furthermore, we found no significant stimulation or group effect for OCD and HC (OCD ON: M = 57.0, SD = 8.3; OCD OFF: 67.8, SD = 19.6; HC: M = 63.0, SD = 24.3). Our study has a number of limitations. Sample sizes are small due to the restricted patient collective. The study was not controlled for use of psychoactive medication or nicotine. Furthermore, we were not able to assess presurgical PPI measurements. In conclusion, we were able to show that PPI is impaired in patients with TS. This finding is in line with recent translational work. With respect to the OCD cohort we were not able to replicate our previously published data. A disability in sensorimotor gating plays a pivotal role in many psychiatric disorders therefore more research should be conducted to disentangle the potential and limitations of modulating sensorimotor gating via brain stimulation techniques.
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Affiliation(s)
- Sophia Schleyken
- Department of Psychiatry and Psychotherapy, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
| | - Juan Baldermann
- Department of Psychiatry and Psychotherapy, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Daniel Huys
- Department of Psychiatry and Psychotherapy, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Jeremy Franklin
- Institute of Medical Statistics and Computational Biology, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Veerle Visser-Vandewalle
- Department of Stereotactic and Functional Neurosurgery, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Jens Kuhn
- Department of Psychiatry and Psychotherapy, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany; Johanniter Hospital Oberhausen, Department of Psychiatry, Psychotherapy and Psychosomatics, Steinbrinkstrasse 96A, 46145, Oberhausen, Germany
| | - Sina Kohl
- Department of Psychiatry and Psychotherapy, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
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Kponee-Shovein KZ, Grashow R, Coull BA, Téllez-Rojo MM, Schnaas L, Del Carmen Hernández-Chávez M, Sánchez B, Peterson K, Hu H, Hernandez-Avila M, Weisskopf MG. Socio-demographic predictors of prepulse inhibition: A prospective study in children and adolescents from Mexico City. Biol Psychol 2019; 145:8-16. [PMID: 30940478 DOI: 10.1016/j.biopsycho.2019.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/08/2019] [Accepted: 03/08/2019] [Indexed: 02/07/2023]
Abstract
Prepulse inhibition (PPI) is a sensorimotor gating mechanism that reduces interfering influences to the neural processing of incoming stimuli, and is associated with several neurodevelopmental disorders. To date, research on PPI and neurodevelopmental disorders has primarily been in cross-sectional, clinical settings. In this prospective, epidemiologic study, we used a data-driven prediction model to identify socio-demographic predictors of PPI in children and adolescents from Mexico City to inform future etiologic studies evaluating PPI. We conducted variable selection and validation using a modified version of the multiple imputation random lasso (MIRL) variable selection algorithm. MIRL identified six predictors of PPI at a stimulus onset asynchrony of 120 ms or 240 ms. Of those six predictors, maternal education, birthweight, and total breastfeeding months were highlighted as previously unstudied variables associated with enhanced PPI. Our findings highlight the potential value of PPI as an adjunct screening tool for identifying children at risk for neurodevelopmental disorders and underscore the relevance for validation research on this topic.
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Affiliation(s)
- Kalé Z Kponee-Shovein
- Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Rachel Grashow
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Brent A Coull
- Departments of Biostatistics and Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Mexico
| | - Lourdes Schnaas
- Division of Research in Community Interventions, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Miguel Hidalgo, Mexico
| | - Maria Del Carmen Hernández-Chávez
- Division of Research in Community Interventions, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Miguel Hidalgo, Mexico
| | - Brisa Sánchez
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Karen Peterson
- Departments of Global Public Health and Nutritional Sciences, University of Michigan School of Public health, Ann Arbor, MI, USA
| | - Howard Hu
- University of Washington School of Public Health, Seattle, WA, USA
| | | | - Marc G Weisskopf
- Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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9
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Meteran H, Vindbjerg E, Uldall SW, Glenthøj B, Carlsson J, Oranje B. Startle habituation, sensory, and sensorimotor gating in trauma-affected refugees with posttraumatic stress disorder. Psychol Med 2019; 49:581-589. [PMID: 29769152 DOI: 10.1017/s003329171800123x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Impairments in mechanisms underlying early information processing have been reported in posttraumatic stress disorder (PTSD); however, findings in the existing literature are inconsistent. This current study capitalizes on technological advancements of research on electroencephalographic event-related potential and applies it to a novel PTSD population consisting of trauma-affected refugees. METHODS A total of 25 trauma-affected refugees with PTSD and 20 healthy refugee controls matched on age, gender, and country of origin completed the study. In two distinct auditory paradigms sensory gating, indexed as P50 suppression, and sensorimotor gating, indexed as prepulse inhibition (PPI), startle reactivity, and habituation of the eye-blink startle response were examined. Within the P50 paradigm, N100 and P200 amplitudes were also assessed. In addition, correlations between psychophysiological and clinical measures were investigated. RESULTS PTSD patients demonstrated significantly elevated stimuli responses across the two paradigms, reflected in both increased amplitude of the eye-blink startle response, and increased N100 and P200 amplitudes relative to healthy refugee controls. We found a trend toward reduced habituation in the patients, while the groups did not differ in PPI and P50 suppression. Among correlations, we found that eye-blink startle responses were associated with higher overall illness severity and lower levels of functioning. CONCLUSIONS Fundamental gating mechanisms appeared intact, while the pattern of deficits in trauma-affected refugees with PTSD point toward a different form of sensory overload, an overall neural hypersensitivity and disrupted the ability to down-regulate stimuli responses. This study represents an initial step toward elucidating sensory processing deficits in a PTSD subgroup.
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Affiliation(s)
- Hanieh Meteran
- Competence Centre for Transcultural Psychiatry,Mental Health Services Ballerup,Copenhagen,Denmark
| | - Erik Vindbjerg
- Competence Centre for Transcultural Psychiatry,Mental Health Services Ballerup,Copenhagen,Denmark
| | - Sigurd Wiingaard Uldall
- Competence Centre for Transcultural Psychiatry,Mental Health Services Ballerup,Copenhagen,Denmark
| | - Birte Glenthøj
- Centre for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services Glostrup, University of Copenhagen,Copenhagen,Denmark
| | - Jessica Carlsson
- Competence Centre for Transcultural Psychiatry,Mental Health Services Ballerup,Copenhagen,Denmark
| | - Bob Oranje
- Centre for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services Glostrup, University of Copenhagen,Copenhagen,Denmark
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10
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Kearns NT, Carl E, Stein AT, Vujanovic AA, Zvolensky MJ, Smits JAJ, Powers MB. Posttraumatic stress disorder and cigarette smoking: A systematic review. Depress Anxiety 2018; 35:1056-1072. [PMID: 30192425 DOI: 10.1002/da.22828] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 07/16/2018] [Accepted: 07/23/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Previous reviews of the PTSD and cigarette smoking literature showed high PTSD-smoking comorbidity and problematic smoking outcomes (Feldner et al., 2007, Clinical Psychology Review, 27, 14-45; Fu et al., 2007, Nicotine & Tobacco Research, 9, 1071-1084). However, past reviews also noted several prominent gaps in the literature, including a lack of etiological work examining underlying mechanisms and research on specialized PTSD-smoking treatments. The present review summarizes an extensive body of research conducted since the previous reviews targeting these areas of need. METHODS Literature searches identified 66 empirical studies specific to smoking and PTSD. RESULTS Smokers were approximately twice more likely to have PTSD than nonsmokers in the general population, and individuals with PTSD were approximately twice as likely to be current smokers. Smokers with PTSD evidenced more negative affect, trauma history, and comorbid psychiatric history, as well as quit attempts and higher relapse rates. PTSD symptoms were associated with expectations that smoking would reduce negative affect, which, in turn, was associated with increased smoking rate and nicotine dependence. Male sex was associated with nicotine dependence and PTSD avoidance, while the relationship between PTSD and smoking relapse due to withdrawal was stronger in females. Specialized, integrated PTSD and smoking cessation treatments showed promise in increasing quit success relative to standard care in randomized trials. CONCLUSIONS Rates of PTSD-smoking co-occurrence remain high. Notable gains have been made in relevant epidemiological and etiological research, although more work is needed in trauma-specific subpopulations. Several promising specialized treatments for comorbid smoking-PTSD have been developed and empirically tested but require replication.
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Affiliation(s)
- Nathan T Kearns
- Department of Psychology, University of North Texas, Denton, Texas
| | - Emily Carl
- Institute of Mental Health Research, University of Texas at Austin, Austin, Texas
| | - Aliza T Stein
- Institute of Mental Health Research, University of Texas at Austin, Austin, Texas
| | | | | | - Jasper A J Smits
- Institute of Mental Health Research, University of Texas at Austin, Austin, Texas
| | - Mark B Powers
- Institute of Mental Health Research, University of Texas at Austin, Austin, Texas.,Trauma, Critical Care, and Cute Care Surgery Research, Baylor University Medical Center, Dellas, Texas
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11
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Pericot-Valverde I, Elliott RJ, Miller ME, Tidey JW, Gaalema DE. Posttraumatic stress disorder and tobacco use: A systematic review and meta-analysis. Addict Behav 2018; 84:238-247. [PMID: 29753221 PMCID: PMC7285418 DOI: 10.1016/j.addbeh.2018.04.024] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/18/2018] [Accepted: 04/30/2018] [Indexed: 12/26/2022]
Abstract
Posttraumatic stress disorder (PTSD) and tobacco use are prevalent conditions that co-occur at striking rates in the US. Previous reviews examined prevalence and factors associated with cigarette smoking among individuals with PTSD but have not been summarized since 2007. Moreover, none explored rates and factors associated with the use of other tobacco products. This study aimed to systematically review the most recent literature examining the comorbidity of PTSD and tobacco use to provide prevalence rates, as well as summarize the literature exploring other factors associated with tobacco use among individuals with PTSD. Studies were identified using a systematic search of keywords related to tobacco use and PTSD within the following databases: PubMed, PsycINFO, Web of Knowledge, CINAHL, PsycARTICLES, and Cochrane Clinical Trials Library. The studies included in this review (N = 66) showed that the prevalence of current use of tobacco products in individuals with PTSD was 24.0% and the rate of PTSD among users of tobacco products was 20.2%. Additionally, results demonstrated that individuals with PTSD present with high levels of nicotine dependence and heavy use of tobacco products, as well as underscore the importance of negative emotional states as a contributing factor to tobacco use among individuals with PTSD. It is imperative that future studies continue monitoring tobacco use among individuals with PTSD while also assessing factors identified as having a prominent role in tobacco use among individuals with PTSD. These findings also demonstrate the need for more innovative approaches to reduce the pervasive tobacco use among individuals with PTSD.
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Affiliation(s)
- Irene Pericot-Valverde
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States; Department of Psychiatry, University of Vermont, Burlington, VT, United States; Department of Psychological Science, University of Vermont, Burlington, VT, United States.
| | - Rebecca J Elliott
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States; Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Mollie E Miller
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, United States
| | - Jennifer W Tidey
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, United States
| | - Diann E Gaalema
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States; Department of Psychiatry, University of Vermont, Burlington, VT, United States; Department of Psychological Science, University of Vermont, Burlington, VT, United States
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12
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Lisieski MJ, Eagle AL, Conti AC, Liberzon I, Perrine SA. Single-Prolonged Stress: A Review of Two Decades of Progress in a Rodent Model of Post-traumatic Stress Disorder. Front Psychiatry 2018; 9:196. [PMID: 29867615 PMCID: PMC5962709 DOI: 10.3389/fpsyt.2018.00196] [Citation(s) in RCA: 127] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 04/25/2018] [Indexed: 12/21/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a common, costly, and often debilitating psychiatric condition. However, the biological mechanisms underlying this disease are still largely unknown or poorly understood. Considerable evidence indicates that PTSD results from dysfunction in highly-conserved brain systems involved in stress, anxiety, fear, and reward. Pre-clinical models of traumatic stress exposure are critical in defining the neurobiological mechanisms of PTSD, which will ultimately aid in the development of new treatments for PTSD. Single prolonged stress (SPS) is a pre-clinical model that displays behavioral, molecular, and physiological alterations that recapitulate many of the same alterations observed in PTSD, illustrating its validity and giving it utility as a model for investigating post-traumatic adaptations and pre-trauma risk and protective factors. In this manuscript, we review the present state of research using the SPS model, with the goals of (1) describing the utility of the SPS model as a tool for investigating post-trauma adaptations, (2) relating findings using the SPS model to findings in patients with PTSD, and (3) indicating research gaps and strategies to address them in order to improve our understanding of the pathophysiology of PTSD.
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Affiliation(s)
- Michael J Lisieski
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Andrew L Eagle
- Department of Physiology, Michigan State University, East Lansing, MI, United States
| | - Alana C Conti
- Research and Development Service, John D. Dingell Veterans Affairs Medical Center, Detroit, MI, United States.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States
| | - Israel Liberzon
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.,Mental Health Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - Shane A Perrine
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
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13
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Massa NM, Duncan E, Jovanovic T, Kerley K, Weng L, Gensler L, Lee SS, Norrholm S, Powers A, Almli LM, Gillespie CF, Ressler K, Pearce BD. Relationship between Toxoplasma gondii seropositivity and acoustic startle response in an inner-city population. Brain Behav Immun 2017; 61:176-183. [PMID: 27884623 PMCID: PMC5316358 DOI: 10.1016/j.bbi.2016.11.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 11/10/2016] [Accepted: 11/20/2016] [Indexed: 01/09/2023] Open
Abstract
Toxoplasma gondii (TOXO) is a neuroinvasive protozoan parasite that induces the formation of persistent cysts in mammalian brains. It infects approximately 1.1million people in the United States annually. Latent TOXO infection is implicated in the etiology of psychiatric disorders, especially schizophrenia (SCZ), and has been correlated with modestly impaired cognition. The acoustic startle response (ASR) is a reflex seen in all mammals. It is mediated by a simple subcortical circuit, and provides an indicator of neural function. We previously reported the association of TOXO with slowed acoustic startle latency, an index of neural processing speed, in a sample of schizophrenia and healthy control subjects. The alterations in neurobiology with TOXO latent infection may not be specific to schizophrenia. Therefore we examined TOXO in relation to acoustic startle in an urban, predominately African American, population with mixed psychiatric diagnoses, and healthy controls. Physiological and diagnostic data along with blood samples were collected from 364 outpatients treated at an inner-city hospital. TOXO status was determined with an ELISA assay for TOXO-specific IgG. A discrete titer was calculated based on standard cut-points as an indicator of seropositivity, and the TOXO-specific IgG concentration served as serointensity. A series of linear regression models were used to assess the association of TOXO seropositivity and serointensity with ASR magnitude and latency in models adjusting for demographics and psychiatric diagnoses (PTSD, major depression, schizophrenia, psychosis, substance abuse). ASR magnitude was 11.5% higher in TOXO seropositive subjects compared to seronegative individuals (p=0.01). This effect was more pronounced in models with TOXO serointensity that adjusted for sociodemographic covariates (F=7.41, p=0.0068; F=10.05, p=0.0017), and remained significant when psychiatric diagnoses were stepped into the models. TOXO showed no association with startle latency (t=0.49, p=0.63) in an unadjusted model, nor was TOXO associated with latency in models that included demographic factors. After stepping in individual psychiatric disorders, we found a significant association of latency with a diagnosis of PTSD (F=5.15, p=0.024), but no other psychiatric diagnoses, such that subjects with PTSD had longer startle latency. The mechanism by which TOXO infection is associated with high startle magnitude is not known, but possible mechanisms include TOXO cyst burden in the brain, parasite recrudescence, or molecular mimicry of a host epitope by TOXO. Future studies will focus on the neurobiology underlying the effects of latent TOXO infection as a potential inroad to the development of novel treatment targets for psychiatric disease.
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Affiliation(s)
- Nick M Massa
- Atlanta Veterans Affairs Medical Center, 1670 Clairmont Rd, Decatur, GA 30033, United States; Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd., Atlanta, GA 30322, United States
| | - Erica Duncan
- Atlanta Veterans Affairs Medical Center, 1670 Clairmont Rd, Decatur, GA 30033, United States; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 201 Dowman Drive, Atlanta, GA 30322, United States
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 201 Dowman Drive, Atlanta, GA 30322, United States
| | - Kimberly Kerley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 201 Dowman Drive, Atlanta, GA 30322, United States
| | - Lei Weng
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd., Atlanta, GA 30322, United States
| | - Lauren Gensler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 201 Dowman Drive, Atlanta, GA 30322, United States
| | - Samuel S Lee
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 201 Dowman Drive, Atlanta, GA 30322, United States
| | - Seth Norrholm
- Atlanta Veterans Affairs Medical Center, 1670 Clairmont Rd, Decatur, GA 30033, United States; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 201 Dowman Drive, Atlanta, GA 30322, United States
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 201 Dowman Drive, Atlanta, GA 30322, United States
| | - Lynn M Almli
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 201 Dowman Drive, Atlanta, GA 30322, United States
| | - Charles F Gillespie
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 201 Dowman Drive, Atlanta, GA 30322, United States
| | - Kerry Ressler
- Department of Psychiatry, Harvard School of Medicine, 25 Shattuck St, Boston, MA 02115, United States
| | - Bradley D Pearce
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd., Atlanta, GA 30322, United States.
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14
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Cook JW, Baker TB, Beckham JC, McFall M. Smoking-induced affect modulation in nonwithdrawn smokers with posttraumatic stress disorder, depression, and in those with no psychiatric disorder. JOURNAL OF ABNORMAL PSYCHOLOGY 2016; 126:184-198. [PMID: 28004948 DOI: 10.1037/abn0000247] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This research sought to determine whether smoking influences affect by means other than withdrawal reduction. Little previous evidence suggests such an effect. We surmised that such an effect would be especially apparent in posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), 2 disorders that are frequently comorbid with smoking and that involve dysregulated affect. Participants were U.S. veterans who were regular smokers (N = 159): 52 with PTSD (58% with comorbid MDD), 51 with MDD, and 56 controls with no psychiatric disorder. During 3 positive and 3 negative mood induction trials (scheduled over 2 sessions), nonwithdrawn participants smoked either a nicotine-containing cigarette (NIC+), a nicotine-free cigarette (NIC-), or held a pen. Positive and negative affect were each measured before and after mood induction. Results showed a significant 2-way interaction of Smoking Condition × Time on negative affect during the negative mood induction (F(6, 576) = 2.41, p = .03) in those with PTSD and controls. In these groups, both NIC+ and NIC-, relative to pen, produced lower negative affect ratings after the negative mood induction. There was also a 2-way interaction of Smoking Condition × Time on positive affect response to the positive mood induction among those with PTSD and controls (F(6, 564) = 3.17, p = .005) and among MDD and controls (F(6, 564) = 2.27, p = .036). Among all smokers, NIC+ enhanced the magnitude and duration of positive affect more than did NIC-. Results revealed affect modulation outside the context of withdrawal relief; such effects may motivate smoking among those with psychiatric diagnoses, and among smokers in general. (PsycINFO Database Record
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Affiliation(s)
- Jessica W Cook
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health
| | - Timothy B Baker
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health
| | | | - Miles McFall
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine and Public Health
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15
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Pineles SL, Blumenthal TD, Curreri AJ, Nillni YI, Putnam KM, Resick PA, Rasmusson AM, Orr SP. Prepulse inhibition deficits in women with PTSD. Psychophysiology 2016; 53:1377-85. [PMID: 27237725 DOI: 10.1111/psyp.12679] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
Abstract
Prepulse inhibition (PPI) is an automatic and preattentive process, whereby a weak stimulus attenuates responding to a sudden and intense startle stimulus. PPI is a measure of sensorimotor filtering, which is conceptualized as a mechanism that facilitates processing of an initial stimulus and is protective from interruption by a later response. Impaired PPI has been found in (a) healthy women during the luteal phase of the menstrual cycle, and (b) individuals with types of psychopathology characterized by difficulty suppressing and filtering sensory, motor, or cognitive information. In the current study, 47 trauma-exposed women with or without posttraumatic stress disorder (PTSD) completed a PPI session during two different phases of the menstrual cycle: the early follicular phase, when estradiol and progesterone are both low, and the midluteal phase, when estradiol and progesterone are both high. Startle stimuli were 100 dB white noise bursts presented for 50 ms, and prepulses were 70 dB white noise bursts presented for 20 ms that preceded the startle stimuli by 120 ms. Women with PTSD showed deficits in PPI relative to the healthy trauma-exposed participants. Menstrual phase had no effect on PPI. These results provide empirical support for individuals with PTSD having difficulty with sensorimotor filtering. The potential utility of PPI as a Research Domain Criteria (RDoC) phenotype is discussed.
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Affiliation(s)
- Suzanne L Pineles
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Terry D Blumenthal
- Department of Psychology, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Andrew J Curreri
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Yael I Nillni
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Katherine M Putnam
- Department of Psychology, VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts, USA
| | - Patricia A Resick
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Ann M Rasmusson
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Scott P Orr
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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16
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Echiverri-Cohen AM, Zoellner LA, Ho W, Husain J. An analysis of inhibitory functioning in individuals with chronic posttraumatic stress disorder. J Anxiety Disord 2016; 37:94-103. [PMID: 26745516 PMCID: PMC4724420 DOI: 10.1016/j.janxdis.2015.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 11/29/2015] [Accepted: 12/03/2015] [Indexed: 02/06/2023]
Abstract
Cognitive abnormalities in posttraumatic stress disorder (PTSD) may be a function of underlying inhibitory deficits. Prepulse inhibition (PPI) and attentional blink (AB) are paradigms thought to assess inhibition. Using a sample of 28 individuals with PTSD compared to 20 trauma-exposed and 19 healthy individuals, PPI was examined using white noise that was preceded by a tone, and AB was examined using a presentation of letters in a stream of numbers. Relative to the control group, the PTSD and trauma-exposed groups did not follow the u-shaped pattern in AB, suggesting trauma-exposure and subsequent PTSD are associated with similar impairment in attention. Individuals with PTSD showed reduced PPI compared to trauma-exposed and healthy individuals, suggesting individuals with PTSD exhibit faulty automatic processing. For individuals with PTSD, PTSD severity was associated with a decline in PPI. These findings suggest a general faulty inhibitory mechanism associated with trauma exposure and PTSD.
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Affiliation(s)
- Aileen M. Echiverri-Cohen
- Department of Psychology, University of Washington, Seattle, Washington, USA,Correspondence concerning this article should be addressed to Aileen M. Echiverri-Cohen Harbor-UCLA Medical Center 1000 W. Carson St. Torrance, CA 90502. Phone: (310) 222-1633,
| | - Lori A. Zoellner
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - William Ho
- Department of Psychology, University of Washington, Seattle, Washington, USA.
| | - Jawad Husain
- Department of Psychology, University of Washington, Seattle, Washington, USA.
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17
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Vrana SR, Calhoun PS, Dennis MF, Kirby AC, Beckham JC. Acoustic startle and prepulse inhibition predict smoking lapse in posttraumatic stress disorder. J Psychopharmacol 2015; 29:1070-6. [PMID: 26253620 PMCID: PMC4586071 DOI: 10.1177/0269881115598319] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Most smokers who attempt to quit lapse within the first week and are ultimately unsuccessful in their quit attempt. Nicotine withdrawal exacerbates cognitive and attentional problems and may be one factor in smoking relapse. The startle reflex response and prepulse inhibition (PPI) of the response are sensitive to arousal and early attentional dysregulation. The current study examined whether startle response and PPI are related to early smoking lapse, and if this differs in people with and without posttraumatic stress disorder (PTSD). Participants with (N = 34) and without (N = 57) PTSD completed a startle reflex and PPI assessment during (1) ad lib smoking (2) on the first day of abstinence during a quit attempt. Most (88%) participants lapsed within the first week of the quit attempt. PTSD status predicted shorter time to lapse. Larger startle magnitude and greater PPI predicted a longer duration before smoking lapse. When diagnostic groups were examined separately, greater PPI predicted a longer successful quit attempt only in participants with a PTSD diagnosis. The startle reflex response and PPI may provide an objective, neurophysiological evaluation of regulation of arousal and early attentional processes by nicotine, which are important factors in smoking cessation success.
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Affiliation(s)
- Scott R. Vrana
- Virginia Commonwealth University, 508 Fulton St., Durham, NC, 27705
| | - Patrick S. Calhoun
- Durham VA Medical Center, 508 Fulton St., Durham, NC, 27705,MidAtlantic Research Education and Clinical Center, 508 Fulton St., Durham, NC, 27705,Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC, 27708
| | - Michelle F. Dennis
- Durham VA Medical Center, 508 Fulton St., Durham, NC, 27705,MidAtlantic Research Education and Clinical Center, 508 Fulton St., Durham, NC, 27705,Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC, 27708
| | | | - Jean C. Beckham
- Durham VA Medical Center, 508 Fulton St., Durham, NC, 27705,MidAtlantic Research Education and Clinical Center, 508 Fulton St., Durham, NC, 27705,Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC, 27708
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18
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Abstract
The high prevalence of cigarette smoking and tobacco related morbidity and mortality in people with chronic mental illness is well documented. This review summarizes results from studies of smoking cessation treatments in people with schizophrenia, depression, anxiety disorders, and post-traumatic stress disorder. It also summarizes experimental studies aimed at identifying biopsychosocial mechanisms that underlie the high smoking rates seen in people with these disorders. Research indicates that smokers with chronic mental illness can quit with standard cessation approaches with minimal effects on psychiatric symptoms. Although some studies have noted high relapse rates, longer maintenance on pharmacotherapy reduces rates of relapse without untoward effects on psychiatric symptoms. Similar biopsychosocial mechanisms are thought to be involved in the initiation and persistence of smoking in patients with different disorders. An appreciation of these common factors may aid the development of novel tobacco treatments for people with chronic mental illness. Novel nicotine and tobacco products such as electronic cigarettes and very low nicotine content cigarettes may also be used to improve smoking cessation rates in people with chronic mental illness.
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Affiliation(s)
- Jennifer W Tidey
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI 02912, USA
| | - Mollie E Miller
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI 02912, USA
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19
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Schreurs BG, Burhans LB. Eyeblink classical conditioning and post-traumatic stress disorder - a model systems approach. Front Psychiatry 2015; 6:50. [PMID: 25904874 PMCID: PMC4389289 DOI: 10.3389/fpsyt.2015.00050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 03/25/2015] [Indexed: 12/11/2022] Open
Abstract
Not everyone exposed to trauma suffers flashbacks, bad dreams, numbing, fear, anxiety, sleeplessness, hyper-vigilance, hyperarousal, or an inability to cope, but those who do may suffer from post-traumatic stress disorder (PTSD). PTSD is a major physical and mental health problem for military personnel and civilians exposed to trauma. There is still debate about the incidence and prevalence of PTSD especially among the military, but for those who are diagnosed, behavioral therapy and drug treatment strategies have proven to be less than effective. A number of these treatment strategies are based on rodent fear conditioning research and are capable of treating only some of the symptoms because the extinction of fear does not deal with the various forms of hyper-vigilance and hyperarousal experienced by people with PTSD. To help address this problem, we have developed a preclinical eyeblink classical conditioning model of PTSD in which conditioning and hyperarousal can both be extinguished. We review this model and discuss findings showing that unpaired stimulus presentations can be effective in reducing levels of conditioning and hyperarousal even when unconditioned stimulus intensity is reduced to the point where it is barely capable of eliciting a response. These procedures have direct implications for the treatment of PTSD and could be implemented in a virtual reality environment.
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Affiliation(s)
- Bernard G Schreurs
- Blanchette Rockefeller Neurosciences Institute, West Virginia University , Morgantown, WV , USA ; Department of Physiology and Pharmacology, West Virginia University , Morgantown, WV , USA
| | - Lauren B Burhans
- Blanchette Rockefeller Neurosciences Institute, West Virginia University , Morgantown, WV , USA ; Department of Physiology and Pharmacology, West Virginia University , Morgantown, WV , USA
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20
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Korem N, Akirav I. Cannabinoids prevent the effects of a footshock followed by situational reminders on emotional processing. Neuropsychopharmacology 2014; 39:2709-22. [PMID: 24897957 PMCID: PMC4200492 DOI: 10.1038/npp.2014.132] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 05/06/2014] [Accepted: 05/30/2014] [Indexed: 01/04/2023]
Abstract
Posttraumatic stress disorder (PTSD) can develop following exposure to a traumatic event. Hence, what we do in the first few hours after trauma exposure may alter the trajectory of PTSD. We examined whether cannabinoids can prevent the effects of a single footshock followed by situational reminders (SRs) on emotional processing. Rats were exposed to a footshock (1.5 mA, 10 s) on day 1 followed by exposure to SRs of the shock on days 3 and 5. The CB1/2 receptor agonist WIN55,212-2 or vehicle were injected intraperitoneally 2 h after the shock. After 1 week, PTSD-like symptoms were examined. Exposure to SRs exacerbated the effects of the shock as rats exposed to shock and SRs, but not shock alone, showed impaired extinction of the traumatic event, impaired plasticity in the hippocmapal-accumbens pathway, enhanced latency to startle, and altered expression of CB1 receptors (CB1r) and glucocorticoid receptors (GRs) in the CA1, basolateral amygdala (BLA) and prefrontal cortex (PFC). WIN55,212-2 prevented the effects of the shock and SRs on extinction, plasticity, and startle response. WIN55,212-2 normalized the shock/SR-induced upregulation in CB1r in the PFC, and CA1 and GRs in the CA1, with no effect on BLA downregulation of CB1r and GRs. Shock and SRs caused lasting (1 week) alterations in emotional processing associated with changes in GR and CB1r expression in brain areas related to PTSD. WIN55,212-2 administered after trauma exposure prevented these alterations via PFC- and CA1-CB1r and CA1-GRs.
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Affiliation(s)
- Nachshon Korem
- Department of Psychology, University of Haifa, Haifa, Israel
| | - Irit Akirav
- Department of Psychology, University of Haifa, Haifa, Israel,Department of Psychology, University of Haifa, Mount Carmel, Haifa 31905, Israel, Tel: +972 4 8288268, Fax: +972 4 8263157, E-mail:
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21
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Lei M, Luo L, Qu T, Jia H, Li L. Perceived location specificity in perceptual separation-induced but not fear conditioning-induced enhancement of prepulse inhibition in rats. Behav Brain Res 2014; 269:87-94. [DOI: 10.1016/j.bbr.2014.04.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 04/14/2014] [Accepted: 04/16/2014] [Indexed: 11/24/2022]
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22
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Acheson DT, Geyer MA, Risbrough VB. Psychophysiology in the study of psychological trauma: where are we now and where do we need to be? Curr Top Behav Neurosci 2014; 21:157-183. [PMID: 25158622 DOI: 10.1007/7854_2014_346] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a major public health concern, which has been seeing increased recent attention partly due to the wars in Iraq and Afghanistan. Historically, research attempting to understand the etiology and treatment of PTSD has made frequent use of psychophysiological measures of arousal as they provide a number of advantages in providing objective, non-self-report outcomes that are closely related to proposed neurobiological mechanisms and provide opportunity for cross-species translation. Further, the ongoing shift in classification of psychiatric illness based on symptom clusters to specific biological, physiological, and behavioral constructs, as outlined in the US National Institute of Mental Health (NIMH) Research Domain Criteria project (RDoC), promises that psychophysiological research will continue to play a prominent role in research on trauma-related illnesses. This review focuses on the current state of the knowledge regarding psychophysiological measures and PTSD with a focus on physiological markers associated with current PTSD symptoms, as well as markers of constructs thought to be relevant to PTSD symptomatology (safety signal learning, fear extinction), and psychophysiological markers of risk for developing PTSD following trauma. Future directions and issues for the psychophysiological study of trauma including traumatic brain injury (TBI), treatment outcome studies, and new wearable physiological monitoring technologies are also discussed.
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Affiliation(s)
- D T Acheson
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr. Mail Code 0804, La Jolla, CA, 92093-0804, USA
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23
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Tipps ME, Raybuck JD, Lattal KM. Substance abuse, memory, and post-traumatic stress disorder. Neurobiol Learn Mem 2013; 112:87-100. [PMID: 24345414 DOI: 10.1016/j.nlm.2013.12.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 11/23/2013] [Accepted: 12/03/2013] [Indexed: 12/20/2022]
Abstract
A large body of literature demonstrates the effects of abused substances on memory. These effects differ depending on the drug, the pattern of delivery (acute or chronic), and the drug state at the time of learning or assessment. Substance use disorders involving these drugs are often comorbid with anxiety disorders, such as post-traumatic stress disorder (PTSD). When the cognitive effects of these drugs are considered in the context of the treatment of these disorders, it becomes clear that these drugs may play a deleterious role in the development, maintenance, and treatment of PTSD. In this review, we examine the literature evaluating the cognitive effects of three commonly abused drugs: nicotine, cocaine, and alcohol. These three drugs operate through both common and distinct neurobiological mechanisms and alter learning and memory in multiple ways. We consider how the cognitive and affective effects of these drugs interact with the acquisition, consolidation, and extinction of learned fear, and we discuss the potential impediments that substance abuse creates for the treatment of PTSD.
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Affiliation(s)
- Megan E Tipps
- Department of Behavioral Neuroscience, Oregon Health & Science University, United States.
| | - Jonathan D Raybuck
- Department of Behavioral Neuroscience, Oregon Health & Science University, United States.
| | - K Matthew Lattal
- Department of Behavioral Neuroscience, Oregon Health & Science University, United States.
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