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Martinez B, Peplow PV. MicroRNAs as potential biomarkers for diagnosis of post-traumatic stress disorder. Neural Regen Res 2025; 20:1957-1970. [PMID: 39101663 DOI: 10.4103/nrr.nrr-d-24-00354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 07/04/2024] [Indexed: 08/06/2024] Open
Abstract
Post-traumatic stress disorder is a mental disorder caused by exposure to severe traumatic life events. Currently, there are no validated biomarkers or laboratory tests that can distinguish between trauma survivors with and without post-traumatic stress disorder. In addition, the heterogeneity of clinical presentations of post-traumatic stress disorder and the overlap of symptoms with other conditions can lead to misdiagnosis and inappropriate treatment. Evidence suggests that this condition is a multisystem disorder that affects many biological systems, raising the possibility that peripheral markers of disease may be used to diagnose post-traumatic stress disorder. We performed a PubMed search for microRNAs (miRNAs) in post-traumatic stress disorder (PTSD) that could serve as diagnostic biomarkers and found 18 original research articles on studies performed with human patients and published January 2012 to December 2023. These included four studies with whole blood, seven with peripheral blood mononuclear cells, four with plasma extracellular vesicles/exosomes, and one with serum exosomes. One of these studies had also used whole plasma. Two studies were excluded as they did not involve microRNA biomarkers. Most of the studies had collected samples from adult male Veterans who had returned from deployment and been exposed to combat, and only two were from recently traumatized adult subjects. In measuring miRNA expression levels, many of the studies had used microarray miRNA analysis, miRNA Seq analysis, or NanoString panels. Only six studies had used real time polymerase chain reaction assay to determine/validate miRNA expression in PTSD subjects compared to controls. The miRNAs that were found/validated in these studies may be considered as potential candidate biomarkers for PTSD and include miR-3130-5p in whole blood; miR-193a-5p, -7113-5p, -125a, -181c, and -671-5p in peripheral blood mononuclear cells; miR-10b-5p, -203a-3p, -4488, -502-3p, -874-3p, -5100, and -7641 in plasma extracellular vesicles/exosomes; and miR-18a-3p and -7-1-5p in blood plasma. Several important limitations identified in the studies need to be taken into account in future studies. Further studies are warranted with war veterans and recently traumatized children, adolescents, and adults having PTSD and use of animal models subjected to various stressors and the effects of suppressing or overexpressing specific microRNAs.
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Affiliation(s)
- Bridget Martinez
- Department of Pharmacology, University of Nevada-Reno, Reno, NV, USA
- Department of Medicine, University of Nevada-Reno, Reno, NV, USA
| | - Philip V Peplow
- Department of Anatomy, University of Otago, Dunedin, New Zealand
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Huang CY, Zhao YF, Zhang ZX, Liu RB, Liu JL, Li XZ, Luo J, Yue L, Zhang C. Psychotherapeutic and pharmacological agents for post-traumatic stress disorder with sleep disorder: network meta-analysis. Ann Med 2024; 56:2381696. [PMID: 39061119 DOI: 10.1080/07853890.2024.2381696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/21/2023] [Accepted: 02/26/2024] [Indexed: 07/28/2024] Open
Abstract
OBJECTIVE The current guidelines and canonical norms of diagnosis or treatment for Post-traumatic stress disorder (PTSD) with sleep disorder are still conflicting and have not yet reached a consensus. This study aimed to unravel the most effective countermeasures between two categories (psychotherapy and pharmacotherapy) put forward by the National Institute for Health and Clinical Excellence (NICE) and World Federation of Societies of Biological Psychiatry (WFSBP) respectively to treat PTSD individuals co-exist with sleep disorders. METHODS Four databases, including PubMed, EMBASE, Cochrane Library, and APA PsyNet, were searched from inception to February 02, 2023. RESULTS Twenty articles with 24 Randomized controlled trials (RCTs) and a total number of 1,647 participants were included. As demonstrated in the network meta-analysis comparison results, CBT-I (standardized mean differences (SMD) = -1.51,95% confidence interval (CI):-2.55 to -0.47), CBT-I plus IRT (SMD = -1.71, 95%CI:-3.39, -0.03), prazosin (SMD = -0.87,95%CI:-1.59 to -0.16) and hydroxyzine (SMD = -1.06, 95%CI: -1.94 to -0.19) significantly reduced PTSD symptoms compared with placebo. In contrast to placebo, CBT-I (SMD = -5.61,95%CI:-8.82 to -2.40) significantly improved sleep quality. For nightmare severity, IRT (SMD =-0.65, 95%CI:-1.00 to -0.31), prazosin (SMD = -1.20,95%CI:-1.72 to -0.67) and hydroxyzine (SMD = -0.98,95%CI:-1.58 to -0.37) significantly reduced nightmare severity in comparison with placebo. CONCLUSIONS This study suggested that under most circumstances, psychotherapy namely CBT-I had a favorable profile, but pharmacotherapy with prazosin was effective in managing nightmare severity. The sole avail of CBT-I was recommended to improving sleep quality while CBT-I and CBT-I plus IRT showed excellent management of PTSD symptom severity. Exposure to CBT-I isrecommended for depression. The relevant clinical guidelines for the management of individuals with PTSD and sleep disorders may regard this as a reference. PROSPERO CRD42023415240.
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Affiliation(s)
- Cheng-Yang Huang
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yi-Fan Zhao
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Zhi-Xin Zhang
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Run-Ben Liu
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Jia-Ling Liu
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Xiao-Zheng Li
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Jie Luo
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
- Center for Neurological Diseases, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Li Yue
- Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Chao Zhang
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
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Choi C, Johnson DE, Chen-Li D, Rosenblat J. Mechanisms of psilocybin on the treatment of posttraumatic stress disorder. J Psychopharmacol 2024:2698811241286771. [PMID: 39360403 DOI: 10.1177/02698811241286771] [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] [Indexed: 10/04/2024]
Abstract
Posttraumatic stress disorder (PTSD) is a condition that can develop after a traumatic event, causing distressing symptoms, including intrusive re-experiencing symptoms, alterations in mood and cognition, and changes in arousal and reactivity. Few treatment options exist for patients who find conventional psychotherapy and pharmacotherapy to be inaccessible, ineffective, or intolerable. We explore psilocybin as a potential treatment option for PTSD by examining the neurobiology of PTSD as well as psilocybin's mechanism of action. Based on both pharmacodynamic and psychoanalytic principles, psilocybin may be an underexplored treatment option for patients with PTSD, though further research is required.
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Affiliation(s)
- Charles Choi
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Danica E Johnson
- Mood Disorders Psychopharmacology Unit, Poul Hansen Depression Center, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - David Chen-Li
- Mood Disorders Psychopharmacology Unit, Poul Hansen Depression Center, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Joshua Rosenblat
- Mood Disorders Psychopharmacology Unit, Poul Hansen Depression Center, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
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Specht L, Freiberg A, Mojahed A, Garthus-Niegel S, Schellong J. Adrenocortical deviations and adverse clinical outcomes in children and adolescents exposed to interparental intimate partner violence: A systematic review. Neurosci Biobehav Rev 2024; 165:105866. [PMID: 39233285 DOI: 10.1016/j.neubiorev.2024.105866] [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: 06/14/2024] [Revised: 08/21/2024] [Accepted: 08/25/2024] [Indexed: 09/06/2024]
Abstract
Childhood exposure to interparental intimate partner violence (i-IPV) is a pervasive form of child maltreatment, posing major public health concerns and elevating risks for enduring adverse clinical and developmental consequences. However, assessing the full spectrum of clinical effects is challenging, potentially leading to inconsistent identification of children in need of early intervention. This systematic review aimed to identify hypothalamic-pituitary-adrenocortical axis dysfunction following i-IPV exposure, elucidating the underlying biopsychobehavioural mechanisms and predicting adverse outcomes. We searched Embase, MEDLINE, and PsycINFO for peer-reviewed studies from infancy through adolescence, screened reference lists and conducted forward searches. Analysis of 23 publications (N = 1848) revealed associations between i-IPV and altered adrenocortical function from early childhood, influenced by FKBP5 haplotype, parental caregiving and offspring emotional insecurity. Results showed that the adrenocortical stress response may predict internalising and externalising problems, childhood asthma, impaired executive function and poor academic performance. Nonetheless, inconsistencies in findings between studies suggest methodological heterogeneity and potential bias. Identifying biomarkers such as cortisol can enhance prediction and mechanism-based intervention efforts but long-term studies with a common theoretical and methodological framework are needed for comprehensive understanding. Integrating biological, emotional, and behavioural assessments could potentiate trauma services and research, ultimately improving outcomes for affected children.
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Affiliation(s)
- Lina Specht
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany.
| | - Alice Freiberg
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany
| | - Amera Mojahed
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany
| | - Susan Garthus-Niegel
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany; Institute for Systems Medicine (ISM) and Faculty of Medicine, Medical School Hamburg, Am Kaiserkai 1, Hamburg 20457, Germany; Department of Childhood and Families, Norwegian Institute of Public Health, Postboks 222 Skøyen, Oslo 0213, Norway
| | - Julia Schellong
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany
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Sanders JE. "I Think the Teachers Should Really Connect More With the Students": The Influence of Systemic Racism, Inequity, School, and Community Violence on Connection for High School Students Who Are Suspended or Expelled. YOUTH & SOCIETY 2024; 56:1191-1211. [PMID: 39290444 PMCID: PMC11402595 DOI: 10.1177/0044118x231226396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
The objective of this constructivist grounded theory study was to understand the experiences of students who have been disciplinarily excluded from school. Fifteen students (male, n = 11; Black, n = 10; having special education needs, n = 9) and 16 multidisciplinary staff in Ontario participated. Students experienced high rates of expanded adversities, including school and community violence, systemic racism and inequity. The importance of connection wove throughout the data; however, three themes were found to block connection: unacknowledged impact of adversity, a climate of fear, and the disproportionate impact of limited resources. Trauma-informed culturally attuned approaches that focus on the disproportionate impact of adversity and school discipline at the point of a disciplinary response, and throughout a student's educational experience, are essential.
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Affiliation(s)
- Jane E Sanders
- King's University College at Western University Canada, London, ON, Canada
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Johnston N, Chapman M, Gibson J, Paterson C, Turner M, Strickland K, Liu WM, Phillips C, Bail K. Re-living trauma near death: an integrative review using Grounded Theory narrative analysis. Palliat Care Soc Pract 2024; 18:26323524241277851. [PMID: 39346008 PMCID: PMC11439169 DOI: 10.1177/26323524241277851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 08/07/2024] [Indexed: 10/01/2024] Open
Abstract
Background Symptoms of emotional and physical stress near death may be related to previous experiences of trauma. Objective To investigate current evidence regarding the following: (1) Is previous trauma identified in people who are dying, and if so, how? (2) How is previous trauma associated with the experience of death/dying in people with or without cognitive impairment? and (3) What palliative care interventions are available to people with previous trauma at the end of life? Design This integrative review was conducted per Whittemore and Knafl's guidelines, which involves a stepped approach, specifically (1) problem identification, (2) literature search, (3) data evaluation, (4) data analysis and (5) presentation. Methods This integrative review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Electronic databases were searched in August 2021 and updated in August 2023. The articles were quality appraised, and narrative data were analysed using Grounded Theory (GT). Results Of 1310 studies screened, 11 met the inclusion criteria (four qualitative and seven quantitative) conducted in Australia, Canada, Japan and the United States; and American studies accounted for 7/11 studies. Eight were focused on war veterans. Descriptive studies accounted for the majority, with only two publications testing interventions. Re-living trauma near death has additional features to a diagnosis of post-traumatic stress disorder alone, such as physical symptoms of uncontrolled, unexplained acute pain and this distress was reported in the last weeks of life. Conclusion This study proposes that re-living trauma near death is a recognisable phenomenon with physical and psychological impacts that can be ameliorated with improved clinical knowledge and appropriate management as a new GT. Further research is needed to enable past trauma identification at the end of life, and trauma-informed safe interventions at the end of life are an urgent need.
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Affiliation(s)
- Nikki Johnston
- Faculty of Health, University of Canberra, Building 10, 11 Kirinari Street, Bruce, Australia, ACT Health Directorate, Canberra, ACT, Bruce, ACT 2617, Australia
- Synergy Nursing and Midwifery Research Centre, Australia
- Centre of Ageing Research and Translation, University of Canberra, Bruce, ACT, Australia
| | - Michael Chapman
- Palliative and Supportive Care, Canberra Health Services, Garran, ACT, Australia
- School of Medicine and Psychology, Australian National University, Canberra, ACT, Australia
- Palliative Care Research Service, Canberra Health Services, Garran, ACT, Australia
| | - Jo Gibson
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Catherine Paterson
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Central Adelaide Local Health Network, Adelaide, SA, Australia
- Robert Gordon University, Aberdeen, Scotland, UK
| | - Murray Turner
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Karen Strickland
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia
- School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland
| | - Wai-Man Liu
- Research School of Finance, Actuarial Studies and Statistics, Australian National University, Canberra, ACT, Australia
| | - Christine Phillips
- School of Medicine and Psychology, Australian National University, Canberra, ACT, Australia
| | - Kasia Bail
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
- Synergy Nursing and Midwifery Research Centre, ACT Health Directorate, Canberra, ACT, Australia
- Centre of Ageing Research and Translation, University of Canberra, Bruce, ACT, Australia
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7
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Wani AH, Katrinli S, Zhao X, Daskalakis NP, Zannas AS, Aiello AE, Baker DG, Boks MP, Brick LA, Chen CY, Dalvie S, Fortier C, Geuze E, Hayes JP, Kessler RC, King AP, Koen N, Liberzon I, Lori A, Luykx JJ, Maihofer AX, Milberg W, Miller MW, Mufford MS, Nugent NR, Rauch S, Ressler KJ, Risbrough VB, Rutten BPF, Stein DJ, Stein MB, Ursano RJ, Verfaellie MH, Vermetten E, Vinkers CH, Ware EB, Wildman DE, Wolf EJ, Nievergelt CM, Logue MW, Smith AK, Uddin M. Blood-based DNA methylation and exposure risk scores predict PTSD with high accuracy in military and civilian cohorts. BMC Med Genomics 2024; 17:235. [PMID: 39334086 PMCID: PMC11429352 DOI: 10.1186/s12920-024-02002-6] [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: 02/12/2024] [Accepted: 08/29/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Incorporating genomic data into risk prediction has become an increasingly popular approach for rapid identification of individuals most at risk for complex disorders such as PTSD. Our goal was to develop and validate Methylation Risk Scores (MRS) using machine learning to distinguish individuals who have PTSD from those who do not. METHODS Elastic Net was used to develop three risk score models using a discovery dataset (n = 1226; 314 cases, 912 controls) comprised of 5 diverse cohorts with available blood-derived DNA methylation (DNAm) measured on the Illumina Epic BeadChip. The first risk score, exposure and methylation risk score (eMRS) used cumulative and childhood trauma exposure and DNAm variables; the second, methylation-only risk score (MoRS) was based solely on DNAm data; the third, methylation-only risk scores with adjusted exposure variables (MoRSAE) utilized DNAm data adjusted for the two exposure variables. The potential of these risk scores to predict future PTSD based on pre-deployment data was also assessed. External validation of risk scores was conducted in four independent cohorts. RESULTS The eMRS model showed the highest accuracy (92%), precision (91%), recall (87%), and f1-score (89%) in classifying PTSD using 3730 features. While still highly accurate, the MoRS (accuracy = 89%) using 3728 features and MoRSAE (accuracy = 84%) using 4150 features showed a decline in classification power. eMRS significantly predicted PTSD in one of the four independent cohorts, the BEAR cohort (beta = 0.6839, p=0.006), but not in the remaining three cohorts. Pre-deployment risk scores from all models (eMRS, beta = 1.92; MoRS, beta = 1.99 and MoRSAE, beta = 1.77) displayed a significant (p < 0.001) predictive power for post-deployment PTSD. CONCLUSION The inclusion of exposure variables adds to the predictive power of MRS. Classification-based MRS may be useful in predicting risk of future PTSD in populations with anticipated trauma exposure. As more data become available, including additional molecular, environmental, and psychosocial factors in these scores may enhance their accuracy in predicting PTSD and, relatedly, improve their performance in independent cohorts.
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Affiliation(s)
- Agaz H Wani
- Genomics Program, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Seyma Katrinli
- Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA
| | - Xiang Zhao
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Nikolaos P Daskalakis
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center of Excellence in Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Anthony S Zannas
- University of North Carolina at Chapel Hill, Carolina Stress Initiative, Chapel Hill, NC, USA
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Allison E Aiello
- Robert N Butler Columbia Aging Center, Department of Epidemiology, Columbia University, New York, NY, USA
| | - Dewleen G Baker
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Psychiatry Service, San Diego, CA, USA
| | - Marco P Boks
- Department of Psychiatry, Brain Center University Medical Center Utrecht, Utrecht, UT, Netherlands
| | - Leslie A Brick
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Chia-Yen Chen
- Biogen Inc., Translational Sciences, Cambridge, MA, USA
| | - Shareefa Dalvie
- Department of Pathology, University of Cape Town, Cape Town, Western Province, South Africa
- Division of Human Genetics, University of Cape Town, Cape Town, Western Province, South Africa
| | - Catherine Fortier
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- VA Boston Healthcare System, TRACTS/GRECC, Boston, MA, USA
| | - Elbert Geuze
- Brain Research and Innovation Centre, Netherlands Ministry of Defence, Utrecht, UT, Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, UT, Netherlands
| | - Jasmeet P Hayes
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Anthony P King
- The Ohio State University, College of Medicine, Institute for Behavioral Medicine Research, Columbus, OH, USA
| | - Nastassja Koen
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, Western Province, South Africa
- University of Cape Town, Neuroscience Institute, Cape Town, Western Province, South Africa
- SA MRC Unit On Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, Western Province, South Africa
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Sciences, Texas A&M University College of Medicine, Bryan, TX, USA
| | - Adriana Lori
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Jurjen J Luykx
- Department of Psychiatry, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, UT, Netherlands
- Department of Translational Neuroscience, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, UT, Netherlands
| | - Adam X Maihofer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
| | | | - Mark W Miller
- Boston University School of Medicine, Psychiatry, Boston, MA, USA
- VA Boston Healthcare System, National Center for PTSD, Boston, MA, USA
| | - Mary S Mufford
- University of Cape Town, Neuroscience Institute, Cape Town, Western Province, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Western Province, South Africa
| | - Nicole R Nugent
- Department of Emergency Medicine, Warren Alpert Brown Medical School, Providence, RI, USA
- Department of Pediatrics, Warren Alpert Brown Medical School, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Brown Medical School, Providence, RI, USA
| | - Sheila Rauch
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA, USA
- Joseph Maxwell Cleland Atlanta Veterans Affairs Medical Center, Mental Health Service Line, Atlanta, USA
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
- McLean Hospital, Belmont, MA, USA
| | - Victoria B Risbrough
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
| | - Bart P F Rutten
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht Universitair Medisch Centrum, Maastricht, Limburg, Netherlands
| | - Dan J Stein
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, Western Province, South Africa
- University of Cape Town, Neuroscience Institute, Cape Town, Western Province, South Africa
- SA MRC Unit On Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, Western Province, South Africa
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Psychiatry Service, San Diego, CA, USA
- School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Robert J Ursano
- Department of Psychiatry, Uniformed Services University, Bethesda, MD, USA
| | - Mieke H Verfaellie
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
- VA Boston Healthcare System, Memory Disorders Research Center, Boston, MA, USA
| | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Center, Leiden, ZH, Netherlands
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Christiaan H Vinkers
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, Holland, Netherlands
- Department of Anatomy and Neurosciences, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Holland, Netherlands
- Department of Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Holland, Netherlands
| | - Erin B Ware
- Survey Research Center, University of Michigan, Institute for Social Research, Ann Arbor, MI, USA
| | - Derek E Wildman
- Genomics Program, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Erika J Wolf
- VA Boston Healthcare System, National Center for PTSD, Boston, MA, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Caroline M Nievergelt
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
| | - Mark W Logue
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- VA Boston Healthcare System, National Center for PTSD, Boston, MA, USA
- Boston University School of Medicine, Psychiatry, Biomedical Genetics, Boston, MA, USA
| | - Alicia K Smith
- Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
- Department of Human Genetics, Emory University, Atlanta, GA, USA
| | - Monica Uddin
- Genomics Program, College of Public Health, University of South Florida, Tampa, FL, USA.
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8
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Jin F, Hsu SM, Li Y. A Systematic Review of Aphantasia: Concept, Measurement, Neural Basis, and Theory Development. Vision (Basel) 2024; 8:56. [PMID: 39330760 PMCID: PMC11437436 DOI: 10.3390/vision8030056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 09/11/2024] [Accepted: 09/18/2024] [Indexed: 09/28/2024] Open
Abstract
People with aphantasia exhibit the inability to voluntarily generate or form mental imagery in their minds. Since the term "aphantasia" was proposed to describe this, it has gained increasing attention from psychiatrists, neuroscientists, and clinicians. Previous studies have mainly focused on the definition, prevalence, and measurement of aphantasia, its impacts on individuals' cognitive and emotional processing, and theoretical frameworks synthesizing existing findings, which have contributed greatly to our understanding of aphantasia. However, there are still some debates regarding the conclusions derived from existing research and the theories that were constructed from various sources of evidence. Building upon existing endeavors, this systematic review emphasizes that future research is much needed to refine the definition and diagnosis of aphantasia, strengthen empirical investigations at behavioral and neural levels, and, more importantly, develop or update theories. These multiple lines of efforts could lead to a deeper understanding of aphantasia and further guide researchers in future research directions.
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Affiliation(s)
- Feiyang Jin
- Applied Psychology Program, Department of Life Sciences, BNU-HKBU United International College, Zhuhai 519087, China
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Shen-Mou Hsu
- Imaging Center for Integrated Body, Mind and Culture Research, National Taiwan University, Taipei 10617, Taiwan
| | - Yu Li
- Applied Psychology Program, Department of Life Sciences, BNU-HKBU United International College, Zhuhai 519087, China
- Guangdong Provincial Key Laboratory of Interdisciplinary Research and Application for Data Science, BNU-HKBU United International College, Zhuhai 519087, China
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9
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McFarlane A. Staging model of PTSD: a strategy for the implementation of precision medicine in military settings. BMJ Mil Health 2024; 170:409-411. [PMID: 37280012 DOI: 10.1136/military-2023-002352] [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: 01/14/2023] [Accepted: 05/15/2023] [Indexed: 06/08/2023]
Abstract
Biomarkers have been of considerable interest in military medicine as a strategy to identify objective measures of resilience in the context of the cumulative trauma exposure of combat as well defining the emerging neurobiological dysregulation associated with post-traumatic stress disorder (PTSD). This body of work has been driven by the imperative of developing strategies to optimally manage the long-term health outcomes of personnel and finding novel treatment approaches. However, the challenge of defining the relevant phenotypes of PTSD and in the context of the multiplicity of biological systems of interest has hampered the identification of biomarkers that have clinical utility. One key strategy to improve the utility of precision medicine in military settings is to use a staging approach to define the relevant phenotypes. A staging model of PTSD captures the progression of the disorder and the transitions from being at risk to subsyndromal disorder and the path to chronic disorder.A staging approach addresses the longitudinal course of PTSD and the fluidity of the disorder across time. Staging describes how symptoms evolve into more stable diagnostic syndromes and the stepwise changes in clinical status which is key to the identification of phenotypes that can be tied to relevant biomarkers. When a population is exposed to a trauma, the individuals will be at different stages in the emergence of risk and the development of PTSD. The staging approach provides a method of capturing the matrix of phenotypes that need to be demarcated to study the role of multiple biomarkers. This paper forms part of the Special issue of BMJ Military Health dedicated to personalised digital technology for mental health in the armed forces.
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Rowland JA, Stapleton-Kotloski JR, Godwin DW, Hamilton CA, Martindale SL. The Functional Connectome and Long-Term Symptom Presentation Associated With Mild Traumatic Brain Injury and Blast Exposure in Combat Veterans. J Neurotrauma 2024. [PMID: 39150013 DOI: 10.1089/neu.2023.0315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024] Open
Abstract
Mild traumatic brain injury (TBI) sustained in a deployment environment (deployment TBI) can be associated with increased severity of long-term symptom presentation, despite the general expectation of full recovery from a single mild TBI. The heterogeneity in the effects of deployment TBI on the brain can be difficult for a case-control design to capture. The functional connectome of the brain is an approach robust to heterogeneity that allows global measurement of effects using a common set of outcomes. The present study evaluates how differences in the functional connectome relate to remote symptom presentation following combat deployment and determines if deployment TBI, blast exposure, or post-traumatic stress disorder (PTSD) are associated with these neurological differences. Participants included 181 Iraq and Afghanistan combat-exposed Veterans, approximately 9.4 years since deployment. Structured clinical interviews provided diagnoses and characterizations of TBI, blast exposure, and PTSD. Self-report measures provided characterization of long-term symptoms (psychiatric, behavioral health, and quality of life). Resting-state magnetoencephalography was used to characterize the functional connectome of the brain individually for each participant. Linear regression identified factors contributing to symptom presentation including relevant covariates, connectome metrics, deployment TBI, blast exposure PTSD, and conditional relationships. Results identified unique contributions of aspects of the connectome to symptom presentation. Furthermore, several conditional relationships were identified, demonstrating that the connectome was related to outcomes in the presence of only deployment-related TBI (including blast-related TBI, primary blast TBI, and blast exposure). No conditional relationships were identified for PTSD; however, the main effect of PTSD on symptom presentation was significant for all models. These results demonstrate that the connectome captures aspects of brain function relevant to long-term symptom presentation, highlighting that deployment-related TBI influences symptom outcomes through a neurological pathway. These findings demonstrate that changes in the functional connectome associated with deployment-related TBI are relevant to symptom presentation over a decade past the injury event, providing a clear demonstration of a brain-based mechanism of influence.
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Affiliation(s)
- Jared A Rowland
- Research and Academic Affairs, W. G. (Bill) Hefner VA Healthcare System, Salisbury, North Carolina, USA
- Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham, North Carolina, USA
- Department of Translational Neuroscience, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jennifer R Stapleton-Kotloski
- Research and Academic Affairs, W. G. (Bill) Hefner VA Healthcare System, Salisbury, North Carolina, USA
- Department of Translational Neuroscience, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Dwayne W Godwin
- Department of Translational Neuroscience, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Craig A Hamilton
- Research and Academic Affairs, W. G. (Bill) Hefner VA Healthcare System, Salisbury, North Carolina, USA
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Sarah L Martindale
- Research and Academic Affairs, W. G. (Bill) Hefner VA Healthcare System, Salisbury, North Carolina, USA
- Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham, North Carolina, USA
- Department of Translational Neuroscience, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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11
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Rojczyk P, Seitz-Holland J, Heller C, Marcolini S, Marshall AD, Sydnor VJ, Kaufmann E, Jung LB, Bonke EM, Berger L, Umminger LF, Wiegand TLT, Cho KIK, Rathi Y, Bouix S, Pasternak O, Hinds SR, Fortier CB, Salat D, Milberg WP, Shenton ME, Koerte IK. Posttraumatic survivor guilt is associated with white matter microstructure alterations. J Affect Disord 2024; 361:768-777. [PMID: 38897303 DOI: 10.1016/j.jad.2024.06.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 05/31/2024] [Accepted: 06/15/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Military veterans with posttraumatic stress disorder (PTSD) commonly experience posttraumatic guilt. Guilt over commission or omission evolves when responsibility is assumed for an unfortunate outcome (e.g., the death of a fellow combatant). Survivor guilt is a state of intense emotional distress experienced by the weight of knowing that one survived while others did not. METHODS This study of the Translational Research Center for TBI and Stress Disorders (TRACTS) analyzed structural and diffusion-weighted magnetic resonance imaging data from 132 male Iraq/Afghanistan veterans with PTSD. The Clinician-Administered PTSD Scale for DSM-IV (CAPS-IV) was employed to classify guilt. Thirty (22.7 %) veterans experienced guilt over acts of commission or omission, 34 (25.8 %) experienced survivor guilt, and 68 (51.5 %) had no posttraumatic guilt. White matter microstructure (fractional anisotropy, FA), cortical thickness, and cortical volume were compared between veterans with guilt over acts of commission or omission, veterans with survivor guilt, and veterans without guilt. RESULTS Veterans with survivor guilt had significantly lower white matter FA compared to veterans who did not experience guilt (p < .001), affecting several regions of major white matter fiber bundles. There were no significant differences in white matter FA, cortical thickness, or volumes between veterans with guilt over acts of commission or omission and veterans without guilt (p > .050). LIMITATIONS This cross-sectional study with exclusively male veterans precludes inferences of causality between the studied variables and generalizability to the larger veteran population that includes women. CONCLUSION Survivor guilt may be a particularly impactful form of posttraumatic guilt that requires specific treatment efforts targeting brain health.
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Affiliation(s)
- Philine Rojczyk
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Johanna Seitz-Holland
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Carina Heller
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Department of Clinical Psychology, Friedrich Schiller University Jena, Jena, Germany; German Center for Mental Health (DZPG), Partner Site Jena-Magdeburg-Halle, Jena, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Partner Site Jena-Magdeburg-Halle, Jena, Germany
| | - Sofia Marcolini
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology, Alzheimer Center Groningen, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Amy D Marshall
- Department of Psychology, The Pennsylvania State University, PA, USA
| | - Valerie J Sydnor
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Elisabeth Kaufmann
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Leonard B Jung
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Elena M Bonke
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Luisa Berger
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Lisa F Umminger
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Tim L T Wiegand
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Kang Ik K Cho
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Software Engineering and Information Technology, École de technologie supérieure, Université du Québec, Montréal, QC, Canada
| | - Ofer Pasternak
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sidney R Hinds
- Department of Neurology, Uniformed Services University, Bethesda, MD, USA
| | - Catherine B Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - David Salat
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital Department of Radiology, Boston, MA, USA
| | - William P Milberg
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, USA
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, VA Boston Healthcare System, Brockton, MA, USA
| | - Inga K Koerte
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, VA Boston Healthcare System, Brockton, MA, USA; Graduate School of Systemic Neurosciences, Ludwig-Maximilians-University, Munich, Germany.
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12
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Peng Z, Luo Y, Qi R, Cao Z, Ge J, Wu L, Liu J, Zhang L. Influencing factors of posttraumatic stress disorder in Shidu parents who have lost their only child: a cross-sectional survey. BMC Psychiatry 2024; 24:612. [PMID: 39261892 PMCID: PMC11391783 DOI: 10.1186/s12888-024-06059-6] [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: 01/18/2024] [Accepted: 09/04/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND In China, parents who have lost their only child are referred to as Shidu parents (SDPs). This study aimed to investigate the prevalence and risk factors of post-traumatic stress disorder (PTSD) and investigate the influence of depressive and anxiety symptoms on the development of PTSD. METHOD Four hundred and thirty-six SDPs completed assessments of PTSD (Structured Clinical Interview for DSM-IV Disorders, SCID-IV; The Clinician-Administered PTSD Scale-IV, CAPS-IV), depression (Hamilton depression scale), and anxiety (Hamilton Anxiety Scale) via in-person interviews. Logistic regression and hierarchical multiple linear regression analyses were used to explore the association of demographic characteristics, depression, and anxiety symptoms with PTSD. RESULTS The prevalence of PTSD in SDPs was 14.45%. The comorbidity of depression and anxiety symptoms was 87.30% in the SDPs with PTSD. The logistic regression model, which included factors of gender, age, education, depression, and anxiety, which contributed to the development of PTSD, was significant [χ² (11) = 122.47, p < 0.001]. The hierarchical multiple linear regression analysis indicated that female gender and the severity of comorbidities (depression and anxiety) were positively associated with the severity of PTSD. CONCLUSION This study found that the severity of depression and anxiety was closely related to the severity of PTSD, supporting that SDPs are highly prone to the co-occurrence of PTSD, depression, and anxiety after bereavement. Our findings may provide more insights into the development of individualized interventions for parents who have experienced the loss of their only child.
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Affiliation(s)
- Zhuo Peng
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yifeng Luo
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhihong Cao
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Jiyuan Ge
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Luoan Wu
- Department of Psychiatry, Yixing Mental Health Center, Wuxi, China
| | - Jin Liu
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Li Zhang
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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13
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Gattuso JJ, Wilson C, Hannan AJ, Renoir T. Psilocybin as a lead candidate molecule in preclinical therapeutic studies of psychiatric disorders: A systematic review. J Neurochem 2024; 168:1687-1720. [PMID: 38019032 DOI: 10.1111/jnc.16017] [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: 09/03/2023] [Revised: 11/02/2023] [Accepted: 11/10/2023] [Indexed: 11/30/2023]
Abstract
Psilocybin is the main psychoactive compound found in hallucinogenic/magic mushrooms and can bind to both serotonergic and tropomyosin receptor kinase b (TrkB) receptors. Psilocybin has begun to show efficacy for a range of neuropsychiatric conditions, including treatment-resistant depression and anxiety disorders; however, neurobiological mechanisms are still being elucidated. Clinical research has found that psilocybin can alter functional connectivity patterns in human brains, which is often associated with therapeutic outcomes. However, preclinical research affords the opportunity to assess the potential cellular mechanisms by which psilocybin may exert its therapeutic effects. Preclinical rodent models can also facilitate a more tightly controlled experimental context and minimise placebo effects. Furthermore, where there is a rationale, preclinical researchers can investigate psilocybin administration in neuropsychiatric conditions that have not yet been researched clinically. As a result, we have systematically reviewed the knowledge base, identifying 82 preclinical studies which were screened based on specific criteria. This resulted in the exclusion of 44 articles, with 34 articles being included in the main review and another 2 articles included as Supporting Information materials. We found that psilocybin shows promise as a lead candidate molecule for treating a variety of neuropsychiatric conditions, albeit showing the most efficacy for depression. We discuss the experimental findings, and identify possible mechanisms whereby psilocybin could invoke therapeutic changes. Furthermore, we critically evaluate the between-study heterogeneity and possible future research avenues. Our review suggests that preclinical rodent models can provide valid and translatable tools for researching novel psilocybin-induced molecular and cellular mechanisms, and therapeutic outcomes.
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Affiliation(s)
- James J Gattuso
- Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Carey Wilson
- Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Anthony J Hannan
- Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, University of Melbourne, Parkville, Victoria, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Thibault Renoir
- Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, University of Melbourne, Parkville, Victoria, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
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14
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Bonomi R, Hillmer AT, Woodcock E, Bhatt S, Rusowicz A, Angarita GA, Carson RE, Davis MT, Esterlis I, Nabulsi N, Huang Y, Krystal JH, Pietrzak RH, Cosgrove KP. Microglia-mediated neuroimmune suppression in PTSD is associated with anhedonia. Proc Natl Acad Sci U S A 2024; 121:e2406005121. [PMID: 39172786 PMCID: PMC11363315 DOI: 10.1073/pnas.2406005121] [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: 03/26/2024] [Accepted: 07/16/2024] [Indexed: 08/24/2024] Open
Abstract
Dynamic brain immune function in individuals with posttraumatic stress disorder is rarely studied, despite evidence of peripheral immune dysfunction. Positron emission tomography brain imaging using the radiotracer [11C]PBR28 was used to measure the 18-kDa translocator protein (TSPO), a microglial marker, at baseline and 3 h after administration of lipopolysaccharide (LPS), a potent immune activator. Data were acquired in 15 individuals with PTSD and 15 age-matched controls. The PTSD group exhibited a significantly lower magnitude LPS-induced increase in TSPO availability in an a priori prefrontal-limbic circuit compared to controls. Greater anhedonic symptoms in the PTSD group were associated with a more suppressed neuroimmune response. In addition, while a reduced granulocyte-macrophage colony-stimulating factor response to LPS was observed in the PTSD group, other measured cytokine responses and self-reported sickness symptoms did not differ between groups; these findings highlight group differences in central-peripheral immune system relationships. The results of this study provide evidence of a suppressed microglia-mediated neuroimmune response to a direct immune system insult in individuals with PTSD that is associated with the severity of symptoms. They also provide further support to an emerging literature challenging traditional concepts of microglial and immune function in psychiatric disease.
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Affiliation(s)
- Robin Bonomi
- Department of Psychiatry, Yale School of Medicine, New Haven, CT06511
| | - Ansel T. Hillmer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT06511
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT06520
- Yale Positron Emission Tomography Center, Yale School of Medicine, New Haven, CT06519
| | - Eric Woodcock
- Department of Psychiatry, Yale School of Medicine, New Haven, CT06511
| | - Shivani Bhatt
- Department of Psychiatry, Yale School of Medicine, New Haven, CT06511
| | | | | | - Richard E. Carson
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT06520
- Yale Positron Emission Tomography Center, Yale School of Medicine, New Haven, CT06519
| | - Margaret T. Davis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT06511
- U.S. Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, Veterans Affairs Connecticut Healthcare System, West Haven, CT06516
| | - Irina Esterlis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT06511
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT06520
- U.S. Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, Veterans Affairs Connecticut Healthcare System, West Haven, CT06516
| | - Nabeel Nabulsi
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT06520
- Yale Positron Emission Tomography Center, Yale School of Medicine, New Haven, CT06519
| | - Yiyun Huang
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT06520
- Yale Positron Emission Tomography Center, Yale School of Medicine, New Haven, CT06519
| | - John H. Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT06511
- U.S. Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, Veterans Affairs Connecticut Healthcare System, West Haven, CT06516
| | - Robert H. Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT06511
- U.S. Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, Veterans Affairs Connecticut Healthcare System, West Haven, CT06516
| | - Kelly P. Cosgrove
- Department of Psychiatry, Yale School of Medicine, New Haven, CT06511
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT06520
- U.S. Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, Veterans Affairs Connecticut Healthcare System, West Haven, CT06516
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15
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Oppo A, Forresi B, Barbieri A, Koenen KC. Trajectories of posttraumatic stress symptoms following collective violence: A systematic review and meta-analyses. J Trauma Stress 2024. [PMID: 39176467 DOI: 10.1002/jts.23090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/30/2024] [Accepted: 06/21/2024] [Indexed: 08/24/2024]
Abstract
Although collective violence represents a significant public health concern, a limited number of longitudinal studies have addressed this topic, with no systematic reviews focusing on posttraumatic stress symptom (PTSS) trajectories. The present systematic review and meta-analyses examined PTSS prevalence and trajectories after exposure to collective violence. A systematic literature search across six databases (APA PsycInfo, APA PsycArticles, PSYINDEX, MEDLINE, ERIC, and PubMed) identified 771 studies that were screened for the following eligibility criteria: exposure to collective violence, adult sample, longitudinal design, PTSS assessment using validated measures, PTSS trajectories estimated using latent growth modeling, and report sample prevalence rate for each trajectory. Ten studies met the criteria, and five meta-analyses were performed to assess the overall prevalence of each trajectory. Most included studies (63.6%) identified four trajectories, characterized as low-stable, high-stable, decreasing, and delayed-worsening. The low-stable trajectory was the modal response, with a pooled prevalence of 58.0%, 95% CI [51.0, 65.0]. The high-stable prevalence was 7.0%, 95% CI [4.0, 19.0]; the decreasing trajectory was 13%, 95% CI [9.0, 17.0]; and the delayed-worsening trajectory was 8.0%, 95% CI [5.0, 10.0]. A fifth trajectory, moderately stable, had a prevalence of 19.0%, 95% CI [9.0, 29.0]. The trajectory models robustly identified clinically relevant patterns of response to collective violence, offering a contribution to the literature and a starting point for future research. Further studies are needed, as a better comprehension of symptom trajectories after collective violence events has important clinical and public health implications.
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Affiliation(s)
- Annalisa Oppo
- Department of Psychology, Sigmund Freud University, Milan, Italy
| | - Barbara Forresi
- Department of Psychology, Sigmund Freud University, Milan, Italy
| | - Alice Barbieri
- Department of Psychology, Sigmund Freud University, Milan, Italy
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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16
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Sowden WJ, Jones RL. Amplified PTSD Symptoms From Self-Attributed Moral Transgressions Are Linked to Internalized Moral Identity During Military Deployment. Mil Med 2024; 189:156-164. [PMID: 38554270 DOI: 10.1093/milmed/usae064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/30/2024] [Accepted: 02/13/2024] [Indexed: 04/01/2024] Open
Abstract
INTRODUCTION Military personnel frequently experience stressful, morally challenging situations that can lead to posttraumatic stress disorder (PTSD). The relationships between moral identity, transgressive acts, and symptoms related to posttraumatic stress disorder (i.e., posttraumatic stress symptoms; PTSS) among U.S. Army Soldiers were assessed. MATERIALS AND METHODS A convenience cohort of 1,547 soldiers completed a survey assessing moral identity and PTSS before deployment. A subset of 505 soldiers completed another survey assessing transgressive acts and PTSS during deployment. Exploratory and confirmatory factor analyses were conducted to determine the underlying factor structure of the measures of moral identity and transgressive acts. Generalized linear modeling, robustness checks, and sensitivity analysis were used to evaluate the predictive relationships. RESULTS Moral identity did not directly predict PTSS during deployment. However, self-attributed and betrayal-based transgressive acts were significant predictors. Specifically, self-attributed transgressive acts and PTSS were moderated by internalized moral identity; individuals with a higher internalized moral identity experienced more severe PTSS following self-attributed transgressive acts. These findings were consistent across various model checks, including covariate adjustments, data imputation, and the application of a data quality filter. CONCLUSIONS The study highlights the significant role of self-attributed moral transgressions during deployment in the development of PTSS among military service members-especially in those with a strong internalized moral identity. This finding suggests a "target of opportunity" for the development of intervention strategies that mitigate PTSS by addressing the moral dimensions of military service.
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Affiliation(s)
- Walter J Sowden
- Department of Behavioral Health, Tripler Army Medical Center, Honolulu, HI 96859, USA
- Operational Research Team, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Rachell L Jones
- Operational Research Team, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
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Martin ZT, Shah AJ, Ko YA, Sheikh SAA, Daaboul O, Haddad G, Goldberg J, Smith NL, Lewis TT, Quyyumi AA, Bremner JD, Vaccarino V. Exaggerated Peripheral and Systemic Vasoconstriction During Trauma Recall in Posttraumatic Stress Disorder: A Co-Twin Control Study. Biol Psychiatry 2024; 96:278-286. [PMID: 38142719 PMCID: PMC11192861 DOI: 10.1016/j.biopsych.2023.12.014] [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: 07/27/2023] [Revised: 11/23/2023] [Accepted: 12/14/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Individuals with posttraumatic stress disorder (PTSD) face an increased risk of cardiovascular disease, but the mechanisms linking PTSD to cardiovascular disease remain incompletely understood. We used a co-twin control study design to test the hypothesis that individuals with PTSD exhibit augmented peripheral and systemic vasoconstriction during a personalized trauma recall task. METHODS In 179 older male twins from the Vietnam Era Twin Registry, lifetime history of PTSD and current (last month) PTSD symptoms were assessed. Participants listened to neutral and personalized trauma scripts while peripheral vascular tone (Peripheral Arterial Tone ratio) and systemic vascular tone (e.g., total vascular conductance) were measured. Linear mixed-effect models were used to assess the within-pair relationship between PTSD and vascular tone indices. RESULTS The mean age of participants was 68 years, and 19% had a history of PTSD. For the Peripheral Arterial Tone ratio analysis, 32 twins were discordant for a history of PTSD, and 46 were discordant for current PTSD symptoms. Compared with their brothers without PTSD, during trauma recall, participants with a history of PTSD had greater increases in peripheral (β = -1.01, 95% CI [-1.72, -0.30]) and systemic (total vascular conductance: β = -1.12, 95% CI [-1.97, -0.27]) vasoconstriction after adjusting for cardiovascular risk factors. Associations persisted after adjusting for antidepressant medication use and heart rate and blood pressure during the tasks. Analysis of current PTSD symptom severity showed consistent results. CONCLUSIONS PTSD is associated with exaggerated peripheral and systemic vasoconstrictor responses to traumatic stress reminders, which may contribute to elevated risk of cardiovascular disease.
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Affiliation(s)
- Zachary T Martin
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Amit J Shah
- Rollins School of Public Health, Emory University, Atlanta, Georgia; Emory University School of Medicine, Emory University, Atlanta, Georgia; Joseph Maxwell Cleland Atlanta VA Medical Center, Decatur, Georgia
| | - Yi-An Ko
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | | | - Obada Daaboul
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - George Haddad
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jack Goldberg
- Seattle Epidemiologic Research and Information Center, U.S. Department of Veterans Affairs Office of Research and Development, Seattle, Washington
| | - Nicholas L Smith
- Seattle Epidemiologic Research and Information Center, U.S. Department of Veterans Affairs Office of Research and Development, Seattle, Washington
| | - Tené T Lewis
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Arshed A Quyyumi
- Emory University School of Medicine, Emory University, Atlanta, Georgia
| | - J Douglas Bremner
- Emory University School of Medicine, Emory University, Atlanta, Georgia; Joseph Maxwell Cleland Atlanta VA Medical Center, Decatur, Georgia
| | - Viola Vaccarino
- Rollins School of Public Health, Emory University, Atlanta, Georgia; Emory University School of Medicine, Emory University, Atlanta, Georgia.
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18
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Landvater J, Kim S, Caswell K, Kwon C, Odafe E, Roe G, Tripathi A, Vukovics C, Wang J, Ryan K, Cocozza V, Brock M, Tchopev Z, Tonkin B, Capaldi V, Collen J, Creamer J, Irfan M, Wickwire E, Williams S, Werner JK. Traumatic brain injury and sleep in military and veteran populations: A literature review. NeuroRehabilitation 2024:NRE230380. [PMID: 39121144 DOI: 10.3233/nre-230380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2024]
Abstract
BACKGROUND Traumatic brain injury (TBI) is a hallmark of wartime injury and is related to numerous sleep wake disorders (SWD), which persist long term in veterans. Current knowledge gaps in pathophysiology have hindered advances in diagnosis and treatment. OBJECTIVE We reviewed TBI SWD pathophysiology, comorbidities, diagnosis and treatment that have emerged over the past two decades. METHODS We conducted a literature review of English language publications evaluating sleep disorders (obstructive sleep apnea, insomnia, hypersomnia, parasomnias, restless legs syndrome and periodic limb movement disorder) and TBI published since 2000. We excluded studies that were not specifically evaluating TBI populations. RESULTS Highlighted areas of interest and knowledge gaps were identified in TBI pathophysiology and mechanisms of sleep disruption, a comparison of TBI SWD and post-traumatic stress disorder SWD. The role of TBI and glymphatic biomarkers and management strategies for TBI SWD will also be discussed. CONCLUSION Our understanding of the pathophysiologic underpinnings of TBI and sleep health, particularly at the basic science level, is limited. Developing an understanding of biomarkers, neuroimaging, and mixed-methods research in comorbid TBI SWD holds the greatest promise to advance our ability to diagnose and monitor response to therapy in this vulnerable population.
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Affiliation(s)
- Jeremy Landvater
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Sharon Kim
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Keenan Caswell
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Caroline Kwon
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Emamoke Odafe
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Grace Roe
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Ananya Tripathi
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Johnathan Wang
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Keith Ryan
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Victoria Cocozza
- Wilford Hall Ambulatory Surgical Center Center, San Antonio, TX, USA
| | - Matthew Brock
- Wilford Hall Ambulatory Surgical Center Center, San Antonio, TX, USA
| | - Zahari Tchopev
- Wilford Hall Ambulatory Surgical Center Center, San Antonio, TX, USA
| | - Brionn Tonkin
- University of Minnesota, Minneapolis, MN, USA
- Minneapolis Veterans Administration Medical Center, Minneapolis, MN, USA
| | - Vincent Capaldi
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jacob Collen
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Muna Irfan
- University of Minnesota, Minneapolis, MN, USA
- Minneapolis Veterans Administration Medical Center, Minneapolis, MN, USA
| | - Emerson Wickwire
- Department of Medicine, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Scott Williams
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Defense Health Headquarters, Falls Church, VA, USA
| | - J Kent Werner
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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19
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Yang XJ, Meng XX, Zhang LB, Wang LL, Deng H, Yang YC, Zhou SJ. Mediating effects of insomnia and resilience on COVID-19-related post-traumatic stress disorder and quality of life in adolescents. Sci Rep 2024; 14:17969. [PMID: 39095413 PMCID: PMC11297128 DOI: 10.1038/s41598-024-69093-0] [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: 05/04/2024] [Accepted: 07/31/2024] [Indexed: 08/04/2024] Open
Abstract
The coronavirus disease-2019 (COVID-19) pandemic has impaired the quality of life (QoL) for many due to its extensive impacts. However, few studies have addressed the specific impact of COVID-19 on the mental health of adolescents, particularly post-traumatic stress disorder (PTSD). This study considered the impact of COVID-19-related PTSD on the QoL of adolescents in China, the mediating effects of insomnia, and the moderating effects of resilience. Participants included 50,666 adolescents aged 12-18 years selected using a comprehensive sampling method. We performed data collection from January 8th to January 18th, 2023, using the Children's Revised Impact of Event Scale, Pittsburgh Sleep Quality Index, Ten-item Connor-Davidson Resilience Scale, and Screening for and Promotion of Health-related QoL in Children and Adolescents Questionnaire for data collection. Male adolescents exhibited significantly lower levels of PTSD and insomnia compared to females and scored significantly higher in psychological resilience and overall QoL. Insomnia played a mediating role between PTSD and QoL. Psychological resilience moderated the impact of COVID-19-related stress on adolescents' QoL through its influence on insomnia. PTSD resulting from the COVID-19 pandemic affects the QoL of adolescents through the presence of insomnia. Psychological resilience plays a moderating role in this process. Cultivating psychological resilience in adolescents can effectively enhance their ability to cope with the impacts of sudden public events.
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Affiliation(s)
- Xing-Jie Yang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, 100096, China
| | - Xue-Xue Meng
- School of Psychology and Mental Health, North China University of Science and Technology, Hebei, China
| | - Li-Bin Zhang
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - Lei-Lei Wang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, 100096, China
| | - Hu Deng
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, 100096, China
| | - Yu-Chun Yang
- Faculty of Education, Beijing Normal University, Beijing, 100875, China.
| | - Shuang-Jiang Zhou
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, 100096, China.
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20
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Lu W, Bullock D, Ruszczyk L, Ettinger S, Srijeyanthan J, Caldwell B, Oursler J, Minor T, Beninato J, Hauck E. Positive PTSD Screening and Its Health Correlates in Patients With HIV in Urban Primary Care Settings. J Psychosoc Nurs Ment Health Serv 2024; 62:25-36. [PMID: 38095852 DOI: 10.3928/02793695-20231206-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Abstract
Posttraumatic stress disorder (PTSD) is underdiagnosed and undertreated in primary care, especially among African American individuals. The current study assessed documentation rates of PTSD and clinical health correlates among 135 predominantly African American patients with HIV and positive PTSD screens in a primary care unit. The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) and a retrospective chart review of 135 patients with HIV were conducted. On the PCPTSD-5 (cut point of 3), approximately one half of patients (49.6%; n = 67) had probable PTSD; however, only 11.9% of patients (n = 16) had a chart diagnosis of PTSD. A positive PTSD screen was associated with higher rates of depression and insomnia, but not anxiety, alcohol use, drug use, or pain in patients with HIV. Multi-morbidity of HIV, major depression, and positive PTSD screens was associated with increased risk for asthma, number of medical diagnoses, depression, insomnia, and anxiety. Findings highlight the need for trauma-informed care in primary care settings for people with PTSD and HIV. Larger samples are warranted to further explore health correlates of PTSD. [Journal of Psychosocial Nursing and Mental Health Services, 62(8), 25-36.].
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21
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Gazi AH, Sanchez-Perez JA, Saks GL, Alday EAP, Haffar A, Ahmed H, Herraka D, Tarlapally N, Smith NL, Bremner JD, Shah AJ, Inan OT, Vaccarino V. Quantifying Posttraumatic Stress Disorder Symptoms During Traumatic Memories Using Interpretable Markers of Respiratory Variability. IEEE J Biomed Health Inform 2024; 28:4912-4924. [PMID: 38713564 PMCID: PMC11364449 DOI: 10.1109/jbhi.2024.3397589] [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] [Indexed: 05/09/2024]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) causes heightened fight-or-flight responses to traumatic memories (i.e., hyperarousal). Although hyperarousal is hypothesized to cause irregular breathing (i.e., respiratory variability), no quantitative markers of respiratory variability have been shown to correspond with PTSD symptoms in humans. OBJECTIVE In this study, we define interpretable markers of respiration pattern variability (RPV) and investigate whether these markers respond during traumatic memories, correlate with PTSD symptoms, and differ in patients with PTSD. METHODS We recruited 156 veterans from the Vietnam-Era Twin Registry to participate in a trauma recall protocol. From respiratory effort and electrocardiogram measurements, we extracted respiratory timings and rate using a robust quality assessment and fusion approach. We then quantified RPV using the interquartile range and compared RPV between baseline and trauma recall conditions, correlated PTSD symptoms to the difference between trauma recall and baseline RPV (i.e., ∆RPV), and compared ∆RPV between patients with PTSD and trauma-exposed controls. Leveraging a subset of 116 paired twins, we then uniquely controlled for factors shared by co-twins via within-pair analysis for further validation. RESULTS We found RPV was increased during traumatic memories (p .001), ∆ RPV was positively correlated with PTSD symptoms (p .05), and patients with PTSD exhibited higher ∆ RPV than trauma-exposed controls (p . 05). CONCLUSIONS This paper is the first to elucidate RPV markers that respond during traumatic memories, especially in patients with PTSD, and correlate with PTSD symptoms. SIGNIFICANCE These findings encourage future studies outside the clinic, where interpretable markers of respiratory variability are used to track hyperarousal.
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22
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Horn AJ, Cole S, Nazarloo HP, Nazarloo P, Davis JM, Carrier D, Bryan C, Carter CS. Severe PTSD is marked by reduced oxytocin and elevated vasopressin. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2024; 19:100236. [PMID: 38764609 PMCID: PMC11101686 DOI: 10.1016/j.cpnec.2024.100236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 04/17/2024] [Accepted: 04/21/2024] [Indexed: 05/21/2024] Open
Abstract
Neuroendocrine analyses of posttraumatic stress disorder (PTSD) have generally focused on hypothalamic-pituitary-adrenal (HPA) axis alterations. In the present analyses, we examine two additional neuroendocrine factors that have been previously implicated in biological stress responses: oxytocin (OT) and arginine vasopressin (AVP). Here we examined basal neuropeptide status in military veterans clinically diagnosed with PTSD (n = 29) and in two non-traumatized comparison groups with previous stress exposure (n = 11 SWAT trainees and n = 21 ultramarathon runners). PTSD patients showed low levels of plasma OT and high levels of AVP. The ratio of AVP/OT robustly related to PTSD status, and emerged as a statistically plausible mediator of relationships between the number of personal traumatic experiences and subsequent PTSD symptom burden. Over the course of behavioral therapy for PTSD, measures of OT showed a significant but modest normalization. Plasma cortisol levels were not statistically different among the three groups. This study suggests that AVP/OT ratios may represent a neuroendocrine predictor of severe PTSD, as well as a potential treatment response biomarker.
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Affiliation(s)
| | - Steve Cole
- UCLA School of Medicine, Department of Psychiatry & Biobehavioral Sciences, Los Angeles, CA, USA
| | | | | | - John M. Davis
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - David Carrier
- Department of Biology, University of Utah, Salt Lake City, UT, USA
| | - Craig Bryan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - C. Sue Carter
- Kinsey Institute, Indiana University, Bloomington, IN, USA
- Department of Psychology, University of Virginia, Charlottesville, VA, USA
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23
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Lippi G, Favaloro EJ. Heparin and Posttraumatic Stress Disorder. Semin Thromb Hemost 2024. [PMID: 39047991 DOI: 10.1055/s-0044-1788697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, University Hospital of Verona, Verona, Italy
| | - Emmanuel J Favaloro
- Department of Haematology, Institute of Clinical Pathology and Medical Research (ICPMR), Sydney Centres for Thrombosis and Haemostasis, NSW Health Pathology, Westmead Hospital, Westmead, New South Wales, Australia
- Faculty of Science and Health, Charles Sturt University, Wagga Wagga, New South Wales, Australia
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Westmead Hospital, Westmead, New South Wales, Australia
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24
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Mitten EH, Souders A, Marron Fernandez de Velasco E, Wickman K. Stress-induced anxiety-related behavior in mice is driven by enhanced excitability of ventral tegmental area GABA neurons. Front Behav Neurosci 2024; 18:1425607. [PMID: 39086371 PMCID: PMC11288924 DOI: 10.3389/fnbeh.2024.1425607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 06/24/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Stress and trauma are significant risk factors for many neuropsychiatric disorders and diseases, including anxiety disorders. Stress-induced anxiety symptoms have been attributed to enhanced excitability in circuits controlling fear, anxiety, and aversion. A growing body of evidence has implicated GABAergic neurons of the ventral tegmental area (VTA) in aversion processing and affective behavior. Methods We used an unpredictable footshock (uFS) model, together with electrophysiological and behavioral approaches, to investigate the role of VTA GABA neurons in anxiety-related behavior in mice. Results One day after a single uFS session, C57BL/6J mice exhibited elevated anxiety-related behavior and VTA GABA neuron excitability. The enhanced excitability of VTA GABA neurons was correlated with increased glutamatergic input and a reduction in postsynaptic signaling mediated via GABAA and GABAB receptors. Chemogenetic activation of VTA GABA neurons was sufficient to increase anxiety-related behavior in stress-naïve mice. In addition, chemogenetic inhibition of VTA GABA neurons suppressed anxiety-related behavior in mice exposed to uFS. Discussion These data show that VTA GABA neurons are an early substrate for stress-induced anxiety-related behavior in mice and suggest that approaches mitigating enhanced excitability of VTA GABA neurons may hold promise for the treatment of anxiety provoked by stress and trauma.
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Affiliation(s)
- Eric H. Mitten
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN, United States
| | - Anna Souders
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, United States
| | | | - Kevin Wickman
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, United States
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25
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Lee J, Jeong Y, Park S, Kim S, Oh H, Jin JA, Sohn JW, Kim D, Shin HS, Do Heo W. Phospholipase C beta 1 in the dentate gyrus gates fear memory formation through regulation of neuronal excitability. SCIENCE ADVANCES 2024; 10:eadj4433. [PMID: 38959322 PMCID: PMC11221510 DOI: 10.1126/sciadv.adj4433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 05/28/2024] [Indexed: 07/05/2024]
Abstract
Memory processes rely on a molecular signaling system that balances the interplay between positive and negative modulators. Recent research has focused on identifying memory-regulating genes and their mechanisms. Phospholipase C beta 1 (PLCβ1), highly expressed in the hippocampus, reportedly serves as a convergence point for signal transduction through G protein-coupled receptors. However, the detailed role of PLCβ1 in memory function has not been elucidated. Here, we demonstrate that PLCβ1 in the dentate gyrus functions as a memory suppressor. We reveal that mice lacking PLCβ1 in the dentate gyrus exhibit a heightened fear response and impaired memory extinction, and this excessive fear response is repressed by upregulation of PLCβ1 through its overexpression or activation using a newly developed optogenetic system. Last, our results demonstrate that PLCβ1 overexpression partially inhibits exaggerated fear response caused by traumatic experience. Together, PLCβ1 is crucial in regulating contextual fear memory formation and potentially enhancing the resilience to trauma-related conditions.
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Affiliation(s)
- Jinsu Lee
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Yeonji Jeong
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Seahyung Park
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Sungsoo Kim
- Department of Pathology and Cell Biology, Columbia University, New York, NY 10032, USA
| | - Hyunsik Oh
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Ju-Ae Jin
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Jong-Woo Sohn
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Daesoo Kim
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
- Department of Brain and Cognitive Sciences, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Hee-Sup Shin
- Center for Cognition and Sociality, Institute for Basic Science (IBS), Daejeon 34141, Korea
| | - Won Do Heo
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
- Department of Brain and Cognitive Sciences, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
- KAIST Institute for the BioCentury (KIB), Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea
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26
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Millot F, Endomba FT, Forestier N. Light Therapy in Post-Traumatic Stress Disorder: A Systematic Review of Interventional Studies. J Clin Med 2024; 13:3926. [PMID: 38999491 PMCID: PMC11242885 DOI: 10.3390/jcm13133926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/01/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
Background: Due to limitations in treatment strategies for post-traumatic stress disorders (PTSD), therapeutic options such as light therapy (LT) have garnered some interest in recent years. We aimed to review the effectiveness of LT in patients with PTSD. Methods: Using PubMed, PsycINFO, Web of Science, the Cochrane database, ClinicalTrials.gov, and PTSDpubs, we systematically searched for papers assessing the effect of LT in PTSD. We evaluated the risk of bias of included studies using the Cochrane handbook, and synthesized our findings following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA 2020). Results: From 140 initial papers, we included four randomized controlled trials (RCTs) and one single-arm study. The study sample size ranged between 15 and 82, the mean age (standard deviation) varied between 31.4 (8.8) and 44.9 (11.8) years, and LT was applied for four or six weeks. The risk of bias was low in three studies, and of some concern in the two other trials. Most studies reported no significant differences between LT and placebo regarding effects on subjective (sleep quality and insomnia severity) and objective sleep parameters. LT was associated with a significant improvement in PTSD symptom severity in the single-arm study and two RCTs, as well as a greater retention of extinction learning. Results on depression and anxiety were discrepant. Conclusions: This review revealed that relevant studies are scarce, with promising findings concerning PTSD symptoms, but inconsistencies for the other parameters. Further research projects are needed to better explore this topic.
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Affiliation(s)
- Florian Millot
- Psychiatry Internship Program, University of Burgundy, Dijon, France
| | - Francky Teddy Endomba
- Service de Psychiatrie Adultes, Centre Hospitalier Universitaire, Dijon, France
- INSERM LNC UMR1231, University of Burgundy, Dijon, France
| | - Nathalie Forestier
- Service de Psychiatrie Adultes, Centre Hospitalier Universitaire, Dijon, France
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27
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Bhargava A, Knapp JD, Fiehn O, Neylan TC, Inslicht SS. An exploratory study on lipidomic profiles in a cohort of individuals with posttraumatic stress disorder. Sci Rep 2024; 14:15256. [PMID: 38956202 PMCID: PMC11219863 DOI: 10.1038/s41598-024-62971-7] [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: 02/21/2024] [Accepted: 05/23/2024] [Indexed: 07/04/2024] Open
Abstract
Posttraumatic stress disorder (PTSD) can develop after trauma exposure. Some studies report that women develop PTSD at twice the rate of men, despite greater trauma exposure in men. Lipids and their metabolites (lipidome) regulate a myriad of key biological processes and pathways such as membrane integrity, oxidative stress, and neuroinflammation in the brain by maintaining neuronal connectivity and homeostasis. In this study, we analyzed the lipidome of 40 adults with PTSD and 40 trauma-exposed non-PTSD individuals (n = 20/sex/condition; 19-39 years old). Plasma samples were analyzed for lipidomics using Quadrupole Time-of-Flight (QToF) mass spectrometry. Additionally, ~ 90 measures were collected, on sleep, and mental and physical health indices. Poorer sleep quality was associated with greater PTSD severity in both sexes. The lipidomics analysis identified a total of 348 quantifiable known lipid metabolites and 1951 lipid metabolites that are yet unknown; known metabolites were part of 13 lipid subclasses. After adjusting for BMI and sleep quality, in women with PTSD, only one lipid subclass, phosphatidylethanolamine (PE) was altered, whereas, in men with PTSD, 9 out of 13 subclasses were altered compared to non-PTSD women and men, respectively. Severe PTSD was associated with 22% and 5% of altered lipid metabolites in men and women, respectively. Of the changed metabolites, only 0.5% measures (2 PEs and cholesterol) were common between women and men with PTSD. Several sphingomyelins, PEs, ceramides, and triglycerides were increased in men with severe PTSD. The correlations between triglycerides and ceramide metabolites with cholesterol metabolites and systolic blood pressure were dependent upon sex and PTSD status. Alterations in triglycerides and ceramides are linked with cardiac health and metabolic function in humans. Thus, disturbed sleep and higher body mass may have contributed to changes in the lipidome found in PTSD.
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Affiliation(s)
- Aditi Bhargava
- Department of Obstetrics and Gynecology, Center for Reproductive Sciences, University of California San Francisco, San Francisco, CA, 94143, USA.
- Aseesa Inc., Hillsborough, CA, 94010, USA.
| | | | - Oliver Fiehn
- NIH West Coast Metabolomics Center, University of California Davis Genome Center, Davis, CA, 95616, USA
| | - Thomas C Neylan
- San Francisco VA Health Care System, 4150 Clement St. (116P), San Francisco, CA, 94121, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Sabra S Inslicht
- San Francisco VA Health Care System, 4150 Clement St. (116P), San Francisco, CA, 94121, USA.
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, 94143, USA.
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28
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Adrien V, Bosc N, Peccia Galletto C, Diot T, Claverie D, Reggente N, Trousselard M, Bui E, Baubet T, Schoeller F. Enhancing Agency in Posttraumatic Stress Disorder Therapies Through Sensorimotor Technologies. J Med Internet Res 2024; 26:e58390. [PMID: 38742989 PMCID: PMC11250045 DOI: 10.2196/58390] [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: 03/14/2024] [Revised: 04/17/2024] [Accepted: 05/02/2024] [Indexed: 05/16/2024] Open
Abstract
Posttraumatic stress disorder (PTSD) is a significant public health concern, with only a third of patients recovering within a year of treatment. While PTSD often disrupts the sense of body ownership and sense of agency (SA), attention to the SA in trauma has been lacking. This perspective paper explores the loss of the SA in PTSD and its relevance in the development of symptoms. Trauma is viewed as a breakdown of the SA, related to a freeze response, with peritraumatic dissociation increasing the risk of PTSD. Drawing from embodied cognition, we propose an enactive perspective of PTSD, suggesting therapies that restore the SA through direct engagement with the body and environment. We discuss the potential of agency-based therapies and innovative technologies such as gesture sonification, which translates body movements into sounds to enhance the SA. Gesture sonification offers a screen-free, noninvasive approach that could complement existing trauma-focused therapies. We emphasize the need for interdisciplinary collaboration and clinical research to further explore these approaches in preventing and treating PTSD.
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Affiliation(s)
- Vladimir Adrien
- Department of Infectious and Tropical Diseases, Avicenne Hospital, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
- Institute of Psychiatry and Neuroscience of Paris, Inserm UMR-S 1266, Université Paris Cité, Paris, France
- Department of Psychopathology, Avicenne Hospital, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
| | - Nicolas Bosc
- Department of Psychopathology, Avicenne Hospital, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
| | | | - Thomas Diot
- Department of Adult Psychiatry, Impact, Mondor Hospital, AP-HP, Université Paris-Est Créteil, Créteil, France
| | - Damien Claverie
- Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Nicco Reggente
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
| | - Marion Trousselard
- Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
- INSPIIRE, Inserm UMR 1319, Université de Lorraine, Nancy, France
- ADES, CNRS UMR 7268, Aix-Marseille Université, Marseille, France
| | - Eric Bui
- Department of Psychiatry, Caen Normandy University Hospital, Normandie Université, Caen, France
- Physiopathology and Imaging of Neurological Disorders, UNICAEN, Inserm UMR-S 1237, Normandie Université, Caen, France
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Thierry Baubet
- Department of Psychopathology, Avicenne Hospital, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
- Unité Transversale de Psychogénèse et Psychopathologie, Université Sorbonne Paris Nord, Villetaneuse, France
- Centre National de Ressources et de Résilience, Lille, France
| | - Félix Schoeller
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, United States
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Hori H, Fukushima H, Nagayoshi T, Ishikawa R, Zhuo M, Yoshida F, Kunugi H, Okamoto K, Kim Y, Kida S. Fear memory regulation by the cAMP signaling pathway as an index of reexperiencing symptoms in posttraumatic stress disorder. Mol Psychiatry 2024; 29:2105-2116. [PMID: 38409596 PMCID: PMC11408251 DOI: 10.1038/s41380-024-02453-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 01/11/2024] [Accepted: 01/23/2024] [Indexed: 02/28/2024]
Abstract
Posttraumatic stress disorder (PTSD) is a psychiatric disorder associated with traumatic memory, yet its etiology remains unclear. Reexperiencing symptoms are specific to PTSD compared to other anxiety-related disorders. Importantly, reexperiencing can be mimicked by retrieval-related events of fear memory in animal models of traumatic memory. Recent studies revealed candidate PTSD-associated genes that were related to the cyclic adenosine monophosphate (cAMP) signaling pathway. Here, we demonstrate the tight linkage between facilitated cAMP signaling and PTSD by analyzing loss- and gain-of-cAMP signaling effects on fear memory in mice and the transcriptomes of fear memory-activated mice and female PTSD patients with reexperiencing symptoms. Pharmacological and optogenetic upregulation or downregulation of cAMP signaling transduction enhanced or impaired, respectively, the retrieval and subsequent maintenance of fear memory in mice. In line with these observations, integrative mouse and human transcriptome analysis revealed the reduced mRNA expression of phosphodiesterase 4B (PDE4B), an enzyme that degrades cAMP, in the peripheral blood of PTSD patients showing more severe reexperiencing symptoms and the mouse hippocampus after fear memory retrieval. Importantly, more severe reexperiencing symptoms and lower PDE4B mRNA levels were correlated with decreased DNA methylation of a locus within PDE4B, suggesting the involvement of methylation in the mechanism of PTSD. These findings raise the possibility that the facilitation of cAMP signaling mediating the downregulation of PDE4B expression enhances traumatic memory, thereby playing a key role in the reexperiencing symptoms of PTSD patients as a functional index of these symptoms.
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Affiliation(s)
- Hiroaki Hori
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan.
| | - Hotaka Fukushima
- Department of Bioscience, Graduate School of Life Sciences, Tokyo University of Agriculture, Tokyo, 156-8502, Japan
| | - Taikai Nagayoshi
- Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, 113-8657, Japan
| | - Rie Ishikawa
- Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, 113-8657, Japan
| | - Min Zhuo
- Department of Physiology, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, Canada
| | - Fuyuko Yoshida
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
- Department of Psychiatry, Teikyo University School of Medicine, Tokyo, 173-8605, Japan
| | - Kenichi Okamoto
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, 600 University Avenue, Toronto, ON, Canada
- Department of Molecular Genetics, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, Canada
| | - Yoshiharu Kim
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan.
| | - Satoshi Kida
- Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, 113-8657, Japan.
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30
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Wile B, Skowronski K, Shariati K, Olagunju AT. Promoting mental well-being among parents in the neonatal intensive care unit: a perspective on the role of Physician Associates. J Perinatol 2024; 44:1069-1072. [PMID: 38499755 DOI: 10.1038/s41372-024-01936-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 03/08/2024] [Accepted: 03/11/2024] [Indexed: 03/20/2024]
Abstract
Emotional disorders in parents of infants admitted to the neonatal intensive care unit (NICU) carry the potential for serious ramifications in neonatal and childhood outcomes. Despite this, current NICU mental health supports are less than optimum; postpartum mental health screening is limited, often missed in parents of inpatient infants, and may not be applicable to all family structures. Current evidence demonstrates improved outcomes in neonates and family members with early identification and multidisciplinary approaches to managing mental health problems. Physician Associates/Assistants (PAs) are a skilled group of advanced practice providers who are often a point of first contact for parents in the NICU, helping maintain continuity of care. In this perspective, we underscore leveraging the skills of PAs to promote the emotional wellbeing of parents in the NICU by way of practice and policy involvement. We also included a generic set of recommendations to equip PAs in this role.
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Affiliation(s)
- Brooke Wile
- Neonatal Intensive Care Unit, McMaster Children's Hospital, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada
- Physician Assistant Education Program, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Karolina Skowronski
- Neonatal Intensive Care Unit, McMaster Children's Hospital, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada
| | - Khashayar Shariati
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada.
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, 5000, Australia.
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31
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Biggs AT, Seech TR, Johnston SL, Russell DW. Psychological endurance: how grit, resilience, and related factors contribute to sustained effort despite adversity. THE JOURNAL OF GENERAL PSYCHOLOGY 2024; 151:271-313. [PMID: 37697826 DOI: 10.1080/00221309.2023.2253955] [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: 05/24/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023]
Abstract
Many concepts describe how individuals sustain effort despite challenging circumstances. For example, scholars and practitioners may incorporate discussions of grit, hardiness, self-control, and resilience into their ideas of performance under adversity. Although there are nuanced points underlying each construct capable of generating empirically sound propositions, the shared attributes make them difficult to differentiate. As a result, substantial confusion arises when debating how these related factors concomitantly contribute to success, especially when practitioners attempt to communicate these ideas in applied settings. The model proposed here-psychological endurance-is a unified theory to explore how multiple concepts contribute to sustained goal-directed behaviors and individual success. Central to this model is the metaphor of a psychological battery, which potentiates and sustains optimal performance despite adversity. Grit and hardiness are associated with the maximum charge of the psychological battery, or how long an individual could sustain effort. Self-control modulates energy management that augments effort required to sustain endurance, whereas resilience represents the ability to recharge. These factors are constrained by both psychological and physiological stressors in the environment that drain the psychology battery. Taken together, these ideas form a novel framework to discuss related psychological concepts, and ideally, optimize intervention to enhance psychological endurance.
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Melani MS, Paiva JM, Mendlowicz MV, Vilete L, Luz MP, Ventura PR, Passos RBF, Berger W. Are There Differences Among Evidence-Based Psychotherapies for Treating Different DSM-5 PTSD Symptom Clusters? A Systematic Review and Meta-analysis of Controlled Clinical Trials. J Nerv Ment Dis 2024; 212:332-343. [PMID: 38810096 DOI: 10.1097/nmd.0000000000001769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
ABSTRACT Posttraumatic stress disorder (PTSD) is a heterogeneous disease defined by four Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) symptom clusters: reexperiencing, avoidance, negative alterations in cognitions and mood, and hyperarousal. There are effective evidence-based psychotherapies (EBPs) for PTSD. However, given the variety of PTSD clinical presentations, we conducted the first meta-analysis investigating whether DSM-5 PTSD symptom clusters show different responses to EBPs. We systematically reviewed the literature for controlled clinical trials in five databases, performed a meta-analysis, and evaluated the methodological quality of the studies. We screened 633 studies and included seven. Three showed high risk, two showed some concerns, and one showed a low risk of bias. The symptom clusters do not seem to respond differently to EBPs (SMD cluster B: -0.40; 95% confidence interval [CI], -0.87 to 0.08; cluster C: -0.49; 95% CI, -0.90 to -0.08; cluster D: -0.44; 95% CI, -0.94 to 0.05; cluster E: -0.54; 95% CI, -1.07 to -0.0), even when analyzed by the therapeutic focuses. The findings dovetail nicely with the network theory of PTSD symptom, as although it is a heterogeneous disorder, the EBPs seem to promote a kind of cascade of symptom improvement.
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Affiliation(s)
- Marina S Melani
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro
| | - Jéssica M Paiva
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro
| | | | - Liliane Vilete
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro
| | - Mariana P Luz
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro
| | - Paula Rui Ventura
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro
| | | | - William Berger
- Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro
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Lu W, Mueser KT, Yanos PT, Jia Y, Siriram A, Bullock D, Wang K, Silverstein SM, Gottlieb J, Rogers K, Aftab PG, Rosenberg SD. Factor structure of posttraumatic stress disorder (PTSD) in persons with serious mental illness. J Ment Health 2024; 33:366-375. [PMID: 38804258 PMCID: PMC11373362 DOI: 10.1080/09638237.2024.2332809] [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: 06/19/2023] [Revised: 03/06/2024] [Accepted: 03/14/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Trauma and posttraumatic stress disorder (PTSD) are common among individuals with serious mental illness (SMI; e.g., schizophrenia, schizoaffective disorder, bipolar disorder, treatment refractory major depressive disorder), with resultant functional impairment. Previous studies have not evaluated the factor structure of the PTSD Checklist (PCL) among persons with SMI. AIMS This study evaluated the factor structure of the PCL in two large SMI samples from public mental health treatment sectors screened for PTSD using the PCL. METHODS Four different models of PTSD were tested using confirmatory factor analyses. RESULTS Results indicated that the DSM-5 4-factor model (intrusion, avoidance, numbing, and hyperarousal) had the best fit. Further, the DSM-5 4-factor model demonstrated measurement invariance. CONCLUSIONS Results supported the suitability of the DSM-5 4-factor model of PTSD among people with SMI.
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Affiliation(s)
- Weili Lu
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, New Brunswick, New Jersey, USA
| | - Kim T Mueser
- Center for Psychiatric Rehabilitation, Boston University, Boston, Massachusetts, USA
| | - Philip T Yanos
- Psychology Department, City University of New York, New York, New York, USA
| | - Yuane Jia
- Department of Interdisciplinary Studies, Rutgers University, New Brunswick, New Jersey, USA
| | - Amanda Siriram
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, New Brunswick, New Jersey, USA
| | - Deanna Bullock
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, New Brunswick, New Jersey, USA
| | - Ke Wang
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, New Brunswick, New Jersey, USA
| | - Steven M Silverstein
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - Jennifer Gottlieb
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Krista Rogers
- Psychology Department, City University of New York, New York, New York, USA
| | - Pouya G Aftab
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, New Brunswick, New Jersey, USA
| | - Stanley D Rosenberg
- Department of Psychiatry, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA
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Christoffersen MN, Thorup AAE. Post-traumatic Stress Disorder in School-age Children: A Nationwide Prospective Birth Cohort Study. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:139-157. [PMID: 38938938 PMCID: PMC11199452 DOI: 10.1007/s40653-024-00611-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 06/29/2024]
Abstract
Traumatic childhood events are some of the few identifiable and to some extent preventable causes of psychiatric illness. Children exposed to severely stressful events may react with post-traumatic stress disorder (PTSD) and this may impact their level of function in daily life, their future development and mental health. The traumatic stress model suggests that traumatic stress in the family, community violence, and other traumas are regarded as additive environmental factors that can outweigh protective compensatory factors and thus interact with individual vulnerabilities. This study is based on prospective panel data including the whole population of children born in Denmark from 1984 to 1994, who are followed from age 7 to age 18 (N = 679,000) in the window between 2001 and 2012. Risk factors for first-time diagnose with PTSD are analyzed by the discrete time log-odd model. We found a lifetime prevalence of 2.3% PTSD in school-age children (n = 15,636). In accordance with the model, indicators of traumatic stress in the family, family disintegration, community violence, and individual vulnerabilities predicted later diagnose with PTSD. Individual neurodevelopmental disorder - especially autism (adjusted Odds Ratio (OR 7.1) and ADHD (OR 10.7) - were predicative of PTSD. The results cooperated the traumatic stress model. Some results were inconsistent with the traumatic stress model e.g., parental substance abuse were associated with less than expected PTSD in school-age children when adjusted for other risk factors. This indicates that PTSD may be underestimated in these groups. PTSD diagnoses in administrative records underestimate the prevalence, systematically. Efforts to increase PTSD screening may allow for better management.
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Affiliation(s)
| | - Anne A. E. Thorup
- Faculty for Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Su LJ, Chen MJ, Yang R, Zou H, Chen TT, Li SL, Xin HN, Hu RF. Investigating the correlation of delirium after cardiac surgery with memories and posttraumatic stress disorder consequences of intensive care unit: A prospective cohort study. Intensive Crit Care Nurs 2024; 82:103632. [PMID: 38290221 DOI: 10.1016/j.iccn.2024.103632] [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: 10/19/2023] [Revised: 01/11/2024] [Accepted: 01/20/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVES To explore the differences in post-intensive care unit memory and posttraumatic stress disorder symptoms between patients with and without delirium, and assess the correlations between the two. DESIGN Prospective cohort observation study. SETTING A cardiac intensive care unit of a tertiary hospital in China. We enrolled 318 consecutive patients after cardiac surgery between December 2017 and March 2019. MAIN OUTCOME MEASURES Delirium was assessed using the Confusion Assessment Method for the ICU from intensive care unit admission to discharge. Intensive care unit memory was assessed using the ICU-Memory Tool through face-to-face interviews one week after discharge. Posttraumatic stress disorder was measured telephonically using the Impact of Events Scale-revised questionnaire at three months post-discharge. RESULTS Eighty patients each in the delirium and non-delirium groups were enrolled for follow-up interviews. Patients with delirium had vaguer memories of pre-intensive care unit admission and of their stay, and recollected more memories of feelings (vs. without delirium). Posttraumatic stress disorder was diagnosed in 14 patients with and in seven without delirium, with non-significant differences between groups. Delirium did not influence post-intensive care unit factual, feeling, and delusional memories, nor posttraumatic stress disorder and hyperarousal, intrusion, and avoidance. The memories of feelings were positively correlated with the last three (r = 0.285, r = 0.390 and r = 0.373, respectively). CONCLUSION Patients with delirium had vague intensive care unit memories. Memories of feelings were positively correlated with symptoms of hyperarousal, intrusion, and avoidance. Delirium did not influence factual, feeling, or delusional memories nor posttraumatic stress disorder incidence and symptoms. IMPLICATIONS FOR CLINICAL PRACTICE Interventions are needed to reduce the impact of vague memory in patients with post-intensive care unit delirium. Memories of feelings should be focused on because of their correlation with hyperarousal, intrusion, and avoidance. Delirium prevention and early recognition measures are suggested.
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Affiliation(s)
- Li-Jing Su
- School of Nursing, Fujian Medical University, Fuzhou, Fujian Province 350122, China
| | - Mei-Jing Chen
- School of Nursing, Fujian Medical University, Fuzhou, Fujian Province 350122, China
| | - Rong Yang
- Follow-Up Center, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China
| | - Hong Zou
- Department of Clinical Laboratory, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China
| | - Ting-Ting Chen
- School of Nursing, Fujian Medical University, Fuzhou, Fujian Province 350122, China
| | - Sai-Lan Li
- Department of Cardiac Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China
| | - Hui-Ning Xin
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province 350001, China.
| | - Rong-Fang Hu
- School of Nursing, Fujian Medical University, Fuzhou, Fujian Province 350122, China.
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Lapping-Carr L, Pappa ML. Evidence for the Impact of Stress and Trauma on Sexual Function in Women: Review and Clinical Recommendations. Obstet Gynecol Clin North Am 2024; 51:285-298. [PMID: 38777484 DOI: 10.1016/j.ogc.2024.02.003] [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] [Indexed: 05/25/2024]
Abstract
Stressors occur in a spectrum, ranging from daily hassles to life-threatening experiences, and can significantly impact sexual functioning. Thus, this review summarizes the intricate relationship between trauma spectrum experiences and women's sexual functioning. Biological mechanisms are described to elucidate the physiologic complexity that manifests because of trauma-related experiences. Additionally, both psychological and social implications are discussed. Treatment recommendations for practitioners working with women are discussed, underscoring the importance of adopting a trauma-informed care model.
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Affiliation(s)
- Leiszle Lapping-Carr
- Northwestern University, 676 North St Clair Street, Suite 1100, Chicago, IL 60611, USA.
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Nikolaeva M, Arefieva A, Babayan A, Aksenov V, Zhukova A, Kalinina E, Krechetova L, Sukhikh G. Stress Biomarkers Transferred Into the Female Reproductive Tract by Seminal Plasma Are Associated with ICSI Outcomes. Reprod Sci 2024; 31:1732-1746. [PMID: 38393625 DOI: 10.1007/s43032-024-01486-y] [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: 09/15/2023] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
This study aimed to determine whether male stress is related to seminal stress biomarkers and pregnancy achievement in women exposed to their partner's seminal plasma (SP) in the intracytoplasmic sperm injection (ICSI) cycle. In this pilot prospective study, 20 couples undergoing ICSI, as well as 5 fertile sperm donors and 10 saliva donors, were investigated. Women were exposed to their partner's SP via unprotected sexual intercourse during the ICSI cycle and intravaginal application on the day of ovum pick-up (Day-OPU). Semen samples were collected from male partners by masturbation on the Day-OPU. Saliva and serum samples were collected prior to masturbation. Body fluids were frozen at - 80 °C until assayed. Biomarkers of activity of the sympathetic adrenomedullary axis (salivary alpha-amylase and adrenaline), sympathetic neural axis (noradrenaline and dopamine), hypothalamic-pituitary-adrenal (HPA) system (cortisol), and immune system (C-reactive protein and interleukin (IL)-18) were estimated to examine their association with SP composition and clinical pregnancy achievement. The clinical pregnancy rate was 45.0%. In the unsuccessful ICSI group, blunted levels of salivary and serum cortisol were found compared to the successful ICSI group and the fertile sperm donors. With regard to seminal markers, decreased cortisol level and elevated noradrenaline, noradrenaline/cortisol ratio, and lL-18 levels were strongly associated with ICSI failure (areas under the ROC curves were, 0.813, 0.848, 0.899, and 0.828, respectively). These findings confirm that stress response systems activity affects SP composition, which in turn is associated with ICSI outcomes in women exposed to their partner's SP during an ICSI cycle.
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Affiliation(s)
- Marina Nikolaeva
- Laboratory of Clinical Immunology, National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov, Ministry of Health of the Russian Federation, Moscow, Russia.
| | - Alla Arefieva
- Laboratory of Clinical Immunology, National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Alina Babayan
- Department of Assisted Technologies in Treatment of Infertility, National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov, Ministry of Health of the Russian Federation, Moscow, Russia
| | | | - Anastasia Zhukova
- Laboratory of Clinical Immunology, National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Elena Kalinina
- Department of Assisted Technologies in Treatment of Infertility, National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Liubov Krechetova
- Laboratory of Clinical Immunology, National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Gennady Sukhikh
- Laboratory of Clinical Immunology, National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov, Ministry of Health of the Russian Federation, Moscow, Russia
- First Moscow State Medical University Named After I.M. Sechenov, Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
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Reed J, Meiser-Stedman R, Dalgleish T, Goodall B, Wright I, Boyle A, Burgess A, Murphy F, Hitchcock C, Schweizer S, Travers-Hill E, Dixon C, Mul CL, Smith P, Newby J, McKinnon A. Trauma Memory Characteristics and Neurocognitive Performance in Youth Exposed to Single-Event Trauma. Res Child Adolesc Psychopathol 2024; 52:997-1008. [PMID: 38329684 PMCID: PMC11108885 DOI: 10.1007/s10802-024-01171-3] [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] [Accepted: 01/19/2024] [Indexed: 02/09/2024]
Abstract
Cognitive models of posttraumatic stress disorder (PTSD) highlight characteristics of trauma memories, such as disorganisation, as key mechanisms in the aetiology of the disorder. However, studies investigating trauma memory in youth have provided inconsistent findings. Research has highlighted that PTSD in youth may be accompanied by difficulties in neurocognitive functioning, potentially impacting ability to recall the trauma memory. The present study sought to investigate both trauma memory characteristics and neurocognitive functioning in youth aged 8-17 years. Youths exposed to single-event trauma, with (N = 29, Mage = 13.6, 21 female) and without (N = 40, Mage = 13.3, 21 female) a diagnosis of PTSD, completed self-report measures of trauma memory, a narrative memory task and a set of neurocognitive tests two to six months post-trauma. A group of non trauma-exposed youths (N = 36, Mage = 13.9, 27 female) were compared on narrative and neurocognitive tasks. Results indicated that trauma memories in youth with, versus without, PTSD were more sensory-laden, temporally disrupted, difficult to verbally access, and formed a more 'central' part of their identity. Greater differences were observed for self-reported memory characteristics compared to narrative characteristics. No between group differences in neurocognitive function were observed. Self-reported trauma memory characteristics highlight an important factor in the aetiology of PTSD. The observed lack of significant differences in neurocognitive ability potentially suggests that cognitive factors represent a more relevant treatment target than neurocognitive factors in single-event PTSD. Further research to understand the cognitive factors represented by self-reported trauma memory characteristics is recommended.
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Affiliation(s)
- Joanna Reed
- Department of Clinical Psychology, University of East Anglia, Norwich, UK.
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK
| | - Tim Dalgleish
- Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK
| | - Ben Goodall
- Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK
| | - Isobel Wright
- Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK
| | - Adrian Boyle
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Aaron Burgess
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK
| | - Fionnuala Murphy
- Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK
| | - Caitlin Hitchcock
- Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK
| | - Susanne Schweizer
- Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK
| | - Emma Travers-Hill
- Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK
| | - Clare Dixon
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Cari-Lène Mul
- Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK
| | - Patrick Smith
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jill Newby
- Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK
| | - Anna McKinnon
- Centre for Emotional Health, Macquarie University, Sydney, Australia
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Wang Z, Zhang L, Yang J, Zeng Y, Su C, Yao M, Zhang H, Hu W, Liu Y, Lai Y, Wang X, Zeng J, Liu R. Chronic stress induces Alzheimer's disease-like pathologies through DNA damage-Chk1-CIP2A signaling. Aging (Albany NY) 2024; 16:9168-9187. [PMID: 38819231 PMCID: PMC11164505 DOI: 10.18632/aging.205862] [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: 12/19/2023] [Accepted: 03/19/2024] [Indexed: 06/01/2024]
Abstract
Stress is an important initiating factor in promoting Alzheimer's disease (AD) pathogenesis. However, the mechanism by which stress induces AD-like cognitive impairment remains to be clarified. Here, we demonstrate that DNA damage is increased in stress hormone Corticotropin-releasing factor (CRF)-treated cells and in brains of mice exposed to chronic restraint stress. Accumulation of DNA damage drives activation of cell cycle checkpoint protein kinase 1 (Chk1), upregulation of cancerous inhibitor of PP2A (CIP2A), tau hyperphosphorylation, and Aβ overproduction, eventually resulting in synaptic impairment and cognitive deficits. Pharmacological intervention targeting Chk1 by specific inhibitor and DNA damage by vitamin C, suppress DNA damage-Chk1-CIP2A signaling pathway in chronic stress animal model, which in turn attenuate AD-like pathologies, synaptic impairments and cognitive deficits. Our study uncovers a novel molecular mechanism of stress-induced AD-like pathologies and provides effective preventive and therapeutic strategies targeting this signaling pathway.
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Affiliation(s)
- Zhuoqun Wang
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lun Zhang
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Clinical Laboratory, Wuhan Fourth Hospital, Wuhan, China
| | - Jiayu Yang
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Zeng
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chengke Su
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengdong Yao
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiliang Zhang
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenting Hu
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Pathology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yi Liu
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yiwen Lai
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaochuan Wang
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Shenzhen Huazhong University of Science and Technology Research Institute, Shenzhen, China
| | - Ji Zeng
- Department of Clinical Laboratory, Wuhan Fourth Hospital, Wuhan, China
| | - Rong Liu
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Shenzhen Huazhong University of Science and Technology Research Institute, Shenzhen, China
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute for Brain Research, Wuhan Center of Brain Science, Huazhong University of Science and Technology, Wuhan, China
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Rankins EM, Quinn A, McKeever KH, Malinowski K. Ground-based adaptive horsemanship lessons for veterans with post-traumatic stress disorder: a randomized controlled pilot study. Front Psychiatry 2024; 15:1390212. [PMID: 38863605 PMCID: PMC11165701 DOI: 10.3389/fpsyt.2024.1390212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/10/2024] [Indexed: 06/13/2024] Open
Abstract
Introduction Equine-assisted services (EAS) has received attention as a potential treatment strategy for post-traumatic stress disorder (PTSD), as existing literature indicates that symptoms may decrease following EAS. Relatively little is known about the mechanisms at play during lessons and if physiological measures are impacted. The objectives of this pilot study were to 1) explore the effects of adaptive horsemanship (AH) lessons on symptoms of PTSD, hormone concentrations, and social motor synchrony; 2) determine if physiological changes occur as veterans interact with horses; and 3) explore if the interaction between veteran and horse changes over the 8-week session. Methods Veterans with PTSD were randomly assigned to control (CON, n = 3) or AH (n = 6) groups for an 8-week period (clinical trial; NCT04850573; clinicaltrials.gov). Veterans completed the PTSD Checklist (PCL-5) and Brief Symptom Inventory (BSI) at pre-, post-, and 2- and 6-month follow-up time points. They also completed a social motor synchrony test (pendulum swinging) and blood draw at pre- and post-time points. In weeks 1, 4, and 8, blood samples were drawn at 0 min, 3 min, 5 min, 25 min, and 30 min during the 30-min AH lessons. Veterans completed the Human-Animal Interaction Scale (HAIS) after each lesson. Blood samples were assayed for plasma cortisol, epinephrine, norepinephrine, and oxytocin. Data were analyzed with repeated measure ANOVAs. Changes in PTSD symptoms from pre- to post-time point were analyzed with paired t-tests. Results Changes in PCL-5 scores tended to differ (p = 0.0989), and global BSI scores differed (p = 0.0266) between AH (-11.5 ± 5.5, mean ± SE; -0.5 ± 0.2) and CON (5.3 ± 5.4; 0.4 ± 0.2) groups. Social motor synchrony and hormone concentrations did not differ between groups or time points (p > 0.05). Cortisol, norepinephrine, and oxytocin concentrations did not differ across sessions (p > 0.05). Epinephrine concentrations tended (p = 0.0744) to decrease from week 1 to 4 of sessions. HAIS scores increased (p ≥ 0.0437) in week 3 and remained elevated as compared to week 1. Discussion Participant recruitment was the greatest challenge. These preliminary results agree with the literature suggesting that EAS can reduce symptoms of PTSD.
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Affiliation(s)
- Ellen M. Rankins
- Equine Science Center, Department of Animal Sciences, Rutgers University, New Brunswick, NJ, United States
| | - Andrea Quinn
- Center for Psychological Services, Rutgers University, New Brunswick, NJ, United States
| | - Kenneth H. McKeever
- Equine Science Center, Department of Animal Sciences, Rutgers University, New Brunswick, NJ, United States
| | - Karyn Malinowski
- Equine Science Center, Department of Animal Sciences, Rutgers University, New Brunswick, NJ, United States
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Stasiłowicz-Krzemień A, Nogalska W, Maszewska Z, Maleszka M, Dobroń M, Szary A, Kępa A, Żarowski M, Hojan K, Lukowicz M, Cielecka-Piontek J. The Use of Compounds Derived from Cannabis sativa in the Treatment of Epilepsy, Painful Conditions, and Neuropsychiatric and Neurodegenerative Disorders. Int J Mol Sci 2024; 25:5749. [PMID: 38891938 PMCID: PMC11171823 DOI: 10.3390/ijms25115749] [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: 03/12/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Neurological disorders present a wide range of symptoms and challenges in diagnosis and treatment. Cannabis sativa, with its diverse chemical composition, offers potential therapeutic benefits due to its anticonvulsive, analgesic, anti-inflammatory, and neuroprotective properties. Beyond cannabinoids, cannabis contains terpenes and polyphenols, which synergistically enhance its pharmacological effects. Various administration routes, including vaporization, oral ingestion, sublingual, and rectal, provide flexibility in treatment delivery. This review shows the therapeutic efficacy of cannabis in managing neurological disorders such as epilepsy, neurodegenerative diseases, neurodevelopmental disorders, psychiatric disorders, and painful pathologies. Drawing from surveys, patient studies, and clinical trials, it highlights the potential of cannabis in alleviating symptoms, slowing disease progression, and improving overall quality of life for patients. Understanding the diverse therapeutic mechanisms of cannabis can open up possibilities for using this plant for individual patient needs.
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Affiliation(s)
- Anna Stasiłowicz-Krzemień
- Department of Pharmacognosy and Biomaterials, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (A.S.-K.)
| | - Wiktoria Nogalska
- Department of Pharmacognosy and Biomaterials, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (A.S.-K.)
| | - Zofia Maszewska
- Department of Pharmacognosy and Biomaterials, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (A.S.-K.)
| | - Mateusz Maleszka
- Department of Pharmacognosy and Biomaterials, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (A.S.-K.)
| | - Maria Dobroń
- Department of Pharmacognosy and Biomaterials, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (A.S.-K.)
| | - Agnieszka Szary
- Department of Pharmacognosy and Biomaterials, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (A.S.-K.)
| | - Aleksandra Kępa
- Department of Pharmacognosy and Biomaterials, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (A.S.-K.)
| | - Marcin Żarowski
- Department of Developmental Neurology, Poznan University of Medical Sciences, Przybyszewski 49, 60-355 Poznan, Poland;
| | - Katarzyna Hojan
- Department of Occupational Therapy, Poznan University of Medical Sciences, Swięcickiego 6, 61-847 Poznan, Poland;
- Department of Rehabilitation, Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland
| | - Malgorzata Lukowicz
- Department of Rehabilitation, Centre of Postgraduate Medical Education, Konarskiego 13, 05-400 Otwock, Poland;
| | - Judyta Cielecka-Piontek
- Department of Pharmacognosy and Biomaterials, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (A.S.-K.)
- Department of Pharmacology and Phytochemistry, Institute of Natural Fibres and Medicinal Plants, Wojska Polskiego 71b, 60-630 Poznan, Poland
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Boussi-Gross R, Catalogna M, Lang E, Shamai Z, Ablin JN, Aloush V, Doenyas-Barak K, Lorberboym M, Lev-Wiesel R, Efrati S. Hyperbaric oxygen therapy vs. pharmacological intervention in adults with fibromyalgia related to childhood sexual abuse: prospective, randomized clinical trial. Sci Rep 2024; 14:11599. [PMID: 38773296 PMCID: PMC11109175 DOI: 10.1038/s41598-024-62161-5] [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: 11/25/2023] [Accepted: 05/14/2024] [Indexed: 05/23/2024] Open
Abstract
Fibromyalgia syndrome (FMS) is a chronic pain syndrome characterized by disruptions in pain processing within the central nervous system. It exhibits a high prevalence among patients with a history of traumatic experiences, notably childhood sexual abuse (CSA). This study compared the efficacy of hyperbaric oxygen therapy (HBOT) to the current pharmacological standard of care for individuals suffering from CSA-related FMS. Forty-eight participants diagnosed with FMS and a history of CSA were randomly assigned to either the HBOT group (60 sessions of 100% oxygen at 2 ATA for 90 min, with air breaks every 5 min) or the medication (MED) group (FDA-approved medications, Pregabalin and Duloxetine). The primary endpoint was the Fibromyalgia impact questionnaire (FIQ) score, while secondary endpoints encompassed emotional status and daily functioning questionnaires, as well as pain thresholds and conditioned pain modulation tests. Brain activity was evaluated through single photon emission computed tomography (SPECT). Results revealed a significant group-by-time interaction for the FIQ score favoring HBOT over MED (p < 0.001), with a large effect size (Cohen's d = - 1.27). Similar findings were observed in emotional symptoms and functional measures. SPECT imaging demonstrated an increase in activity in pre-frontal and temporal brain areas, which correlated with symptoms improvement. In conclusion, HBOT exhibited superior benefits over medications in terms of physical, functional, and emotional improvements among FMS patients with a history of CSA. This associated with increased activity in pre-frontal and temporal brain areas, highlighting the neuroplasticity effect of HBOT.
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Affiliation(s)
- Rahav Boussi-Gross
- Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Merav Catalogna
- Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Erez Lang
- Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
- School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Zipora Shamai
- Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Jacob N Ablin
- School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Valerie Aloush
- School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Keren Doenyas-Barak
- Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
- School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Mordechai Lorberboym
- Nuclear Medicine Institute, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Rachel Lev-Wiesel
- Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
- The Emili Sagol CAT Research Center, Graduate School of Creative Arts Therapies, University of Haifa, Haifa, Israel
| | - Shai Efrati
- Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel.
- School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.
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Invitto S, Moselli P. Exploring Embodied and Bioenergetic Approaches in Trauma Therapy: Observing Somatic Experience and Olfactory Memory. Brain Sci 2024; 14:385. [PMID: 38672034 PMCID: PMC11048503 DOI: 10.3390/brainsci14040385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/09/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Recent studies highlight how body psychotherapy is becoming highly cited, especially in connection with studies on trauma-related disorders. This review highlights the theoretical assumptions and recent points in common with embodied simulation and new sensory theories by integrating bioenergetic analysis, embodiment, and olfactory memory in trauma and post-traumatic stress disorder (PTSD) therapy. Embodied memory, rooted in sensorimotor experiences, shapes cognitive functions and emotional responses. Trauma, embodied in somatic experiences, disrupts these processes, leading to symptoms such as chronic pain and dissociation. The literature discussed highlights the impact of burning odors on individuals with PTSD and those who have experienced childhood maltreatment. Burning odors can increase stress and heart rate in war veterans, with sensitivity to these odors intensifying over time since the trauma. Additionally, adults who experienced childhood maltreatment exhibit faster processing of unpleasant odors and increased symptom severity. Grounding techniques, such as adopting a balanced posture, enhance breathing and sensory capabilities, potentially aiding in managing symptoms associated with trauma-related disorders such as PTSD.
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Affiliation(s)
- Sara Invitto
- Laboratory on Psychophysiological and Cognitive Olfactory Processes, Department of Biological and Environmental Sciences and Technologies, University of Salento, 73100 Lecce, Italy
- SIAB—Società Italiana Analisi Bioenergetica, 00183 Roma, Italy;
- IIBA International Institute for Bioenergetic Analysis, 08670 Navàs, Barcelona, Spain
| | - Patrizia Moselli
- SIAB—Società Italiana Analisi Bioenergetica, 00183 Roma, Italy;
- IIBA International Institute for Bioenergetic Analysis, 08670 Navàs, Barcelona, Spain
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Mazaheri M, Radahmadi M, Sharifi MR. Effects of chronic social equality and inequality conditions on passive avoidance memory and PTSD-like behaviors in rats under chronic empathic stress. Int J Neurosci 2024:1-12. [PMID: 38598305 DOI: 10.1080/00207454.2024.2341913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/07/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Social inequality conditions induce aversion and affect brain functions and mood. This study investigated the effects of chronic social equality and inequality (CSE and CSI, respectively) conditions on passive avoidance memory and post-traumatic stress disorder (PTSD)-like behaviors in rats under chronic empathic stress. METHODS Rats were divided into different groups, including control, sham-observer, sham-demonstrator, observer, demonstrator, and co-demonstrator groups. Chronic stress (2 h/day) was administered to all stressed groups for 21 days. Fear learning, fear memory, memory consolidation, locomotor activity, and PTSD-like behaviors were evaluated using the passive avoidance test. Apart from the hippocampal weight, the correlations of memory and right hippocampal weight with serum corticosterone (CORT) levels were separately assessed for all experimental groups. RESULTS Latency was significantly higher in the demonstrator and sham-demonstrator groups compared to the control group. It was decreased significantly in other groups compared to the control group. Latency was also decreased in the observer and co-demonstrator groups compared to the demonstrator group. Moreover, the right hippocampal weight was significantly decreased in the demonstrator and sham-demonstrator groups compared to the control group. Pearson's correlation of memory and hippocampal weight with serum CORT levels supported the present findings. CONCLUSION Maladaptive fear responses occurred in demonstrators and sham-demonstrators. Also, extremely high levels of psychological stress, especially under CSI conditions (causing abnormal fear learning) led to heightened fear memory and PTSD-like behaviors. Right hippocampal atrophy confirmed the potential role of CSI conditions in promoting PTSD-like behaviors. Compared to inequality conditions, the abnormal fear memory was reduced under equality conditions.
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Affiliation(s)
- Mohammad Mazaheri
- Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Radahmadi
- Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Sharifi
- Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Evans-Strong A, Walton N, Blandino K, Roper ATC, Donaldson ST, Lewis M, Maguire J. Witnessed trauma exposure induces fear in mice through a reduction in endogenous neurosteroid synthesis. J Neuroendocrinol 2024; 36:e13378. [PMID: 38482748 PMCID: PMC11091913 DOI: 10.1111/jne.13378] [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: 07/11/2023] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 03/27/2024]
Abstract
Neurosteroids have been implicated in the pathophysiology of post-traumatic stress disorder (PTSD). Allopregnanolone is reduced in subsets of individuals with PTSD and has been explored as a novel treatment strategy. Both direct trauma exposure and witnessed trauma are risk factors for PTSD; however, the role of neurosteroids in the behavioral outcomes of these unique experiences has not been explored. Here, we investigate whether observational fear is associated with a reduced capacity for endogenous neurosteroidogenesis and the relationship with behavioral outcomes. We demonstrated that mice directly subjected to a threat (foot shocks) and those witnessing the threat have decreased plasma levels of allopregnanolone. The expression of a key enzyme involved in endogenous neurosteroid synthesis, 5α-reductase type 2, is decreased in the basolateral amygdala, which is a major emotional processing hub implicated in PTSD. We demonstrated that genetic knockdown or pharmacological inhibition of 5α-reductase type 2 exaggerates the behavioral expression of fear in response to witnessed trauma, whereas oral treatment with an exogenous, synthetic neuroactive steroid gamma-aminobutyric acid-A receptor positive allosteric modulator with molecular pharmacology similar to allopregnanolone (SGE-516 [tool compound]) decreased the behavioral response to observational fear. These data implicate impaired endogenous neurosteroidogenesis in the pathophysiology of threat exposure, both direct and witnessed. Further, these data suggest that treatment with exogenous 5α-reduced neurosteroids or targeting endogenous neurosteroidogenesis may be beneficial for the treatment of individuals with PTSD, whether resulting from direct or witnessed trauma.
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Affiliation(s)
- Aidan Evans-Strong
- Neuroscience Department, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Najah Walton
- Neuroscience Department, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Katrina Blandino
- Neuroscience Department, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Abigail T C Roper
- Developmental and Brain Sciences Program, Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - S Tiffany Donaldson
- Developmental and Brain Sciences Program, Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Mike Lewis
- Sage Therapeutics, Inc, Cambridge, Massachusetts, USA
| | - Jamie Maguire
- Neuroscience Department, Tufts University School of Medicine, Boston, Massachusetts, USA
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Niemi L, Washington N, Workman C, Arcila-Valenzuela M, De Brigard F. The emotional impact of baseless discrediting of knowledge: An empirical investigation of epistemic injustice. Acta Psychol (Amst) 2024; 244:104157. [PMID: 38354565 DOI: 10.1016/j.actpsy.2024.104157] [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: 08/29/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/16/2024] Open
Abstract
According to theoretical work on epistemic injustice, baseless discrediting of the knowledge of people with marginalized social identities is a central driver of prejudice and discrimination. Discrediting of knowledge may sometimes be subtle, but it is pernicious, inducing chronic stress and coping strategies such as emotional avoidance. In this research, we sought to deepen the understanding of epistemic injustice's impact by examining emotional responses to being discredited and assessing if marginalized social group membership predicts these responses. We conducted a novel series of three experiments (Total N = 1690) in which participants (1) shared their factual knowledge about how a game worked or their personal feelings about the game; (2) received discrediting feedback (invalidating remarks), validating feedback (affirming remarks), or insulting feedback (general negative social evaluation); and then (3) reported their affect. In all three studies, on average, affective responses to discrediting feedback were less negative than to insulting feedback, and more negative than to validating feedback. Participants who shared their knowledge reported more negative affect after discrediting feedback than participants who shared their feelings. There were consistent individual differences, including a twice-replicated finding of reduced negative affect after receiving discrediting and insulting feedback for Black men compared to White men and women and Black women. Black men's race-based traumatic symptom scores predicted their affective responses to discrediting and insulting feedback, suggesting that experience with discrimination contributed to the emotional processing of a key aspect of epistemic injustice: remarks conveying baseless discrediting of knowledge.
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Affiliation(s)
- Laura Niemi
- Cornell University, Ithaca, NY 14853, United States of America.
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Stevens L, Bregulla M, Scheele D. Out of touch? How trauma shapes the experience of social touch - Neural and endocrine pathways. Neurosci Biobehav Rev 2024; 159:105595. [PMID: 38373642 DOI: 10.1016/j.neubiorev.2024.105595] [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: 09/29/2023] [Revised: 01/20/2024] [Accepted: 02/15/2024] [Indexed: 02/21/2024]
Abstract
Trauma can shape the way an individual experiences the world and interacts with other people. Touch is a key component of social interactions, but surprisingly little is known about how trauma exposure influences the processing of social touch. In this review, we examine possible neurobiological pathways through which trauma can influence touch processing and lead to touch aversion and avoidance in trauma-exposed individuals. Emerging evidence indicates that trauma may affect sensory touch thresholds by modulating activity in the primary sensory cortex and posterior insula. Disturbances in multisensory integration and oxytocin reactivity combined with diminished reward-related and anxiolytic responses may induce a bias towards negative appraisal of touch contexts. Furthermore, hippocampus deactivation during social touch may reflect a dissociative state. These changes depend not only on the type and severity of the trauma but also on the features of the touch. We hypothesise that disrupted touch processing may impair social interactions and confer elevated risk for future stress-related disorders.
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Affiliation(s)
- Laura Stevens
- Social Neuroscience, Research Center One Health Ruhr of the University Alliance Ruhr, Faculty of Medicine, Ruhr University Bochum, Germany; Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Germany
| | - Madeleine Bregulla
- Social Neuroscience, Research Center One Health Ruhr of the University Alliance Ruhr, Faculty of Medicine, Ruhr University Bochum, Germany; Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Germany
| | - Dirk Scheele
- Social Neuroscience, Research Center One Health Ruhr of the University Alliance Ruhr, Faculty of Medicine, Ruhr University Bochum, Germany; Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Germany.
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Sheikh SAA, Shah AJ, Bremner JD, Vaccarino V, Inan OT, Clifford GD, Rad AB. Impedance cardiogram based exploration of cardiac mechanisms in post-traumatic stress disorder during trauma recall. Psychophysiology 2024; 61:e14488. [PMID: 37986190 PMCID: PMC10939951 DOI: 10.1111/psyp.14488] [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: 05/05/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 11/22/2023]
Abstract
Post-traumatic stress disorder (PTSD) is an independent risk factor for developing heart failure; however, the underlying cardiac mechanisms are still elusive. This study aims to evaluate the real-time effects of experimentally induced PTSD symptom activation on various cardiac contractility and autonomic measures. We recorded synchronized electrocardiogram and impedance cardiogram from 137 male veterans (17 PTSD, 120 non-PTSD; 48 twin pairs, 41 unpaired singles) during a laboratory-based traumatic reminder stressor. To identify the parameters describing the cardiac mechanisms by which trauma reminders can create stress on the heart, we utilized a feature selection mechanism along with a random forest classifier distinguishing PTSD and non-PTSD. We extracted 99 parameters, including 76 biosignal-based and 23 sociodemographic, medical history, and psychiatric diagnosis features. A subject/twin-wise stratified nested cross-validation procedure was used for parameter tuning and model assessment to identify the important parameters. The identified parameters included biomarkers such as pre-ejection period, acceleration index, velocity index, Heather index, and several physiology-agnostic features. These identified parameters during trauma recall suggested a combination of increased sympathetic nervous system (SNS) activity and deteriorated cardiac contractility that may increase the heart failure risk for PTSD. This indicates that the PTSD symptom activation associates with real-time reductions in several cardiac contractility measures despite SNS activation. This finding may be useful in future cardiac prevention efforts.
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Affiliation(s)
- Shafa-at Ali Sheikh
- Department of Biomedical Informatics, Emory University, Atlanta, USA
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, USA
| | - Amit J. Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
- Veterans Affairs Health Care System, USA
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, USA
| | - J. Douglas Bremner
- Veterans Affairs Health Care System, USA
- Department of Psychiatry, Emory University School of Medicine, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Omer T. Inan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, USA
| | - Gari D. Clifford
- Department of Biomedical Informatics, Emory University, Atlanta, USA
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, USA
| | - Ali Bahrami Rad
- Department of Biomedical Informatics, Emory University, Atlanta, USA
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49
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Kelly TJ, Bonniwell EM, Mu L, Liu X, Hu Y, Friedman V, Yu H, Su W, McCorvy JD, Liu QS. Psilocybin analog 4-OH-DiPT enhances fear extinction and GABAergic inhibition of principal neurons in the basolateral amygdala. Neuropsychopharmacology 2024; 49:854-863. [PMID: 37752222 PMCID: PMC10948882 DOI: 10.1038/s41386-023-01744-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/08/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023]
Abstract
Psychedelics such as psilocybin show great promise for the treatment of depression and PTSD, but their long duration of action poses practical limitations for patient access. 4-OH-DiPT is a fast-acting and shorter-lasting derivative of psilocybin. Here we characterized the pharmacological profile of 4-OH-DiPT and examined its impact on fear extinction learning as well as a potential mechanism of action. First, we profiled 4-OH-DiPT at all 12 human 5-HT GPCRs. 4-OH-DiPT showed strongest agonist activity at all three 5-HT2A/2B/2C receptors with near full agonist activity at 5-HT2A. Notably, 4-OH-DiPT had comparable activity at mouse and human 5-HT2A/2B/2C receptors. In a fear extinction paradigm, 4-OH-DiPT significantly reduced freezing responses to conditioned cues in a dose-dependent manner with a greater potency in female mice than male mice. Female mice that received 4-OH-DiPT before extinction training had reduced avoidance behaviors several days later in the light dark box, elevated plus maze and novelty-suppressed feeding test compared to controls, while male mice did not show significant differences. 4-OH-DiPT produced robust increases in spontaneous inhibitory postsynaptic currents (sIPSCs) in basolateral amygdala (BLA) principal neurons and action potential firing in BLA interneurons in a 5-HT2A-dependent manner. RNAscope demonstrates that Htr2a mRNA is expressed predominantly in BLA GABA interneurons, Htr2c mRNA is expressed in both GABA interneurons and principal neurons, while Htr2b mRNA is absent in the BLA. Our findings suggest that 4-OH-DiPT activates BLA interneurons via the 5-HT2A receptor to enhance GABAergic inhibition of BLA principal neurons, which provides a potential mechanism for suppressing learned fear.
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Affiliation(s)
- Thomas J Kelly
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Emma M Bonniwell
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Lianwei Mu
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Xiaojie Liu
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Ying Hu
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Vladislav Friedman
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Hao Yu
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Wantang Su
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - John D McCorvy
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
| | - Qing-Song Liu
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
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50
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Chen JJ, Jain J, Merker JB, Webber TK, Huffman JC, Seligowski AV. The impact of PTSD on associations between sex hormones and cardiovascular disease symptoms. Eur J Psychotraumatol 2024; 15:2320993. [PMID: 38445477 PMCID: PMC10919301 DOI: 10.1080/20008066.2024.2320993] [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: 10/23/2023] [Accepted: 02/12/2024] [Indexed: 03/07/2024] Open
Abstract
Background: Women have twice the lifetime prevalence of posttraumatic stress disorder (PTSD) relative to men, and PTSD is a known risk factor for cardiovascular disease (CVD). Two sex hormones - estradiol and progesterone - have been found to impact both PTSD and CVD symptomatology, but the way in which sex hormones influence cardiovascular physiology among individuals with PTSD is not well understood.Objective: This study sought to clarify the association between sex hormones, PTSD, and CVD among trauma-exposed women.Method: Sixty-six trauma-exposed women (M age = 31.45, SD = 8.92) completed a clinical interview for PTSD and self-reported CVD symptoms; estradiol and progesterone were assayed from blood samples. The association between each sex hormone and CVD symptoms was analyzed, controlling for age, systolic blood pressure (BP), and diastolic BP.Results: Neither estradiol nor the PTSD-by-estradiol interaction was significantly associated with CVD symptoms. Higher progesterone and, relatedly, progesterone-to-estradiol ratio (PE ratio) were each significantly associated with greater CVD symptom severity, but only for individuals with lower relative PTSD severity.Conclusions: The findings indicate that PTSD moderates the relationship between progesterone and CVD symptoms, and further research is warranted to reconcile findings in existing literature regarding the direction of and mechanisms behind this relationship.
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Affiliation(s)
| | - Jahnvi Jain
- UT Health McGovern Medical School, Houston, TX, USA
| | - Julia B. Merker
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA
| | | | - Jeffery C. Huffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Antonia V. Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Boston, MA, USA
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