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Domínguez RO, Marschoff ER, Oudkerk LM, de la Ossa Angulo LE, Pérez SV, Bianchi GA, Repetto MG, Serra JA. Neurological Disorders in an Elderly Cohort Experienced Past Stressful Events: A Retrospective-prospective Study. Curr Aging Sci 2022; 15:163-171. [PMID: 35040423 DOI: 10.2174/1874609815666220118104234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Psychological stress may be a risk factor for dementia, but the association between exposure to stressful life events and the development of cognitive dysfunction has not been conclusively demonstrated. We hypothesize that if a stressful event has an impact on the subjects, its effects would be different in the three diseases. OBJECTIVE This study aims to assess the effects of stressful events in senior patients who later developed ischemic stroke, Alzheimer's, or Parkinson's disease. MATERIAL AND METHODS Together with demographic variables (age, sex, race, socioeconomic and cultural levels), five types of past stressful events, such as death or serious illness of close relatives, job dismissal, change of financial status, retirement, and change of residence, were recorded in 1024 patients with Alzheimer's disease, Parkinson's disease, and ischemic stroke. Time-todiagnosis (months from the event to the first symptoms: retrospective study) and evolution time (years of follow-up of each patient: prospective study) were recorded. The variance and nonparametric methods were analyzed to the variables time-to-diagnosis and evolution time to analyze differences between these diseases. RESULTS The demographic variables, such as age, sex, race, economic and cultural levels, were found to be statistically non-significant; differences in the economic level were significant (P<0.05). Significant differences (P<0.001) were found in the mean time-to-diagnosis between diseases (Alzheimer's disease>Parkinson's disease >Stroke), and minor differences (P<0.05) in evolution time. CONCLUSION Differences in time-to-diagnosis between the diseases indicate that the stressful effect of having experienced the death or serious illness of a close relative has an impact on their emergence. The measurement of time-to-diagnosis and evolution time proves useful in detecting differences between diseases.
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Affiliation(s)
- Raúl O Domínguez
- Department of Neurology, School of Medicine, University of Buenos Aires (UBA), Hospital Sirio-Libanés; Campana 4658, C1419AHN, CABA, Argentina
| | - Enrique R Marschoff
- Antarctic Argentine Institute; 25 de Mayo 1149, B1650HMK, General San Martín, Buenos Aires, Argentina
| | - Liliana M Oudkerk
- Department of Neurology, School of Medicine, University of Buenos Aires (UBA), Hospital Sirio-Libanés; Campana 4658, C1419AHN, CABA, Argentina
| | - Luis E de la Ossa Angulo
- Department of Internal Medicine, School of Medicine, University of Buenos Aires (UBA), Hospital Sirio-Libanés; Campana 4658, C1419AHN, CABA, Argentina
| | - Susana Villamizar Pérez
- Department of Internal Medicine, School of Medicine, University of Buenos Aires (UBA), Hospital Sirio-Libanés; Campana 4658, C1419AHN, CABA, Argentina
| | - Graciela A Bianchi
- Department of Internal Medicine, School of Medicine, University of Buenos Aires (UBA), Hospital Sirio-Libanés; Campana 4658, C1419AHN, CABA, Argentina
| | - Marisa G Repetto
- School of Biochemistry and Pharmacy, General and Inorganic Chemistry Division, National Council of Scientific and Technical Investigations (CONICET), Oxidative Stress Lab, Institute of Biochemistry and Molecular Medicine (IBIMOL), University of Buenos Aires (UBA), Junín 954, C1113AAD, CABA, Argentina
| | - Jorge A Serra
- School of Biochemistry and Pharmacy, Institute of Biochemistry and Molecular 5Medicine (IBIMOL), National Council of Scientific and Technical Investigations (CONICET), Oxidative Stress Lab, University of Buenos Aires (UBA), Junín 954, C1113AAD, CABA, Argentina
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Kronenberg G, Schöner J, Levitanus M, Alvarado Balderrama AV, Geran R, Laumeier I, Schlattmann P, Nelson CP, Endres M, Gertz K. The importance of previous lifetime trauma in stroke-induced PTSD symptoms and mental health outcomes. J Psychiatr Res 2021; 136:589-594. [PMID: 33143861 DOI: 10.1016/j.jpsychires.2020.10.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/20/2020] [Accepted: 10/23/2020] [Indexed: 11/29/2022]
Abstract
The 'Stroke Complications after Traumatic Experiences and Stress' (SATURN) study was designed to investigate the effects of a prior traumatic event on PTSD symptoms triggered by a subsequent stroke. First-ever ischemic stroke patients were surveyed 9-13 months after hospitalization at the Charité University Medical Center. Stroke-induced PTSD symptoms were measured using the Impact of Event Scale-revised (IES-R). Prior traumatization together with past PTSD symptoms was assessed retrospectively with the Brief Trauma Questionnaire (BTQ) and the 7-item Short Screening Scale for PTSD. Depressive symptoms were assessed with the Beck Depression Inventory (BDI-II). The Short Form (SF)-36 was used to evaluate physical and mental health outcomes. We received 258 responses from 636 eligible patients (~41%). Based on respondents' scores on the IES-R, the prevalence of probable PTSD due to the stroke event was 11% in our sample. Female sex and younger age were associated with more severe PTSD symptoms. Psychological endpoints did not differ between patients who denied prior trauma exposure and those who reported earlier trauma exposure but denied subsequent PTSD symptoms. However, a history of trauma exposure in tandem with endorsing subsequent PTSD symptoms was linked with significantly increased post-stroke PTSD and depressive symptoms together with decreased psychological well-being. Self-reported physical health did not differ across groups. Younger age, being a woman, and having developed PTSD symptoms in the aftermath of a prior trauma were associated with adverse psychological outcomes after stroke.
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Affiliation(s)
- Golo Kronenberg
- College of Life Sciences, University of Leicester, United Kingdom; Leicestershire Partnership National Health Service Trust, Leicester, United Kingdom.
| | - Johanna Schöner
- Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik und Poliklinik für Psychiatrie und Psychotherapie, 10117, Berlin, Germany
| | - Michael Levitanus
- Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik und Hochschulambulanz für Neurologie und Centrum für Schlaganfallforschung Berlin (CSB), Berlin, Germany
| | - Ana Violeta Alvarado Balderrama
- Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik und Hochschulambulanz für Neurologie und Centrum für Schlaganfallforschung Berlin (CSB), Berlin, Germany
| | - Rohat Geran
- Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik und Hochschulambulanz für Neurologie und Centrum für Schlaganfallforschung Berlin (CSB), Berlin, Germany
| | - Inga Laumeier
- Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik und Hochschulambulanz für Neurologie und Centrum für Schlaganfallforschung Berlin (CSB), Berlin, Germany
| | - Peter Schlattmann
- Universitätsklinikum Jena, Institut für Medizinische Statistik, Informatik und Dokumentation, Jena, Germany
| | - Christopher P Nelson
- Department of Cardiovascular Sciences, University of Leicester, United Kingdom; NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom
| | - Matthias Endres
- Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik und Hochschulambulanz für Neurologie und Centrum für Schlaganfallforschung Berlin (CSB), Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany; Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), 10117, Berlin, Germany
| | - Karen Gertz
- Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik und Hochschulambulanz für Neurologie und Centrum für Schlaganfallforschung Berlin (CSB), Berlin, Germany.
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Young J, Schweber A, Sumner JA, Chang BP, Cornelius T, Kronish IM. Impact of prior trauma exposure on the development of PTSD symptoms after suspected acute coronary syndrome. Gen Hosp Psychiatry 2021; 68:7-11. [PMID: 33232851 PMCID: PMC7855440 DOI: 10.1016/j.genhosppsych.2020.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/22/2020] [Accepted: 11/06/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To determine the association between PTSD symptoms due to prior trauma and prior trauma type with PTSD symptoms after suspected acute coronary syndrome (ACS). METHOD A consecutive sample of patients presenting to the emergency department (ED) for suspected ACS were surveyed. Logistic regression was used to estimate the odds of elevated ACS-related PTSD symptoms [PCL-S ≥ 33] at 1-month associated with PTSD symptoms due to prior trauma and prior trauma type at the time of suspected ACS, adjusting for demographics, comorbidities, depression, and etiology of ACS symptoms. RESULTS Of 984 patients, 81.6% reported ≥1 prior trauma type and 22.5% reported PTSD symptoms due to prior trauma at the time of suspected ACS. One month later, 18.0% had ACS-related PTSD symptoms. Patients with versus without PTSD symptoms due to prior trauma at the time of the suspected ACS had increased odds of ACS-related PTSD symptoms one month later (42.1% vs 9.9%; aOR 4.49, 95% CI:3.05-6.60; p < .001). Prior life-threatening illness was the only trauma type significantly associated with ACS-related PTSD symptoms (aOR 1.57, 95% CI:1.03-2.39; p = .04). CONCLUSIONS PTSD symptoms from prior trauma and history of life-threatening medical illness at the time of suspected ACS increased risk of ACS-related PTSD symptoms one month later.
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Affiliation(s)
- Justin Young
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, 622 W. 168th St, NY, New York, USA; Columbia University Vagelos College of Physicians and Surgeons, 630 W. 168th St, NY, New York, USA
| | - Adam Schweber
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, 622 W. 168th St, NY, New York, USA; Columbia University Vagelos College of Physicians and Surgeons, 630 W. 168th St, NY, New York, USA
| | - Jennifer A Sumner
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, 622 W. 168th St, NY, New York, USA; Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box, 951563, Los Angeles, CA, USA
| | - Bernard P Chang
- Department of Emergency Medicine, Columbia University Irving Medical Center, 622 W. 168th St, NY, New York, USA
| | - Talea Cornelius
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, 622 W. 168th St, NY, New York, USA
| | - Ian M Kronish
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, 622 W. 168th St, NY, New York, USA.
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Gu Y, Zhu D. nNOS-mediated protein-protein interactions: promising targets for treating neurological and neuropsychiatric disorders. J Biomed Res 2020; 35:1-10. [PMID: 33402546 PMCID: PMC7874267 DOI: 10.7555/jbr.34.20200108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Neurological and neuropsychiatric disorders are one of the leading causes of disability worldwide and affect the health of billions of people. Nitric oxide (NO), a free gas with multitudinous bioactivities, is mainly produced from the oxidation of L-arginine by neuronal nitric oxide synthase (nNOS) in the brain. Inhibiting nNOS benefits a variety of neurological and neuropsychiatric disorders, including stroke, depression and anxiety disorders, post-traumatic stress disorder, Parkinson's disease, Alzheimer's disease, chronic pain, and drug addiction. Due to critical roles of nNOS in learning and memory and synaptic plasticity, direct inhibition of nNOS may cause severe side effects. Importantly, interactions of several proteins, including post-synaptic density 95 (PSD-95), carboxy-terminal PDZ ligand of nNOS (CAPON) and serotonin transporter (SERT), with the PSD/Disc-large/ZO-1 homologous (PDZ) domain of nNOS have been demonstrated to influence the subcellular distribution and activity of the enzyme in the brain. Therefore, it will be a preferable means to interfere with nNOS-mediated protein-protein interactions (PPIs), which do not lead to undesirable effects. Herein, we summarize the current literatures on nNOS-mediated PPIs involved in neurological and neuropsychiatric disorders, and the discovery of drugs targeting the PPIs, which is expected to provide potential targets for developing novel drugs and new strategy for the treatment of neurological and neuropsychiatric disorders.
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Affiliation(s)
- Yuanyuan Gu
- Department of Pharmacology, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Dongya Zhu
- Department of Pharmacology, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu 211166, China.,Institution of Stem Cell and Neuroregeneration, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu 211166, China
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Birk JL, Sumner JA, Haerizadeh M, Heyman-Kantor R, Falzon L, Gonzalez C, Gershengoren L, Shapiro P, Edmondson D, Kronish IM. Early interventions to prevent posttraumatic stress disorder symptoms in survivors of life-threatening medical events: A systematic review. J Anxiety Disord 2019; 64:24-39. [PMID: 30925334 PMCID: PMC6504609 DOI: 10.1016/j.janxdis.2019.03.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 02/11/2019] [Accepted: 03/19/2019] [Indexed: 12/16/2022]
Abstract
Post-traumatic stress disorder (PTSD) induced by life-threatening medical events has been associated with adverse physical and mental health outcomes, but it is unclear whether early interventions to prevent the onset of PTSD after these events are efficacious. We conducted a systematic review to address this need. We searched six biomedical electronic databases from database inception to October 2018. Eligible studies used randomized designs, evaluated interventions initiated within 3 months of potentially traumatic medical events, included adult participants, and did not have high risk of bias. The 21 included studies (N = 4,486) assessed a heterogeneous set of interventions after critical illness (9), cancer diagnosis (8), heart disease (2), and cardiopulmonary surgery (2). Fourteen psychological, 2 pharmacological, and 5 other-type interventions were assessed. Four of the psychological interventions emphasizing cognitive behavioral therapy or meaning-making, 1 other-type palliative care intervention, and 1 pharmacological-only intervention (hydrocortisone administration) were efficacious at reducing PTSD symptoms relative to control. One early, in-hospital counseling intervention was less efficacious at lowering PTSD symptoms than an active control. Clinical and methodological heterogeneity prevented quantitative pooling of data. While several promising interventions were identified, strong evidence of efficacy for any specific early PTSD intervention after medical events is currently lacking.
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Affiliation(s)
- Jeffrey L. Birk
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, USA
| | - Jennifer A. Sumner
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, USA
| | - Mytra Haerizadeh
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, USA
| | - Reuben Heyman-Kantor
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, USA
| | - Louise Falzon
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, USA
| | - Christopher Gonzalez
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, USA
| | - Liliya Gershengoren
- Department of Psychiatry, Weill Cornell Medical Center, 525 East 68th Street, New York, NY 10065, USA
| | - Peter Shapiro
- Department of Psychiatry, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, USA
| | - Donald Edmondson
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, USA
| | - Ian M. Kronish
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, USA
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