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Núñez-Rios DL, Martínez-Magaña JJ, Nagamatsu ST, Krystal JH, Martínez-González KG, Giusti-Rodríguez P, Montalvo-Ortiz JL. Cross-Species Convergence of Brain Transcriptomic and Epigenomic Findings in Posttraumatic Stress Disorder: A Systematic Review. Complex Psychiatry 2023; 9:100-118. [PMID: 37404872 PMCID: PMC10315001 DOI: 10.1159/000529536] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 01/31/2023] [Indexed: 08/05/2023] Open
Abstract
Introduction Posttraumatic stress disorder (PTSD) is a complex multifactorial disorder influenced by the interaction of genetic and environmental factors. Analyses of epigenomic and transcriptomic modifications may help to dissect the biological factors underlying the gene-environment interplay in PTSD. To date, most human PTSD epigenetics studies have used peripheral tissue, and these findings have complex and poorly understood relationships to brain alterations. Studies examining brain tissue may help characterize the brain-specific transcriptomic and epigenomic profiles of PTSD. In this review, we compiled and integrated brain-specific molecular findings of PTSD from humans and animals. Methods A systematic literature search according to the PRISMA criteria was performed to identify transcriptomic and epigenomic studies of PTSD, focusing on brain tissue from human postmortem samples or animal-stress paradigms. Results Gene- and pathway-level convergence analyses revealed PTSD-dysregulated genes and biological pathways across brain regions and species. A total of 243 genes converged across species, with 17 of them significantly enriched for PTSD. Chemical synaptic transmission and signaling by G-protein-coupled receptors were consistently enriched across omics and species. Discussion Our findings point out dysregulated genes highly replicated across PTSD studies in humans and animal models and suggest a potential role for the corticotropin-releasing hormone/orexin pathway in PTSD's pathophysiology. Further, we highlight current knowledge gaps and limitations and recommend future directions to address them.
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Affiliation(s)
- Diana Leandra Núñez-Rios
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- National Center for Posttraumatic Stress Disorder, VA CT Healthcare System, West Haven, CT, USA
| | - José Jaime Martínez-Magaña
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- National Center for Posttraumatic Stress Disorder, VA CT Healthcare System, West Haven, CT, USA
| | - Sheila Tiemi Nagamatsu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- National Center for Posttraumatic Stress Disorder, VA CT Healthcare System, West Haven, CT, USA
| | - John H. Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- National Center for Posttraumatic Stress Disorder, VA CT Healthcare System, West Haven, CT, USA
| | | | - Paola Giusti-Rodríguez
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Janitza L. Montalvo-Ortiz
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- National Center for Posttraumatic Stress Disorder, VA CT Healthcare System, West Haven, CT, USA
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Peripheral mRNA Expression and Prognostic Significance of Emotional Stress Biomarkers in Metastatic Breast Cancer Patients. Int J Mol Sci 2022; 23:ijms232214097. [PMID: 36430579 PMCID: PMC9694977 DOI: 10.3390/ijms232214097] [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: 09/20/2022] [Revised: 10/12/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022] Open
Abstract
Emotional stress is believed to be associated with increased tumor progression. Stress-induced epigenetic modifications can contribute to the severity of disease and poor prognosis in cancer patients. The current study aimed to investigate the expression profiles along with the prognostic significance of psychological stress-related genes in metastatic breast cancer patients, to rationalize the molecular link between emotional stress and cancer progression. We profiled the expression of selected stress-associated genes (5-HTT, NR3C1, OXTR, and FKBP5) in breast cancer including the stress evaluation of all participants using the Questionnaire on Distress in Cancer Patients-short form (QSC-R10). A survival database, the Kaplan-Meier Plotter, was used to explore the prognostic significance of these genes in breast cancer. Our results showed relatively low expressions of 5-HTT (p = 0.02) and OXTR (p = 0.0387) in metastatic breast cancer patients as compared to the non-metastatic group of patients. The expression of NR3C1 was low in tumor grade III as compared to grade II (p = 0.04). Additionally, the expression of NR3C1 was significantly higher in patients with positive estrogen receptor status. However, no significant difference was found regarding FKBP5 expression in breast cancer. The results suggest a potential implication of these genes in breast cancer pathology and prognosis.
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Karthan M, Martin R, Holl F, Swoboda W, Kestler HA, Pryss R, Schobel J. Enhancing mHealth data collection applications with sensing capabilities. Front Public Health 2022; 10:926234. [PMID: 36187627 PMCID: PMC9521646 DOI: 10.3389/fpubh.2022.926234] [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: 04/22/2022] [Accepted: 08/11/2022] [Indexed: 01/24/2023] Open
Abstract
Smart mobile devices such as smartphones or tablets have become an important factor for collecting data in complex health scenarios (e.g., psychological studies, medical trials), and are more and more replacing traditional pen-and-paper instruments. However, simply digitizing such instruments does not yet realize the full potential of mobile devices: most modern smartphones have a variety of different sensor technologies (e.g., microphone, GPS data, camera, ...) that can also provide valuable data and potentially valuable insights for the medical purpose or the researcher. In this context, a significant development effort is required to integrate sensing capabilities into (existing) data collection applications. Developers may have to deal with platform-specific peculiarities (e.g., Android vs. iOS) or proprietary sensor data formats, resulting in unnecessary development effort to support researchers with such digital solutions. Therefore, a cross-platform mobile data collection framework has been developed to extend existing data collection applications with sensor capabilities and address the aforementioned challenges in the process. This framework will enable researchers to collect additional information from participants and environment, increasing the amount of data collected and drawing new insights from existing data.
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Affiliation(s)
- Maximilian Karthan
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany,Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany,*Correspondence: Maximilian Karthan
| | - Robin Martin
- Institute of Medical Systems Biology, Ulm University, Ulm, Germany
| | - Felix Holl
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany,Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany
| | - Walter Swoboda
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Hans A. Kestler
- Institute of Medical Systems Biology, Ulm University, Ulm, Germany
| | - Rüdiger Pryss
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Johannes Schobel
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
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Analysis of the cerebellar molecular stress response led to first evidence of a role for FKBP51 in brain FKBP52 expression in mice and humans. Neurobiol Stress 2021; 15:100401. [PMID: 34632006 PMCID: PMC8488056 DOI: 10.1016/j.ynstr.2021.100401] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 09/05/2021] [Accepted: 09/15/2021] [Indexed: 12/15/2022] Open
Abstract
As the cerebellar molecular stress response is understudied, we assessed protein expression levels of hypothalamic-pituitary-adrenal (HPA) axis regulators and neurostructural markers in the cerebellum of a male PTSD mouse model and of unstressed vs. stressed male FK506 binding protein 51 (Fkbp5) knockout (KO) vs. wildtype mice. We explored the translatability of our findings in the Fkbp5 KO model to the situation in humans by correlating mRNA levels of candidates with those of FKBP5 in two whole transcriptome datasets of post-mortem human cerebellum and in blood of unstressed and stressed humans. Fkbp5 deletion rescued the stress-induced loss in hippocampal, prefrontal cortical, and, possibly, also cerebellar FKBP52 expression and modulated post-stress cerebellar expression levels of the glucocorticoid receptor (GR) and possibly (trend) also of glial fibrillary acidic protein (GFAP). Accordingly, expression levels of genes encoding for these three genes correlated with those of FKBP5 in human post-mortem cerebellum, while other neurostructural markers were not related to Fkbp5 either in mouse or human cerebellum. Also, gene expression levels of the two immunophilins correlated inversely in the blood of unstressed and stressed humans. We found transient changes in FKBP52 and persistent changes in GR and GFAP in the cerebellum of PTSD-like mice. Altogether, upon elucidating the cerebellar stress response we found first evidence for a novel facet of HPA axis regulation, i.e., the ability of FKBP51 to modulate the expression of its antagonist FKBP52 in the mouse and, speculatively, also in the human brain and blood and, moreover, detected long-term single stress-induced changes in expression of cerebellar HPA axis regulators and neurostructural markers of which some might contribute to the role of the cerebellum in fear extinction.
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Fischer S, Schumacher T, Knaevelsrud C, Ehlert U, Schumacher S. Genes and hormones of the hypothalamic-pituitary-adrenal axis in post-traumatic stress disorder. What is their role in symptom expression and treatment response? J Neural Transm (Vienna) 2021; 128:1279-1286. [PMID: 33825945 PMCID: PMC8423677 DOI: 10.1007/s00702-021-02330-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 03/22/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Less than half of all individuals with post-traumatic stress disorder (PTSD) remit spontaneously and a large proportion of those seeking treatment do not respond sufficiently. This suggests that there may be subgroups of individuals who are in need of augmentative or alternative treatments. One of the most frequent pathophysiological findings in PTSD is alterations in the hypothalamic-pituitary-adrenal (HPA) axis, including enhanced negative feedback sensitivity and attenuated peripheral cortisol. Given the role of the HPA axis in cognition, this pattern may contribute to PTSD symptoms and interfere with key processes of standard first-line treatments, such as trauma-focused cognitive behavioural therapy (TF-CBT). METHODS This review provides a comprehensive summary of the current state of research regarding the role of HPA axis functioning in PTSD symptoms and treatment. RESULTS Overall, there is preliminary evidence that hypocortisolaemia contributes to symptom manifestation in PTSD; that it predicts non-responses to TF-CBT; and that it is subject to change in parallel with positive treatment trajectories. Moreover, there is evidence that genetic and epigenetic alterations within the genes NR3C1 and FKBP5 are associated with this hypocortisolaemic pattern and that some of these alterations change as symptoms improve over the course of treatment. CONCLUSIONS Future research priorities include investigations into the role of the HPA axis in day-to-day symptom variation, the time scale in which biological changes in response to treatment occur, and the effects of sex. Furthermore, before conceiving augmentative or alternative treatments that target the described mechanisms, multilevel studies are warranted.
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Affiliation(s)
- Susanne Fischer
- Institute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Binzmuehlestrasse 14/Box 26, 8050, Zurich, Switzerland.
| | - Tabea Schumacher
- Department of Education and Psychology, Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Christine Knaevelsrud
- Department of Education and Psychology, Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Ulrike Ehlert
- Institute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Binzmuehlestrasse 14/Box 26, 8050, Zurich, Switzerland
| | - Sarah Schumacher
- Department of Education and Psychology, Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
- Health Faculty, Clinical Psychology and Psychotherapy, Health and Medical University Potsdam, Potsdam, Germany
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Drake J, McMichael GO, Vornholt ES, Cresswell K, Williamson V, Chatzinakos C, Mamdani M, Hariharan S, Kendler KS, Kalsi G, Riley BP, Dozmorov M, Miles MF, Bacanu S, Vladimirov VI. Assessing the Role of Long Noncoding RNA in Nucleus Accumbens in Subjects With Alcohol Dependence. Alcohol Clin Exp Res 2020; 44:2468-2480. [PMID: 33067813 PMCID: PMC7756309 DOI: 10.1111/acer.14479] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 10/01/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Long noncoding RNA (lncRNA) have been implicated in the etiology of alcohol use. Since lncRNA provide another layer of complexity to the transcriptome, assessing their expression in the brain is the first critical step toward understanding lncRNA functions in alcohol use and addiction. Thus, we sought to profile lncRNA expression in the nucleus accumbens (NAc) in a large postmortem alcohol brain sample. METHODS LncRNA and protein-coding gene (PCG) expressions in the NAc from 41 subjects with alcohol dependence (AD) and 41 controls were assessed via a regression model. Weighted gene coexpression network analysis was used to identify lncRNA and PCG networks (i.e., modules) significantly correlated with AD. Within the significant modules, key network genes (i.e., hubs) were also identified. The lncRNA and PCG hubs were correlated via Pearson correlations to elucidate the potential biological functions of lncRNA. The lncRNA and PCG hubs were further integrated with GWAS data to identify expression quantitative trait loci (eQTL). RESULTS At Bonferroni adj. p-value ≤ 0.05, we identified 19 lncRNA and 5 PCG significant modules, which were enriched for neuronal and immune-related processes. In these modules, we further identified 86 and 315 PCG and lncRNA hubs, respectively. At false discovery rate (FDR) of 10%, the correlation analyses between the lncRNA and PCG hubs revealed 3,125 positive and 1,860 negative correlations. Integration of hubs with genotype data identified 243 eQTLs affecting the expression of 39 and 204 PCG and lncRNA hubs, respectively. CONCLUSIONS Our study identified lncRNA and gene networks significantly associated with AD in the NAc, coordinated lncRNA and mRNA coexpression changes, highlighting potentially regulatory functions for the lncRNA, and our genetic (cis-eQTL) analysis provides novel insights into the etiological mechanisms of AD.
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Affiliation(s)
- John Drake
- From the Center for Integrative Life Sciences Education (JD)Virginia Commonwealth UniversityRichmondVirginia
| | - Gowon O. McMichael
- Virginia Institute for Psychiatric and Behavioral Genetics(GOM, ESV, CC, MM, KSK, BPR, MFM, S‐AB, VIV)Virginia Commonwealth UniversityRichmondVirginia
| | - Eric Sean Vornholt
- Virginia Institute for Psychiatric and Behavioral Genetics(GOM, ESV, CC, MM, KSK, BPR, MFM, S‐AB, VIV)Virginia Commonwealth UniversityRichmondVirginia
| | - Kellen Cresswell
- Department of Biostatistics(KC, MD)Virginia Commonwealth UniversityRichmondVirginia
| | - Vernell Williamson
- Department of Pathology(VW)Virginia Commonwealth UniversityRichmondVirginia
| | - Chris Chatzinakos
- Virginia Institute for Psychiatric and Behavioral Genetics(GOM, ESV, CC, MM, KSK, BPR, MFM, S‐AB, VIV)Virginia Commonwealth UniversityRichmondVirginia
| | - Mohammed Mamdani
- Virginia Institute for Psychiatric and Behavioral Genetics(GOM, ESV, CC, MM, KSK, BPR, MFM, S‐AB, VIV)Virginia Commonwealth UniversityRichmondVirginia
| | - Siddharth Hariharan
- Summer Research Fellowship(SH)School of MedicineVirginia Commonwealth UniversityRichmondVirginia
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics(GOM, ESV, CC, MM, KSK, BPR, MFM, S‐AB, VIV)Virginia Commonwealth UniversityRichmondVirginia
- Department of Psychiatry(KSK, BPR, S‐AB, VIV)Virginia Commonwealth UniversityRichmondVirginia
- Department of Human and Molecular Genetics(KSK, BPR)Virginia Commonwealth UniversityRichmondVirginia
| | - Gursharan Kalsi
- Department of Social, Genetic and Developmental Psychiatry(GK)Institute of PsychiatryLondonUK
| | - Brien P. Riley
- Virginia Institute for Psychiatric and Behavioral Genetics(GOM, ESV, CC, MM, KSK, BPR, MFM, S‐AB, VIV)Virginia Commonwealth UniversityRichmondVirginia
- Department of Psychiatry(KSK, BPR, S‐AB, VIV)Virginia Commonwealth UniversityRichmondVirginia
- Department of Human and Molecular Genetics(KSK, BPR)Virginia Commonwealth UniversityRichmondVirginia
| | - Mikhail Dozmorov
- Department of Biostatistics(KC, MD)Virginia Commonwealth UniversityRichmondVirginia
| | - Michael F. Miles
- Virginia Institute for Psychiatric and Behavioral Genetics(GOM, ESV, CC, MM, KSK, BPR, MFM, S‐AB, VIV)Virginia Commonwealth UniversityRichmondVirginia
- Department of Pharmacology and Toxicology(MFM)Virginia Commonwealth UniversityRichmondVirginia
| | - Silviu‐Alin Bacanu
- Virginia Institute for Psychiatric and Behavioral Genetics(GOM, ESV, CC, MM, KSK, BPR, MFM, S‐AB, VIV)Virginia Commonwealth UniversityRichmondVirginia
- Department of Psychiatry(KSK, BPR, S‐AB, VIV)Virginia Commonwealth UniversityRichmondVirginia
| | - Vladimir I. Vladimirov
- Virginia Institute for Psychiatric and Behavioral Genetics(GOM, ESV, CC, MM, KSK, BPR, MFM, S‐AB, VIV)Virginia Commonwealth UniversityRichmondVirginia
- Department of Psychiatry(KSK, BPR, S‐AB, VIV)Virginia Commonwealth UniversityRichmondVirginia
- Center for Biomarker Research and Personalized Medicine(VIV)Virginia Commonwealth UniversityRichmondVirginia
- Lieber Institute for Brain Development(VIV)Johns Hopkins UniversityBaltimoreMaryland
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Zeller AC, Conrad D, Schneider A, Behnke A, Pfeiffer A, Blum GF, Wilker S, Elbert T, Kolassa I. A combination of combat experience, early abduction, and severe traumatization fuels appetitive aggression and violence among abductees of rebel war in Northern Uganda. Aggress Behav 2020; 46:465-475. [PMID: 32643160 DOI: 10.1002/ab.21914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 11/10/2022]
Abstract
Individuals who perpetrate violence may likely perceive violence as appealing and infliction of violence to derive pleasure is termed as appetitive aggression. Individuals who were abducted as children into an armed group often experience a higher number of traumatic event types, that is traumatic load and are usually socialized in a violence-endorsing environment. This study aims to investigate the interaction between age at initial abduction with that of traumatic load, and their influence on appetitive aggression along with perpetration of violent acts by former members of an armed rebel group of both sexes. Semi-structured interviews were conducted among a target group of formerly abducted rebel-war survivors (including participants with and without combat experience) from Northern Uganda. Participants included 596 women and 570 men with N = 1,166 (Mage = 32.58, SDage = 9.76, range: 18-80 years). We conducted robust linear regression models to investigate the influence of age at initial abduction, traumatic load, combat experience, and biological sex on appetitive aggression as well as their perpetrated violent acts. Our study shows, appetitive aggression and the number of perpetrated violent acts were specifically increased in individuals who were abducted young, experienced several traumatic events in their lifetime, and with previous combat experience. For perpetrated violence men showed increased levels whereas for appetitive aggression the association was independent of biological sex. Therefore, early abducted individuals with a higher traumatic load, who have combat experience, need to be given special intervention to prevent any further violence.
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Affiliation(s)
- Anja C. Zeller
- Clinical Psychology and Neuropsychology, Department of Psychology University of Konstanz Konstanz Germany
- vivo international e.V. Konstanz Germany
| | - Daniela Conrad
- Clinical Psychology and Neuropsychology, Department of Psychology University of Konstanz Konstanz Germany
- Department of Clinical and Biological Psychology, Institute of Psychology and Education Ulm University Ulm Germany
| | - Anna Schneider
- vivo international e.V. Konstanz Germany
- Department of Clinical and Biological Psychology, Institute of Psychology and Education Ulm University Ulm Germany
| | - Alexander Behnke
- Department of Clinical and Biological Psychology, Institute of Psychology and Education Ulm University Ulm Germany
| | | | - Gerrit F. Blum
- Institute of Psychology and Education Ulm University Ulm Germany
| | - Sarah Wilker
- vivo international e.V. Konstanz Germany
- Department of Clinical and Biological Psychology, Institute of Psychology and Education Ulm University Ulm Germany
| | - Thomas Elbert
- Clinical Psychology and Neuropsychology, Department of Psychology University of Konstanz Konstanz Germany
- vivo international e.V. Konstanz Germany
| | - Iris‐Tatjana Kolassa
- vivo international e.V. Konstanz Germany
- Department of Clinical and Biological Psychology, Institute of Psychology and Education Ulm University Ulm Germany
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Nold V, Richter N, Hengerer B, Kolassa IT, Allers KA. FKBP5 polymorphisms induce differential glucocorticoid responsiveness in primary CNS cells - First insights from novel humanized mice. Eur J Neurosci 2020; 53:402-415. [PMID: 33030232 PMCID: PMC7894319 DOI: 10.1111/ejn.14999] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/22/2020] [Indexed: 12/24/2022]
Abstract
The brain is a central hub for integration of internal and external conditions and, thus, a regulator of the stress response. Glucocorticoids are the essential communicators of this response. Aberrations in glucocorticoid signaling are a common symptom in patients with psychiatric disorders. The gene FKBP5 encodes a chaperone protein that functionally inhibits glucocorticoid signaling and, thus, contributes to the regulation of stress. In the context of childhood trauma, differential expression of FKBP5 has been found in psychiatric patients compared to controls. These variations in expression levels of FKBP5 were reported to be associated with differences in stress responsiveness in human carriers of the single nucleotide polymorphism (SNP) rs1360780. Understanding the mechanisms underlying FKBP5 polymorphism‐associated glucocorticoid responsiveness in the CNS will lead to a better understanding of stress regulation or associated pathology. To study these mechanisms, two novel humanized mouse lines were generated. The lines carried either the risk (A/T) allele or the resilient (C/G) allele of rs1360780. Primary cells from CNS (astrocytes, microglia, and neurons) were analyzed for their basal expression levels of FKBP5 and their responsiveness to glucocorticoids. Differential expression of FKBP5 was found for these cell types and negatively correlated with the cellular glucocorticoid responsiveness. Astrocytes revealed the strongest transcriptional response, followed by microglia and neurons. Furthermore, the risk allele (A/T) was associated with greater induction of FKBP5 than the resilience allele. Novel FKBP5‐humanized mice display differential glucocorticoid responsiveness due to a single intronic SNP. The vulnerability to stress signaling in the shape of glucocorticoids in the brain correlated with FKBP5 expression levels. The strong responsiveness of astrocytes to glucocorticoids implies astrocytes play a prominent role in the stress response, and in FKBP5‐related differences in glucocorticoid signaling. The novel humanized mouse lines will allow for further study of the role that FKBP5 SNPs have in risk and resilience to stress pathology.
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Affiliation(s)
- Verena Nold
- Boehringer Ingelheim Pharma GmbH & Co KG, CNSDR, Ingelheim, Germany.,Institute of Psychology & Education, Clinical & Biological Psychology, Ulm University, Ulm, Germany
| | - Nadine Richter
- Boehringer Ingelheim Pharma GmbH & Co KG, CNSDR, Ingelheim, Germany
| | - Bastian Hengerer
- Boehringer Ingelheim Pharma GmbH & Co KG, CNSDR, Ingelheim, Germany
| | - Iris-Tatjana Kolassa
- Institute of Psychology & Education, Clinical & Biological Psychology, Ulm University, Ulm, Germany
| | - Kelly Ann Allers
- Boehringer Ingelheim Pharma GmbH & Co KG, CNSDR, Ingelheim, Germany
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Castro-Vale I, Carvalho D. The Pathways between Cortisol-Related Regulation Genes and PTSD Psychotherapy. Healthcare (Basel) 2020; 8:healthcare8040376. [PMID: 33019527 PMCID: PMC7712185 DOI: 10.3390/healthcare8040376] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/24/2020] [Accepted: 09/24/2020] [Indexed: 01/30/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) only develops after exposure to a traumatic event in some individuals. PTSD can be chronic and debilitating, and is associated with co-morbidities such as depression, substance use, and cardiometabolic disorders. One of the most important pathophysiological mechanisms underlying the development of PTSD and its subsequent maintenance is a dysfunctional hypothalamic-pituitary-adrenal (HPA) axis. The corticotrophin-releasing hormone, cortisol, glucocorticoid receptor (GR), and their respective genes are some of the mediators of PTSD's pathophysiology. Several treatments are available, including medication and psychotherapies, although their success rate is limited. Some pharmacological therapies based on the HPA axis are currently being tested in clinical trials and changes in HPA axis biomarkers have been found to occur in response not only to pharmacological treatments, but also to psychotherapy-including the epigenetic modification of the GR gene. Psychotherapies are considered to be the first line treatments for PTSD in some guidelines, even though they are effective for some, but not for all patients with PTSD. This review aims to address how knowledge of the HPA axis-related genetic makeup can inform and predict the outcomes of psychotherapeutic treatments.
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Affiliation(s)
- Ivone Castro-Vale
- Medical Psychology Unit, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- i3S-Institute for Research and Innovation in Health, University of Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal
- Correspondence:
| | - Davide Carvalho
- Department of Endocrinology, Diabetes and Metabolism, São João Hospital University Centre, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal;
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10
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Schneider A, Pfeiffer A, Conrad D, Elbert T, Kolassa IT, Wilker S. Does cumulative exposure to traumatic stressors predict treatment outcome of community-implemented exposure-based therapy for PTSD? Eur J Psychotraumatol 2020; 11:1789323. [PMID: 33062203 PMCID: PMC7534285 DOI: 10.1080/20008198.2020.1789323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background: Posttraumatic Stress Disorder (PTSD) is associated with high levels of functional impairments such as difficulties in academic or occupational performance and in social relationships. With an increasing number of traumatic event types experienced (trauma load), PTSD risk increases in a dose-dependent manner. Accordingly, high rates of PTSD can impair the reconstruction process in post-conflict societies. In order to meet these high needs for mental health services in societies with little access to professional care, task shifting approaches and community-based interventions have been suggested. Narrative Exposure Therapy (NET) has been developed as a short and pragmatic exposure-based PTSD treatment that can be easily trained to lay personnel. Yet, it remains unclear whether NET can be effectively provided by trained lay counsellors even at high levels of trauma load. Objective: To investigate whether trauma load influences the treatment effectiveness of NET provided by trained and supervised local lay counsellors. Method: Linear mixed models were calculated to investigate the influence of trauma load on treatment effectiveness in a sample of N = 323 rebel war survivors from Northern Uganda with PTSD. Results: We found a strong reduction of PTSD symptoms following NET, which was not influenced by trauma load. However, individuals with higher levels of trauma load reported higher PTSD symptoms before therapy as well as 4 and 10 months following treatment completion compared to individuals with lower trauma load. Conclusions: Treatment with NET by lay counsellors is effective independent of trauma load. However, individuals with higher trauma load have a higher probability to show residual symptoms, which might require additional time, sessions or treatment modules.
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Affiliation(s)
- Anna Schneider
- Clinical & Biological Psychology, Ulm University, Konstanz, Germany
| | - Anett Pfeiffer
- Clinical Psychology and Neuropsychology, University of Konstanz, Konstanz, Germany
| | - Daniela Conrad
- Clinical & Biological Psychology, Ulm University, Konstanz, Germany.,Clinical Psychology and Neuropsychology, University of Konstanz, Konstanz, Germany
| | - Thomas Elbert
- Clinical Psychology and Neuropsychology, University of Konstanz, Konstanz, Germany
| | | | - Sarah Wilker
- Clinical & Biological Psychology, Ulm University, Konstanz, Germany.,Clinical Psychology and Psychotherapy, Bielefeld University, Konstanz, Germany
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Kaltenbach E, Hermenau K, Schauer M, Dohrmann K, Elbert T, Schalinski I. Trajectories of posttraumatic stress symptoms during and after Narrative Exposure Therapy (NET) in refugees. BMC Psychiatry 2020; 20:312. [PMID: 32552778 PMCID: PMC7298826 DOI: 10.1186/s12888-020-02720-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 06/09/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Trauma-focused therapy approaches are recommended as treatment for posttraumatic stress disorder (PTSD). This includes the treatment of trauma-related suffering in refugee populations. However, there is a lack of knowledge about symptom trajectories in refugees living in volatile conditions. This has led to fear of "retraumatisation" and general skepticism in clinicians concerning the use of exposure therapy. METHODS To test the relevance of this concern, we investigated PTSD symptom trajectories and potentially influencing factors during the course of Narrative Exposure Therapy (NET) in a refugee sample living in Germany. Refugees filled out the PTSD Checklist prior to each treatment session and also during follow-up interviews. Therapists continuously documented positive and negative life events as well as the content of the treatment sessions. Additionally, structured clinical interviews were conducted pre-treatment and at follow-up time points. RESULTS On average, clients presented with substantial decreases in PTSD symptoms already during and after NET. However, symptom trajectories differed and ranged from fast responders to slow responders to no immediate response during treatment. Importantly, a persistent worsening of symptoms was not observed, also not after exposure to the most distressing events. In contrast, stressful life experiences seemed to aggravate PTSD symptoms. CONCLUSIONS Consistent with earlier studies, NET leads to clinically and behaviorally relevant reductions in PTSD symptoms both throughout and following treatment in refugees living in volatile conditions. Concerns about imaginal exposure in refugees were not substantiated. While stressful life events contributed to transient symptom increases, they weren't found to prevent the overall effectiveness of NET. TRIAL REGISTRATION NCT02852616.
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Affiliation(s)
- Elisa Kaltenbach
- Department of Psychology, University of Konstanz, Konstanz, Germany. .,Centre for Research in Family Health, IWK Health Centre, Halifax, NS, Canada. .,Vivo International e.V., Konstanz, Germany.
| | - Katharin Hermenau
- grid.9811.10000 0001 0658 7699Department of Psychology, University of Konstanz, Konstanz, Germany ,Vivo International e.V., Konstanz, Germany
| | - Maggie Schauer
- grid.9811.10000 0001 0658 7699Department of Psychology, University of Konstanz, Konstanz, Germany ,Vivo International e.V., Konstanz, Germany
| | - Katalin Dohrmann
- grid.9811.10000 0001 0658 7699Department of Psychology, University of Konstanz, Konstanz, Germany ,Vivo International e.V., Konstanz, Germany
| | - Thomas Elbert
- grid.9811.10000 0001 0658 7699Department of Psychology, University of Konstanz, Konstanz, Germany ,Vivo International e.V., Konstanz, Germany
| | - Inga Schalinski
- grid.9811.10000 0001 0658 7699Department of Psychology, University of Konstanz, Konstanz, Germany ,Vivo International e.V., Konstanz, Germany ,Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Medical Psychology, Berlin, Germany
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12
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Meyer DN, Crofts EJ, Akemann C, Gurdziel K, Farr R, Baker BB, Weber D, Baker TR. Developmental exposure to Pb 2+ induces transgenerational changes to zebrafish brain transcriptome. CHEMOSPHERE 2020; 244:125527. [PMID: 31816550 PMCID: PMC7015790 DOI: 10.1016/j.chemosphere.2019.125527] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/27/2019] [Accepted: 11/30/2019] [Indexed: 05/24/2023]
Abstract
Lead (Pb2+) is a major public health hazard for urban children, with profound and well-characterized developmental and behavioral implications across the lifespan. The ability of early Pb2+ exposure to induce epigenetic changes is well-established, suggesting that Pb2+-induced neurobehavioral deficits may be heritable across generations. Understanding the long-term and multigenerational repercussions of lead exposure is crucial for clarifying both the genotypic alterations behind these behavioral outcomes and the potential mechanism of heritability. To study this, zebrafish (Danio rerio) embryos (<2 h post fertilization; EK strain) were exposed for 24 h to waterborne Pb2+ at a concentration of 10 μM. This exposed F0 generation was raised to adulthood and spawned to produce the F1 generation, which was subsequently spawned to produce the F2 generation. Previous avoidance conditioning studies determined that a 10 μM Pb2+ dose resulted in learning impairments persisting through the F2 generation. RNA was extracted from control- and 10 μM Pb2+-lineage F2 brains, (n = 10 for each group), sequenced, and transcript expression was quantified utilizing Quant-Seq. 648 genes were differentially expressed in the brains of F2 lead-lineage fish versus F2 control-lineage fish. Pathway analysis revealed altered genes in processes including synaptic function and plasticity, neurogenesis, endocrine homeostasis, and epigenetic modification, all of which are implicated in lead-induced neurobehavioral deficits and/or their inheritance. These data will inform future investigations to elucidate the mechanism of adult-onset and transgenerational health effects of developmental lead exposure.
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Affiliation(s)
- Danielle N Meyer
- Department of Pharmacology, School of Medicine, Wayne State University, Detroit, MI, USA; Institute of Environmental Health Sciences, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Emily J Crofts
- Institute of Environmental Health Sciences, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Camille Akemann
- Department of Pharmacology, School of Medicine, Wayne State University, Detroit, MI, USA; Institute of Environmental Health Sciences, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Katherine Gurdziel
- Applied Genome Technology Center, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Rebecca Farr
- Department of Pharmacology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Bridget B Baker
- Institute of Environmental Health Sciences, School of Medicine, Wayne State University, Detroit, MI, USA; Division of Laboratory Animal Resources, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Daniel Weber
- Children's Environmental Health Sciences Core Center, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Tracie R Baker
- Department of Pharmacology, School of Medicine, Wayne State University, Detroit, MI, USA; Institute of Environmental Health Sciences, School of Medicine, Wayne State University, Detroit, MI, USA.
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13
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Schobel J, Probst T, Reichert M, Schlee W, Schickler M, Kestler HA, Pryss R. Measuring Mental Effort for Creating Mobile Data Collection Applications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051649. [PMID: 32138381 PMCID: PMC7084515 DOI: 10.3390/ijerph17051649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 02/27/2020] [Accepted: 02/29/2020] [Indexed: 11/16/2022]
Abstract
To deal with drawbacks of paper-based data collection procedures, the QuestionSys approach empowers researchers with none or little programming knowledge to flexibly configure mobile data collection applications on demand. The mobile application approach of QuestionSys mainly pursues the goal to mitigate existing drawbacks of paper-based collection procedures in mHealth scenarios. Importantly, researchers shall be enabled to gather data in an efficient way. To evaluate the applicability of QuestionSys, several studies have been carried out to measure the efforts when using the framework in practice. In this work, the results of a study that investigated psychological insights on the required mental effort to configure the mobile applications are presented. Specifically, the mental effort for creating data collection instruments is validated in a study with N = 80 participants across two sessions. Thereby, participants were categorized into novices and experts based on prior knowledge on process modeling, which is a fundamental pillar of the developed approach. Each participant modeled 10 instruments during the course of the study, while concurrently several performance measures are assessed (e.g., time needed or errors). The results of these measures are then compared to the self-reported mental effort with respect to the tasks that had to be modeled. On one hand, the obtained results reveal a strong correlation between mental effort and performance measures. On the other, the self-reported mental effort decreased significantly over the course of the study, and therefore had a positive impact on measured performance metrics. Altogether, this study indicates that novices with no prior knowledge gain enough experience over the short amount of time to successfully model data collection instruments on their own. Therefore, QuestionSys is a helpful instrument to properly deal with large-scale data collection scenarios like clinical trials.
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Affiliation(s)
- Johannes Schobel
- Institute of Medical Systems Biology, Ulm University, 89069 Ulm, Germany
- Institute of Databases and Information Systems, Ulm University, 89069 Ulm, Germany
- Correspondence:
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria
| | - Manfred Reichert
- Institute of Databases and Information Systems, Ulm University, 89069 Ulm, Germany
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
| | - Marc Schickler
- Institute of Databases and Information Systems, Ulm University, 89069 Ulm, Germany
| | - Hans A. Kestler
- Institute of Medical Systems Biology, Ulm University, 89069 Ulm, Germany
| | - Rüdiger Pryss
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, 97070 Würzburg, Germany
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14
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Zhang L, Hu XZ, Yu T, Chen Z, Dohl J, Li X, Benedek DM, Fullerton CS, Wynn G, Barrett JE, Li M, Russell DW, Ursano RJ. Genetic association of FKBP5 with PTSD in US service members deployed to Iraq and Afghanistan. J Psychiatr Res 2020; 122:48-53. [PMID: 31927265 DOI: 10.1016/j.jpsychires.2019.12.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 12/23/2019] [Accepted: 12/24/2019] [Indexed: 01/21/2023]
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating mental disorder with a prevalence of more than 7% in the US population and 12% in the military. An interaction of childhood trauma with FKBP5 (a glucocorticoid-regulated immunophilin) has been reported to be associated with PTSD in the general population. However, there are few reports on the association of FKBP5 with PTSD, particularly in important high-risk population such as the military. Here, we examined the association between four single-nucleotide polymorphisms (SNPs; rs3800373, rs9296158, rs1360780, rs9470080) covering the FKBP5 gene and probable PTSD in US service members deployed to Iraq and Afghanistan, a high-risk military population (n = 3890) (Hines et al., 2014). We found that probable PTSD subjects were significantly more likely to carry the A-allele of rs3800373, G-allele of rs9296158, C-allele of rs1360780, and C-allele of rs9470080. Furthermore, the four SNPs were in one block of strong pairwise linkage disequilibrium (r = 0.91-0.96). Within the block there were two major haplotypes of CATT and AGCC (rs3800373-rs9296158-rs1360780-rs9470080) that account for 99% of haplotype diversity. The distribution of the AGCC haplotype was significantly higher in probable PTSD subjects compared to non-PTSD (p<.05). The diplotype-based analysis indicated that the AGCC carriers tended to be probable PTSD. In this study, we demonstrated the association between FKBP5 and probable PTSD in US service members deployed to Iraq and Afghanistan, indicating that FKBP5 might be a risk factor for PTSD.
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Affiliation(s)
- Lei Zhang
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA.
| | - Xian-Zhang Hu
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Tianzheng Yu
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Ze Chen
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Jacob Dohl
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Xiaoxia Li
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - David M Benedek
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Carol S Fullerton
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Gary Wynn
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - James E Barrett
- Department of Neurology, Drexel University College of Medicine Philadelphia, PA, 19102-1192, USA
| | - Mian Li
- Department of Neurology, Washington DC VA Medical Center, Washington, DC, 20422, USA
| | - Dale W Russell
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA; Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | | | - Robert J Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
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15
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Cristóbal-Narváez P, Sheinbaum T, Rosa A, de Castro-Catala M, Domínguez-Martínez T, Kwapil TR, Barrantes-Vidal N. Interaction of both positive and negative daily-life experiences with FKBP5 haplotype on psychosis risk. Eur Psychiatry 2020; 63:e11. [PMID: 32093798 PMCID: PMC7315877 DOI: 10.1192/j.eurpsy.2019.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background. There is limited research on the interaction of both positive and negative daily-life environments with stress-related genetic variants on psychotic experiences (PEs) and negative affect (NA) across the extended psychosis phenotype. This study examined whether the FK506 binding protein 51 (FKBP5) variability moderates the association of positive and negative experiences in the moment with PEs and NA in participants with incipient psychosis and their nonclinical counterparts. Methods. A total of 233 nonclinical and 86 incipient psychosis participants were prompted for a 1-week period to assess their day-to-day experiences. Participants were genotyped for four FKBP5 single nucleotide polymorphisms (rs3800373, rs9296158, rs1360780, and rs9470080). Results. Multilevel analyses indicated that, unlike the risk haplotype, the protective FKBP5 haplotype moderated all the associations of positive experiences with diminished PEs and NA in incipient psychosis compared with nonclinical group. Conclusions. Participants with incipient psychosis showed symptomatic improvement when reporting positive appraisals in the interpersonal domain, which suggests that these act as a powerful coping mechanism. The fact that this occurred in daily-life underscores the clinical significance of this finding and pinpoints the importance of identifying protective mechanisms. In addition, results seem to concur with the vantage sensitivity model of gene–environment interaction, which poses that certain genetic variants may enhance the likelihood of benefiting from positive exposures.
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Affiliation(s)
- Paula Cristóbal-Narváez
- Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.,Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Tamara Sheinbaum
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Araceli Rosa
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Secció de Zoologia i Antropologia, Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona (UB), Barcelona, Spain.,Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
| | - Marta de Castro-Catala
- Secció de Zoologia i Antropologia, Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona (UB), Barcelona, Spain.,Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
| | - Tecelli Domínguez-Martínez
- Centro de Investigación en Salud Mental Global, Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría 'Ramon de la Fuente Muñiz', México
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign , Champaign, Illinois, USA
| | - Neus Barrantes-Vidal
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.,Sant Pere Claver-Fundació Sanitària, Barcelona, Spain
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16
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Kang JI, Kim TY, Choi JH, So HS, Kim SJ. Allele-specific DNA methylation level of FKBP5 is associated with post-traumatic stress disorder. Psychoneuroendocrinology 2019; 103:1-7. [PMID: 30605803 DOI: 10.1016/j.psyneuen.2018.12.226] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/05/2018] [Accepted: 12/18/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND FK506-binding protein 5 (FKBP5) binds to glucocorticoid receptors and modulates glucocorticoid sensitivity. The FKBP5 gene has been implicated in the dysregulation of human stress responses, contributing to the risk and treatment response of stress-related disorders. The present study examined whether epigenetic changes in FKBP5 are associated with chronic post-traumatic stress disorder (PTSD) status in the context of FKBP5 genetic variation (rs1360780 polymorphism) among male veterans exposed to combat trauma. METHODS Korean male veterans who served on active duty during the Vietnam War were categorized into 2 groups: with PTSD (n = 123) and without PTSD (n = 116). The genotype of FKBP5 rs1360780 and DNA methylation levels of two CpG sites at the FKBP5 intron 7 region were assessed in peripheral blood. Analysis of covariance was performed to examine main and interaction effects of PTSD status and FKBP5 genotype on FKBP5 DNA methylation level, with age, trauma levels, and alcohol use as covariates. RESULTS A significant main effect of FKBP5 rs1360780 and PTSD and an interaction effect between genotype and PTSD status were found on mean FKBP5 DNA methylation level. The T allele of rs1360780 was associated with lower FKBP5 methylation level. In addition, the PTSD group showed significantly higher methylation than did the non-PTSD group among veterans carrying the risk T allele (n = 96), while no group difference was observed on methylation levels among veterans with the CC genotype (n = 143). Among veterans carrying the T allele, FKBP5 methylation levels were positively correlated with the severity of PTSD symptoms. CONCLUSIONS The present study demonstrated different FKBP5 methylation levels in PTSD depending on FKBP5 genetic variation among veterans exposed to combat trauma. The present finding suggests that the genetic and epigenetic modulation of FKBP5 is involved in the pathophysiology of PTSD. Further longitudinal research involving people exposed to trauma is required to understand causal relationships of FKBP5 in the development and recovery of PTSD.
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Affiliation(s)
- Jee In Kang
- Institute of Behavioral Science in Medicine & Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea.
| | - Tae Yong Kim
- Institute of Behavioral Science in Medicine & Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Hee Choi
- Department of Neuropsychiatry, Veterans Health Service Medical Center, Seoul, South Korea
| | - Hyung Seok So
- Department of Neuropsychiatry, Veterans Health Service Medical Center, Seoul, South Korea
| | - Se Joo Kim
- Institute of Behavioral Science in Medicine & Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea
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17
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Dunlop BW, Wong A. The hypothalamic-pituitary-adrenal axis in PTSD: Pathophysiology and treatment interventions. Prog Neuropsychopharmacol Biol Psychiatry 2019; 89:361-379. [PMID: 30342071 DOI: 10.1016/j.pnpbp.2018.10.010] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 12/26/2022]
Abstract
Questions of how altered functioning of the hypothalamic pituitary adrenal (HPA) axis contribute to the development and maintenance of posttraumatic stress disorder (PTSD) have been the focus of extensive animal and human research. As a rule, results have been inconsistent across studies, likely due to a variety of confounding variables that have received inadequate attention. Important confounding factors include the effects of early life stress, biological sex, and the glucocorticoid used for interventions. In this manuscript we review: 1) the literature on identified abnormalities of HPA axis function in PTSD, both in terms of basal functioning and as part of challenge paradigms; 2) the role of HPA axis function pre- and immediately post-trauma as a risk factor for PTSD development; 3) the impact of HPA axis genes' allelic variants and epigenetic modifications on PTSD risk; 4) the contributions of HPA axis components to fear learning and extinction; and 5) therapeutic manipulations of the HPA axis to both prevent and treat PTSD, including the role of glucocorticoids as part of medication enhanced psychotherapy.
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Affiliation(s)
- Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
| | - Andrea Wong
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
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18
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King G, Baker KD, Bisby MA, Chan D, Cowan CSM, Stylianakis AA, Zimmermann KS, Richardson R. A precision medicine approach to pharmacological adjuncts to extinction: a call to broaden research. Psychopharmacology (Berl) 2019; 236:143-161. [PMID: 30116858 DOI: 10.1007/s00213-018-4999-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/07/2018] [Indexed: 12/21/2022]
Abstract
There is a pressing need to improve treatments for anxiety. Although exposure-based therapy is currently the gold-standard treatment, many people either do not respond to this therapy or experience a relapse of symptoms after treatment has ceased. In recent years, there have been many novel pharmacological agents identified in preclinical research that have potential as adjuncts for exposure therapy, yet very few of these are regularly integrated into clinical practice. Unfortunately, the robust effects observed in the laboratory animal often do not translate to a clinical population. In this review, we discuss how age, sex, genetics, stress, medications, diet, alcohol, and the microbiome can vary across a clinical population and yet are rarely considered in drug development. While not an exhaustive list, we have focused on these factors because they have been shown to influence an individual's vulnerability to anxiety and alter the neurotransmitter systems often targeted by pharmacological adjuncts to therapy. We argue that for potential adjuncts to be successfully translated from the lab to the clinic empirical research must be broadened to consider how individual difference factors will influence drug efficacy.
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Affiliation(s)
- Gabrielle King
- School of Psychology, The University of New South Wales, Sydney, Australia.
| | - Kathryn D Baker
- School of Psychology, The University of New South Wales, Sydney, Australia
| | - Madelyne A Bisby
- School of Psychology, The University of New South Wales, Sydney, Australia
| | - Diana Chan
- School of Psychology, The University of New South Wales, Sydney, Australia
| | | | | | | | - Rick Richardson
- School of Psychology, The University of New South Wales, Sydney, Australia
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19
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Glucocorticoid-induced enhancement of extinction-from animal models to clinical trials. Psychopharmacology (Berl) 2019; 236:183-199. [PMID: 30610352 PMCID: PMC6373196 DOI: 10.1007/s00213-018-5116-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 11/06/2018] [Indexed: 12/13/2022]
Abstract
Extensive evidence from both animal model and human research indicates that glucocorticoid hormones are crucially involved in modulating memory performance. Glucocorticoids, which are released during stressful or emotionally arousing experiences, enhance the consolidation of new memories, including extinction memory, but reduce the retrieval of previously stored memories. These memory-modulating properties of glucocorticoids have recently received considerable interest for translational purposes because strong aversive memories lie at the core of several fear-related disorders, including post-traumatic stress disorder and phobias. Moreover, exposure-based psychological treatment of these disorders relies on successful fear extinction. In this review, we argue that glucocorticoid-based interventions facilitate fear extinction by reducing the retrieval of aversive memories and enhancing the consolidation of extinction memories. Several clinical trials have already indicated that glucocorticoids might be indeed helpful in the treatment of fear-related disorders.
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20
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Thomas N, Gurvich C, Kulkarni J. Borderline personality disorder, trauma, and the hypothalamus-pituitary-adrenal axis. Neuropsychiatr Dis Treat 2019; 15:2601-2612. [PMID: 31564884 PMCID: PMC6743631 DOI: 10.2147/ndt.s198804] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 08/26/2019] [Indexed: 12/14/2022] Open
Abstract
Borderline personality disorder (BPD) is a complex psychiatric illness for which treatment poses a significant challenge due to limited effective pharmacologic treatments, and under-resourced psychological interventions. BPD is one of the most stigmatized conditions in psychiatry today, but can be understood as a modifiable, neurodevelopmental disorder that arises from maladaptive responses to trauma and stress. Stress susceptibility and reactivity in BPD is thought to mediate both the development and maintenance of BPD symptomatology, with trauma exposure considered an early life risk factor of development, and acute stress moderating symptom trajectory. An altered stress response has been characterized in BPD at the structural, neural, and neurobiological level, and is believed to underlie the maladaptive behavioral and cognitive symptomatology presented in BPD. The endocrine hypothalamus-pituitary-adrenal (HPA) axis represents a key stress response system, and growing evidence suggests it is dysfunctional in the BPD patient population. This theoretical review examines BPD in the context of a neurodevelopmental stress-related disorder, providing an overview of measurements of stress with a focus on HPA-axis measurement. Potential confounding factors associated with measurement of the HPA system are discussed, including sex and sex hormones, genetic factors, and the influence of sample collection methods. HPA-axis dysfunction in BPD largely mirrors findings demonstrated in post-traumatic stress disorder and may represent a valuable neuroendocrine target for diagnostic or treatment response biomarkers, or for which novel treatments can be investigated.
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Affiliation(s)
- Natalie Thomas
- Central Clinical School , Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Caroline Gurvich
- Central Clinical School , Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Jayashri Kulkarni
- Central Clinical School , Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Victoria, Australia
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21
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Young DA, Inslicht SS, Metzler TJ, Neylan TC, Ross JA. The effects of early trauma and the FKBP5 gene on PTSD and the HPA axis in a clinical sample of Gulf War veterans. Psychiatry Res 2018; 270:961-966. [PMID: 29576410 DOI: 10.1016/j.psychres.2018.03.037] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 02/01/2018] [Accepted: 03/11/2018] [Indexed: 12/21/2022]
Abstract
Previous research indicates that interactions between FKBP5 single nucleotide polymorphisms (SNPs) and child abuse are associated with posttraumatic stress disorder (PTSD) in adulthood. We examined the relationship between the T-allele of the rs1360780 FKBP5 SNP and child abuse on PTSD and the HPA axis in a clinical sample of Gulf War veterans. Genotyping was completed on 266 veterans and 174 veterans additionally participated in a low dose dexamethasone suppression test (DST). The CAPS was used to determine PTSD status and the THQ was used to determine child abuse operationalized as either childhood physical or sexual abuse. Hierarchical regression models were used to assess FKBP5 × child abuse interactions on PTSD, basal cortisol levels, and post DST cortisol levels. The FKBP5 risk allele and child abuse were separately associated with PTSD diagnosis. The risk allele was also associated with significantly lower cortisol levels at baseline. However, no significant FKBP5 × child abuse interaction on PTSD diagnosis, basal cortisol levels, or greater cortisol suppression was observed. Our results suggest that FKBP5 may be a viable biomarker for PTSD. Nonetheless, further work will be required to reconcile our findings with previous reports of an FKBP5 × child abuse interaction on posttraumatic stress response.
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Affiliation(s)
- Dmitri A Young
- Department of Mental Health, San Francisco Veterans Affairs Medical Center, 4150 Clement St. Bldg. 8., San Francisco, CA 94121, USA; School of Medicine, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave. San Francisco, CA 94143, USA.
| | - Sabra S Inslicht
- Department of Mental Health, San Francisco Veterans Affairs Medical Center, 4150 Clement St. Bldg. 8., San Francisco, CA 94121, USA; School of Medicine, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave. San Francisco, CA 94143, USA
| | - Thomas J Metzler
- School of Medicine, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave. San Francisco, CA 94143, USA
| | - Thomas C Neylan
- Department of Mental Health, San Francisco Veterans Affairs Medical Center, 4150 Clement St. Bldg. 8., San Francisco, CA 94121, USA; School of Medicine, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave. San Francisco, CA 94143, USA
| | - Jessica A Ross
- Department of Mental Health, San Francisco Veterans Affairs Medical Center, 4150 Clement St. Bldg. 8., San Francisco, CA 94121, USA
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22
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Wilker S, Schneider A, Conrad D, Pfeiffer A, Boeck C, Lingenfelder B, Freytag V, Vukojevic V, Vogler C, Milnik A, Papassotiropoulos A, J.-F. de Quervain D, Elbert T, Kolassa S, Kolassa IT. Genetic variation is associated with PTSD risk and aversive memory: Evidence from two trauma-Exposed African samples and one healthy European sample. Transl Psychiatry 2018; 8:251. [PMID: 30467376 PMCID: PMC6250662 DOI: 10.1038/s41398-018-0297-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 09/26/2018] [Accepted: 10/18/2018] [Indexed: 11/11/2022] Open
Abstract
The probability to develop posttraumatic stress disorder (PTSD), characterized by vivid, intrusive emotional memories of the encountered traumatic events, depends - among other factors - on the number of previous traumatic experiences (traumatic load) and individual genetic vulnerability. So far, our knowledge regarding the biological underpinnings of PTSD is relatively sparse. Genome-wide association studies (GWAS) followed by independent replication might help to discover novel, so far unknown biological mechanisms associated with the development of traumatic memories. Here, a GWAS was conducted in N = 924 Northern Ugandan rebel war survivors and identified seven suggestively significant single nucleotide polymorphisms (SNPs; p ≤ 1 × 10-5) for lifetime PTSD risk. Of these seven SNPs, the association of rs3852144 on chromosome 5 was replicated in an independent sample of Rwandan genocide survivors (N = 370, p < .01). While PTSD risk increased with accumulating traumatic experiences, the vulnerability was reduced in carriers of the minor G-allele in an additive manner. Correspondingly, memory for aversive pictures decreased with higher number of the minor G-allele in a sample of N = 2698 healthy Swiss individuals. Finally, investigations on N = 90 PTSD patients treated with Narrative Exposure Therapy indicated an additive effect of genotype on PTSD symptom change from pre-treatment to four months after treatment, but not between pre-treatment and the 10-months follow-up. In conclusion, emotional memory formation seems to decline with increasing number of rs3852144 G-alleles, rendering individuals more resilient to PTSD development. However, the impact on therapy outcome remains preliminary and further research is needed to determine how this intronic marker may affect memory processes in detail.
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Affiliation(s)
- Sarah Wilker
- Clinical & Biological Psychology, Ulm University, Ulm, Germany.
| | - Anna Schneider
- Clinical & Biological Psychology, Ulm University, Ulm, Germany.
| | - Daniela Conrad
- Clinical & Biological Psychology, Ulm University, Ulm, Germany. .,Clinical Psychology and Neuropsychology, University of Konstanz, Konstanz, Germany.
| | - Anett Pfeiffer
- 0000 0001 0658 7699grid.9811.1Clinical Psychology and Neuropsychology, University of Konstanz, Konstanz, Germany
| | - Christina Boeck
- 0000 0004 1936 9748grid.6582.9Clinical & Biological Psychology, Ulm University, Ulm, Germany
| | - Birke Lingenfelder
- 0000 0001 0658 7699grid.9811.1Clinical Psychology and Neuropsychology, University of Konstanz, Konstanz, Germany
| | - Virginie Freytag
- 0000 0004 1937 0642grid.6612.3Division of Molecular Neuroscience, University of Basel, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Vanja Vukojevic
- 0000 0004 1937 0642grid.6612.3Division of Molecular Neuroscience, University of Basel, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3Department Biozentrum, Life Sciences Training Facility, University of Basel, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Christian Vogler
- 0000 0004 1937 0642grid.6612.3Division of Molecular Neuroscience, University of Basel, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Annette Milnik
- 0000 0004 1937 0642grid.6612.3Division of Molecular Neuroscience, University of Basel, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Andreas Papassotiropoulos
- 0000 0004 1937 0642grid.6612.3Division of Molecular Neuroscience, University of Basel, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3Department Biozentrum, Life Sciences Training Facility, University of Basel, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Dominique J.-F. de Quervain
- 0000 0004 1937 0642grid.6612.3Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3Psychiatric University Clinics, University of Basel, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3Division of Cognitive Neuroscience, University of Basel, Basel, Switzerland
| | - Thomas Elbert
- 0000 0001 0658 7699grid.9811.1Clinical Psychology and Neuropsychology, University of Konstanz, Konstanz, Germany
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23
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Modulation of the endocannabinoid system by sex hormones: Implications for posttraumatic stress disorder. Neurosci Biobehav Rev 2018; 94:302-320. [DOI: 10.1016/j.neubiorev.2018.07.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 07/10/2018] [Accepted: 07/10/2018] [Indexed: 12/11/2022]
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24
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Conrad D, Wilker S, Schneider A, Karabatsiakis A, Pfeiffer A, Kolassa S, Freytag V, Vukojevic V, Vogler C, Milnik A, Papassotiropoulos A, J-F de Quervain D, Elbert T, Kolassa IT. Integrated genetic, epigenetic, and gene set enrichment analyses identify NOTCH as a potential mediator for PTSD risk after trauma: Results from two independent African cohorts. Psychophysiology 2018; 57:e13288. [PMID: 30328613 PMCID: PMC7379258 DOI: 10.1111/psyp.13288] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 08/14/2018] [Accepted: 08/17/2018] [Indexed: 12/17/2022]
Abstract
The risk of developing posttraumatic stress disorder (PTSD) increases with the number of traumatic event types experienced (trauma load) in interaction with other psychobiological risk factors. The NOTCH (neurogenic locus notch homolog proteins) signaling pathway, consisting of four different trans‐membrane receptor proteins (NOTCH1–4), constitutes an evolutionarily well‐conserved intercellular communication pathway (involved, e.g., in cell–cell interaction, inflammatory signaling, and learning processes). Its association with fear memory consolidation makes it an interesting candidate for PTSD research. We tested for significant associations of common genetic variants of NOTCH1–4 (investigated by microarray) and genomic methylation of saliva‐derived DNA with lifetime PTSD risk in independent cohorts from Northern Uganda (N1 = 924) and Rwanda (N2 = 371), and investigated whether NOTCH‐related gene sets were enriched for associations with lifetime PTSD risk. We found associations of lifetime PTSD risk with single nucleotide polymorphism (SNP) rs2074621 (NOTCH3) (puncorrected = 0.04) in both cohorts, and with methylation of CpG site cg17519949 (NOTCH3) (puncorrected = 0.05) in Rwandans. Yet, none of the (epi‐)genetic associations survived multiple testing correction. Gene set enrichment analyses revealed enrichment for associations of two NOTCH pathways with lifetime PTSD risk in Ugandans: NOTCH binding (pcorrected = 0.003) and NOTCH receptor processing (pcorrected = 0.01). The environmental factor trauma load was significant in all analyses (all p < 0.001). Our integrated methodological approach suggests NOTCH as a possible mediator of PTSD risk after trauma. The results require replication, and the precise underlying pathophysiological mechanisms should be illuminated in future studies. Integrating genetic, epigenetic, and gene set enrichment analyses, while accounting for the environmental factor traumatic load, we identified stress‐ and memory‐associated neurogenic locus notch homolog protein (NOTCH) genes and related gene sets as potential risk mediators for the development of posttraumatic stress disorder (PTSD) after trauma. Thus, our results strengthen the presumed role of memory‐ and inflammation‐associated genes in PTSD development, and revealed a promising target for future treatment studies. Furthermore, we demonstrated the importance of traumatic load in PTSD etiology, and of an integrated approach in order to obtain a more comprehensive understanding of the functionality of PTSD‐associated markers.
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Affiliation(s)
- Daniela Conrad
- Clinical Psychology and Neuropsychology, University of Konstanz, Konstanz, Germany.,Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Sarah Wilker
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Anna Schneider
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Alexander Karabatsiakis
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Anett Pfeiffer
- Clinical Psychology and Neuropsychology, University of Konstanz, Konstanz, Germany
| | | | - Virginie Freytag
- Division of Molecular Neuroscience, University of Basel, Basel, Switzerland.,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Vanja Vukojevic
- Division of Molecular Neuroscience, University of Basel, Basel, Switzerland.,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland.,Department Biozentrum, Life Sciences Training Facility, University of Basel, Basel, Switzerland.,Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Christian Vogler
- Division of Molecular Neuroscience, University of Basel, Basel, Switzerland.,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland.,Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Annette Milnik
- Division of Molecular Neuroscience, University of Basel, Basel, Switzerland.,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland.,Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Andreas Papassotiropoulos
- Division of Molecular Neuroscience, University of Basel, Basel, Switzerland.,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland.,Department Biozentrum, Life Sciences Training Facility, University of Basel, Basel, Switzerland.,Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Dominique J-F de Quervain
- Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland.,Psychiatric University Clinics, University of Basel, Basel, Switzerland.,Division of Cognitive Neuroscience, University of Basel, Basel, Switzerland
| | - Thomas Elbert
- Clinical Psychology and Neuropsychology, University of Konstanz, Konstanz, Germany
| | - Iris-Tatjana Kolassa
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
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25
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Schobel J, Pryss R, Probst T, Schlee W, Schickler M, Reichert M. Learnability of a Configurator Empowering End Users to Create Mobile Data Collection Instruments: Usability Study. JMIR Mhealth Uhealth 2018; 6:e148. [PMID: 29959107 PMCID: PMC6045789 DOI: 10.2196/mhealth.9826] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 03/18/2018] [Accepted: 05/14/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many research domains still heavily rely on paper-based data collection procedures, despite numerous associated drawbacks. The QuestionSys framework is intended to empower researchers as well as clinicians without programming skills to develop their own smart mobile apps in order to collect data for their specific scenarios. OBJECTIVE In order to validate the feasibility of this model-driven, end-user programming approach, we conducted a study with 80 participants. METHODS Across 2 sessions (7 days between Session 1 and Session 2), participants had to model 10 data collection instruments (5 at each session) with the developed configurator component of the framework. In this context, performance measures like the time and operations needed as well as the resulting errors were evaluated. Participants were separated into two groups (ie, novices vs experts) based on prior knowledge in process modeling, which is one fundamental pillar of the QuestionSys framework. RESULTS Statistical analysis (t tests) revealed that novices showed significant learning effects for errors (P=.04), operations (P<.001), and time (P<.001) from the first to the last use of the configurator. Experts showed significant learning effects for operations (P=.001) and time (P<.001), but not for errors as the experts' errors were already very low at the first modeling of the data collection instrument. Moreover, regarding the time and operations needed, novices got significantly better at the third modeling task than experts were at the first one (t tests; P<.001 for time and P=.002 for operations). Regarding errors, novices did not get significantly better at working with any of the 10 data collection instruments than experts were at the first modeling task, but novices' error rates for all 5 data collection instruments at Session 2 were not significantly different anymore from those of experts at the first modeling task. After 7 days of not using the configurator (from Session 1 to Session 2), the experts' learning effect at the end of Session 1 remained stable at the beginning of Session 2, but the novices' learning effect at the end of Session 1 showed a significant decay at the beginning of Session 2 regarding time and operations (t tests; P<.001 for time and P=.03 for operations). CONCLUSIONS In conclusion, novices were able to use the configurator properly and showed fast (but unstable) learning effects, resulting in their performances becoming as good as those of experts (which were already good) after having little experience with the configurator. Following this, researchers and clinicians can use the QuestionSys configurator to develop data collection apps for smart mobile devices on their own.
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Affiliation(s)
- Johannes Schobel
- Institute of Databases and Information Systems, Ulm University, Ulm, Germany
| | - Rüdiger Pryss
- Institute of Databases and Information Systems, Ulm University, Ulm, Germany
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Marc Schickler
- Institute of Databases and Information Systems, Ulm University, Ulm, Germany
| | - Manfred Reichert
- Institute of Databases and Information Systems, Ulm University, Ulm, Germany
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26
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Felmingham KL, Zuj DV, Hsu KCM, Nicholson E, Palmer MA, Stuart K, Vickers JC, Malhi GS, Bryant RA. The BDNF Val66Met polymorphism moderates the relationship between Posttraumatic Stress Disorder and fear extinction learning. Psychoneuroendocrinology 2018; 91:142-148. [PMID: 29550677 DOI: 10.1016/j.psyneuen.2018.03.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 03/04/2018] [Accepted: 03/05/2018] [Indexed: 12/17/2022]
Abstract
The low expression Met allele of the BDNF Val66Met polymorphism is associated with impaired fear extinction in healthy controls, and poorer response to exposure therapy in patients with Posttraumatic Stress Disorder (PTSD). Given that fear extinction underlies exposure therapy, this raises the question of the impact of BDNFVal66Met polymorphism on fear extinction in PTSD, yet this question has not yet been examined. One hundred and six participants (22 PTSD, 46 trauma-exposed controls (TC) and 38 non-trauma exposed controls (NTC)) completed a fear conditioning and extinction task and saliva samples were taken for DNA extraction and genotyped for the BDNF Val66Met polymorphism. Moderation analyses using PROCESS examined whether BDNF genotype (Val-Val vs Met carriers) moderated the relationship between PTSD symptom severity (and diagnostic status) and skin conductance response (SCR) amplitude during fear extinction. The PTSD group displayed significantly slower fear extinction learning compared to TC and NTC in the early extinction phase. The BDNF Val66Met polymorphism moderated the relationship between PTSD and fear extinction learning, such that poorer fear extinction learning was associated with greater PTSD symptom severity (and PTSD diagnostic status) in individuals with the low-expression Met allele, but no relationship was demonstrated in individuals with the Val-Val allele. This study reveals that impaired fear extinction learning is particularly evident in individuals with PTSD who carry the low-expression BDNF Met allele and importantly not in those with the Val-Val allele. This provides novel evidence of a link between BDNF and impaired fear extinction learning in PTSD, which may contribute to poorer response to exposure therapy.
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Affiliation(s)
- Kim L Felmingham
- School of Psychological Sciences, University of Melbourne, Australia.
| | - Daniel V Zuj
- Division of Psychology, School of Medicine, University of Tasmania, Australia; Department of Psychology, Swansea University, UK
| | - Ken Chia Ming Hsu
- Division of Psychology, School of Medicine, University of Tasmania, Australia
| | - Emma Nicholson
- Division of Psychology, School of Medicine, University of Tasmania, Australia
| | - Matthew A Palmer
- Division of Psychology, School of Medicine, University of Tasmania, Australia
| | - Kimberley Stuart
- Wicking Dementia Research Centre, University of Tasmania, Australia
| | - James C Vickers
- Wicking Dementia Research Centre, University of Tasmania, Australia
| | - Gin S Malhi
- Department of Psychiatry, University of Sydney, Sydney, Australia
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27
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Schneider A, Conrad D, Pfeiffer A, Elbert T, Kolassa IT, Wilker S. Stigmatization Is Associated With Increased PTSD Risk After Traumatic Stress and Diminished Likelihood of Spontaneous Remission-A Study With East-African Conflict Survivors. Front Psychiatry 2018; 9:423. [PMID: 30364089 PMCID: PMC6191513 DOI: 10.3389/fpsyt.2018.00423] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 08/17/2018] [Indexed: 12/25/2022] Open
Abstract
Studies in conflict population have repeatedly documented that the number of traumatic event types experienced (trauma load) increases the risk to develop posttraumatic stress disorder (PTSD) in a dose-dependent manner. Misconceptions about survivors' experiences and actions during the war, as well as mental health symptoms frequently lead to stigmatization by their own families and the community, which might render them even more vulnerable for PTSD development and prevent successful recovery. We therefore investigated whether stigmatization affects trauma-related psychopathology beyond the well-known effect of trauma load. The study sample comprised N = 1131 survivors of the rebel war led by the Lord's Resistance Army (LRA) in Northern Uganda, including a large proportion of formerly abducted individuals and child soldiers. We investigated how the experience of stigmatization affects PTSD risk and the likelihood of spontaneous remission, taking trauma load into account. Further, the association of stigmatization with treatment outcome was determined in a subsample of N = 284 individuals with PTSD who received trauma-focused psychotherapy. More than one third of the total sample, and almost two-thirds of the therapy subsample, reported experiences of stigmatization. The main reasons for stigmatization were related to an association with a rebel group (e.g., being called a rebel), followed by mental health problems/PTSD symptoms and HIV/AIDS. Stigmatization was strongly associated with a higher prevalence of lifetime and current PTSD, a diminished probability of spontaneous remission and higher PTSD symptoms before and after trauma-focused psychotherapy, beyond the effect of trauma load. In sum, our results support the assumption that stigmatization aggravates trauma-related psychopathology and impede symptom improvement. In post-conflict regions, community and family interventions which aim at reducing stigmatization and discrimination might therefore complement individual psychotherapy in order to allow survivors to recover and reintegrate into society.
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Affiliation(s)
- Anna Schneider
- Department of Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.,Vivo International e.V., Konstanz, Germany
| | - Daniela Conrad
- Department of Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.,Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Anett Pfeiffer
- Vivo International e.V., Konstanz, Germany.,Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Thomas Elbert
- Vivo International e.V., Konstanz, Germany.,Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Iris-Tatjana Kolassa
- Department of Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.,Vivo International e.V., Konstanz, Germany
| | - Sarah Wilker
- Department of Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.,Vivo International e.V., Konstanz, Germany
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28
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A novel Differential Susceptibility framework for the study of nightmares: Evidence for trait sensory processing sensitivity. Clin Psychol Rev 2017; 58:86-96. [DOI: 10.1016/j.cpr.2017.10.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 10/02/2017] [Accepted: 10/15/2017] [Indexed: 12/21/2022]
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29
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Carvalho CM, Coimbra BM, Ota VK, Mello MF, Belangero SI. Single-nucleotide polymorphisms in genes related to the hypothalamic-pituitary-adrenal axis as risk factors for posttraumatic stress disorder. Am J Med Genet B Neuropsychiatr Genet 2017; 174:671-682. [PMID: 28686326 DOI: 10.1002/ajmg.b.32564] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 05/30/2017] [Indexed: 01/12/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a common psychiatric disorder. The etiology of PTSD is multifactorial, depending on many environmental and genetic risk factors, and the exposure to life or physical integrity-threatening events. Several studies have shown significant correlations of many neurobiological findings with PTSD. Hypothalamic-pituitary-adrenal (HPA) axis dysfunction is strongly correlated with this disorder. One hypothesis is that HPA axis dysfunction may precede the traumatic event, suggesting that genes expressed in the HPA axis may be involved in the development of PTSD. This article reviews molecular genetic studies related to PTSD collected through a literature search performed in PubMed, MEDLINE, ScienceDirect, and Scientific Electronic Library Online (SciELO). The results of these studies suggest that several polymorphisms in the HPA axis genes, including FKBP5, NR3C1, CRHR1, and CRHR2, may be risk factors for PTSD development or may be associated with the severity of PTSD symptoms.
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Affiliation(s)
- Carolina M Carvalho
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,LINC-Interdisciplinary Laboratory of Clinical Neurosciences, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Bruno M Coimbra
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Vanessa K Ota
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,LINC-Interdisciplinary Laboratory of Clinical Neurosciences, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Marcelo F Mello
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Sintia I Belangero
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,LINC-Interdisciplinary Laboratory of Clinical Neurosciences, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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30
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Lokshina Y, Liberzon I. Enhancing efficacy of PTSD treatment: Role of circuits, genetics, and optimal timing. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2017. [DOI: 10.1111/cpsp.12203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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Hong C, Schüffler A, Kauhl U, Cao J, Wu CF, Opatz T, Thines E, Efferth T. Identification of NF-κB as Determinant of Posttraumatic Stress Disorder and Its Inhibition by the Chinese Herbal Remedy Free and Easy Wanderer. Front Pharmacol 2017; 8:181. [PMID: 28428751 PMCID: PMC5382210 DOI: 10.3389/fphar.2017.00181] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 03/20/2017] [Indexed: 01/09/2023] Open
Abstract
Posttraumatic stress disorder (PTSD) is a mental disorder developing after exposure to traumatic events. Although psychotherapy reveals some therapeutic effectiveness, clinically sustainable cure is still uncertain. Some Chinese herbal formulae are reported to work well clinically against mental diseases in Asian countries, but the safety and their mode of action are still unclear. In this study, we investigated the mechanisms of Chinese remedy free and easy wanderer (FAEW) on PTSD. We used a reverse pharmacology approach combining clinical data to search for mechanisms of PTSD with subsequent in vitro verification and bioinformatics techniques as follows: (1) by analyzing microarray-based transcriptome-wide mRNA expression profiling of PTSD patients; (2) by investigating the effect of FAEW and the antidepressant control drug fluoxetine on the transcription factor NF-κB using reporter cell assays and western blotting; (3) by performing molecular docking and literature data mining based on phytochemical constituents of FAEW. The results suggest an involvement of inflammatory processes mediated through NF-κB in the progression of PTSD. FAEW was non-cytotoxic in vitro and inhibited NF-κB activity and p65 protein expression. FAEW's anti-inflammatory compounds, i.e., paeoniflorin, isoliquiritin, isoliquiritin apioside and ononin were evaluated for binding to IκK and p65-RelA in a molecular docking approach. Paeoniflorin, albiflorin, baicalin, isoliquiritin and liquiritin have been reported to relieve depression in vivo or in clinical trials, which might be the active ingredients for FAEW against PTSD.
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Affiliation(s)
- Chunlan Hong
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg UniversityMainz, Germany
| | - Anja Schüffler
- Institut für Biotechnologie und Wirkstoff Forschung gGmbHKaiserslautern, Germany.,Institute of Molecular Physiology, Johannes Gutenberg UniversityMainz, Germany
| | - Ulrich Kauhl
- Institute of Organic Chemistry, Johannes Gutenberg UniversityMainz, Germany
| | - Jingming Cao
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg UniversityMainz, Germany
| | - Ching-Fen Wu
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg UniversityMainz, Germany
| | - Till Opatz
- Institute of Organic Chemistry, Johannes Gutenberg UniversityMainz, Germany
| | - Eckhard Thines
- Institut für Biotechnologie und Wirkstoff Forschung gGmbHKaiserslautern, Germany.,Institute of Molecular Physiology, Johannes Gutenberg UniversityMainz, Germany
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg UniversityMainz, Germany
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32
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Olff M, van Zuiden M. Neuroendocrine and neuroimmune markers in PTSD: pre-, peri- and post-trauma glucocorticoid and inflammatory dysregulation. Curr Opin Psychol 2017; 14:132-137. [PMID: 28813312 DOI: 10.1016/j.copsyc.2017.01.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 01/03/2017] [Accepted: 01/03/2017] [Indexed: 01/04/2023]
Abstract
We review current knowledge on how posttraumatic stress disorder (PTSD) is associated with dysregulation of the most commonly studied markers of the endocrine and immune systems pre-, peri- and post-trauma. Lower basal cortisol output, enhanced glucocorticoid receptor function, and a proinflammatory state have been most consistently found in PTSD, with considerable variability among studies and participants. Longitudinal research is scarce, but there is converging evidence that biological dysregulation is present before PTSD onset. Biological dysregulation may become more apparent with increasing time since trauma, and may be reversible with and predict effective treatment. However, considering the variability of findings and the complex interplay of these systems with other factors, the current clinical application of these findings remains limited.
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Affiliation(s)
- Miranda Olff
- Department of Psychiatry, Academic Medical Center at the University of Amsterdam, The Netherlands; Arq Psychotrauma Expert Group, Diemen, The Netherlands.
| | - Mirjam van Zuiden
- Department of Psychiatry, Academic Medical Center at the University of Amsterdam, The Netherlands
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33
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Binder EB. Dissecting the molecular mechanisms of gene x environment interactions: implications for diagnosis and treatment of stress-related psychiatric disorders. Eur J Psychotraumatol 2017; 8:1412745. [PMID: 29372006 PMCID: PMC5774411 DOI: 10.1080/20008198.2017.1412745] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 11/03/2017] [Indexed: 12/14/2022] Open
Abstract
Epidemiological studies indicate a combined contribution of genetic and environmental factors, mainly exposure to adverse life events, in the risk for psychiatric disease. Understanding how adverse life events interact with genetic predisposition on the molecular level to shape risk and resilience to psychiatric disorders may yield important insight into disease mechanism. Using the example of the molecular mechanisms of interaction of functional genetic variants within the stress-regulating gene FKBP5 and early adversity, it is delineated how this interaction could contribute to transdiagnostic disease risk via a combined genetic and epigenetic disinhibition of FKBP5 transcription. This knowledge may now allow to develop biomarkers for a transdiagnostic subset of psychiatric patients and to personalize treatment.
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Affiliation(s)
- Elisabeth B Binder
- Department of Translational Research in PsychiatryMax-Planck Institute of Psychiatry, Munich, Germany.,Department of Psychiatry and Behavioral SciencesEmory University School of Medicine, Atlanta, GA, USA
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34
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Conrad D, Wilker S, Pfeiffer A, Lingenfelder B, Ebalu T, Lanzinger H, Elbert T, Kolassa IT, Kolassa S. Does trauma event type matter in the assessment of traumatic load? Eur J Psychotraumatol 2017; 8:1344079. [PMID: 28804594 PMCID: PMC5533143 DOI: 10.1080/20008198.2017.1344079] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 06/05/2017] [Indexed: 11/05/2022] Open
Abstract
Background: The likelihood of developing Posttraumatic Stress Disorder (PTSD) depends on the interaction of individual risk factors and cumulative traumatic experiences. Hence, the identification of individual susceptibility factors warrants precise quantification of trauma exposure. Previous research indicated that some traumatic events may have more severe influences on mental health than others; thus, the assessment of traumatic load may be improved by weighting event list items rather than calculating the simple sum score. Objective: We compared two statistical methods, Random Forests using Conditional Interference (RF-CI) and Least Absolute Shrinkage and Selection Operator (LASSO), based on their ability to rank traumatic experiences according to their importance for predicting lifetime PTSD. Methods: Statistical models were initially fitted in a sample of N1 = 441 survivors of the Northern Ugandan rebel war. The ability to correctly predict lifetime PTSD was then tested in an independent sample of N2 = 211, and subsequently compared with predictions by the simple sum score of different traumatic event types experienced. Results: Results indicate that RF-CI and LASSO allow for a ranking of traumatic events according to their predictive importance for lifetime PTSD. Moreover, RF-CI showed slightly better prediction accuracy than the simple sum score, followed by LASSO when comparing prediction results in the validation sample. Conclusion: Given the expense in time and calculation effort by RF-CI and LASSO, and the relatively low increase in prediction accuracy by RF-CI, we recommend using the simple sum score to measure the environmental factor traumatic load, e.g., in analyses of gene × environment interactions.
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Affiliation(s)
- Daniela Conrad
- Clinical Psychology and Neuropsychology, Department of Psychology, University of Konstanz, Konstanz, Germany.,Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Sarah Wilker
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Anett Pfeiffer
- Clinical Psychology and Neuropsychology, Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Birke Lingenfelder
- Clinical Psychology and Neuropsychology, Department of Psychology, University of Konstanz, Konstanz, Germany
| | | | - Hartmut Lanzinger
- Institute of Number Theory and Probability Theory, Ulm University, Ulm, Germany
| | - Thomas Elbert
- Clinical Psychology and Neuropsychology, Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Iris-Tatjana Kolassa
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
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35
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Toepfer P, Heim C, Entringer S, Binder E, Wadhwa P, Buss C. Oxytocin pathways in the intergenerational transmission of maternal early life stress. Neurosci Biobehav Rev 2016; 73:293-308. [PMID: 28027955 DOI: 10.1016/j.neubiorev.2016.12.026] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 12/08/2016] [Accepted: 12/17/2016] [Indexed: 12/17/2022]
Abstract
Severe stress in early life, such as childhood abuse and neglect, constitutes a major risk factor in the etiology of psychiatric disorders and somatic diseases. Importantly, these long-term effects may impact the next generation. The intergenerational transmission of maternal early life stress (ELS) may occur via pre-and postnatal pathways, such as alterations in maternal-fetal-placental stress physiology, maternal depression during pregnancy and postpartum, as well as impaired mother-offspring interactions. The neuropeptide oxytocin (OT) has gained considerable attention for its role in modulating all of these assumed transmission pathways. Moreover, central and peripheral OT signaling pathways are highly sensitive to environmental exposures and may be compromised by ELS with implications for these putative transmission mechanisms. Together, these data suggest that OT pathways play an important role in the intergenerational transmission of maternal ELS in humans. By integrating recent studies on gene-environment interactions and epigenetic modifications in OT pathway genes, the present review aims to develop a conceptual framework of intergenerational transmission of maternal ELS that emphasizes the role of OT.
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Affiliation(s)
- Philipp Toepfer
- Institute of Medical Psychology, Charité - Universitätsmedizin Berlin, Luisenstraße 57, 10117, Berlin, Germany
| | - Christine Heim
- Institute of Medical Psychology, Charité - Universitätsmedizin Berlin, Luisenstraße 57, 10117, Berlin, Germany; Department of Biobehavioral Health, Penn State University, 219 Biobehavioral Health Building University Park, PA, 16802, USA
| | - Sonja Entringer
- Institute of Medical Psychology, Charité - Universitätsmedizin Berlin, Luisenstraße 57, 10117, Berlin, Germany; UC Irvine Development, Health and Disease Research Program, 333 The City Blvd. W, Suite 810, Orange, CA, 92868, USA
| | - Elisabeth Binder
- Max-Planck Institute of Psychiatry, Kraepelinstr. 2-10, 80804, Munich, Germany; Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, School of Medicine Atlanta, GA, 30307, USA
| | - Pathik Wadhwa
- UC Irvine Development, Health and Disease Research Program, 333 The City Blvd. W, Suite 810, Orange, CA, 92868, USA
| | - Claudia Buss
- Institute of Medical Psychology, Charité - Universitätsmedizin Berlin, Luisenstraße 57, 10117, Berlin, Germany; UC Irvine Development, Health and Disease Research Program, 333 The City Blvd. W, Suite 810, Orange, CA, 92868, USA.
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36
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Hong C, Efferth T. Systematic Review on Post-Traumatic Stress Disorder Among Survivors of the Wenchuan Earthquake. TRAUMA, VIOLENCE & ABUSE 2016; 17:542-561. [PMID: 26028651 DOI: 10.1177/1524838015585313] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Post-traumatic stress disorder (PTSD) widely occurs among victims or witness of disasters. With flashbacks, hyperarousal, and avoidance being the typical symptoms, PTSD became a focus of psychological research. The earthquake in Wenchuan, China, on May 12, 2008, was without precedent in magnitude and aftermath and caused huge damage, which drew scientists' attention to mental health of the survivors. We conducted a systematic overview by collecting published articles from the PubMed database and classifying them into five points: epidemiology, neuropathology, biochemistry, genetics and epigenetics, and treatment. The large body of research during the past 6 years showed that adolescents and adults were among the most studied populations with high prevalence rates for PTSD. Genomic and transcriptomic studies focusing on gene × environment studies as well as epigenetics are still rare, although a few available data showed great potential to better understand the pathophysiology of PTSD as multifactorial disease. Phytotherapy with Chinese herbs and acupuncture are rarely reported as of yet, although the first published data indicated promising therapy effects. Future studies should focus on the following points: (1) The affected populations under observation should be better defined concerning individual risk factor, time of observation, spatial movement, and individual disease courses of patients. (2) The role of social support for prevalence rates of PTSD should be observed in more detail. (3) Efficacy and safety of Chinese medicine should be studied to find potential interventions and effective treatments of PTSD.
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Affiliation(s)
- Chunlan Hong
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Mainz, Germany
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Mainz, Germany
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37
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de Quervain D, Schwabe L, Roozendaal B. Stress, glucocorticoids and memory: implications for treating fear-related disorders. Nat Rev Neurosci 2016; 18:7-19. [PMID: 27881856 DOI: 10.1038/nrn.2016.155] [Citation(s) in RCA: 310] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Glucocorticoid stress hormones are crucially involved in modulating mnemonic processing of emotionally arousing experiences. They enhance the consolidation of new memories, including those that extinguish older memories, but impair the retrieval of information stored in long-term memory. As strong aversive memories lie at the core of several fear-related disorders, including post-traumatic stress disorder and phobias, the memory-modulating properties of glucocorticoids have recently become of considerable translational interest. Clinical trials have provided the first evidence that glucocorticoid-based pharmacotherapies aimed at attenuating aversive memories might be helpful in the treatment of fear-related disorders. Here, we review important advances in the understanding of how glucocorticoids mediate stress effects on memory processes, and discuss the translational potential of these new conceptual insights.
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Affiliation(s)
- Dominique de Quervain
- Transfaculty Research Platform, University of Basel, CH-4055, Basel, Switzerland.,Division of Cognitive Neuroscience, Department of Psychology, University of Basel, CH-4055, Basel, Switzerland.,University Psychiatric Clinics, University of Basel, CH-4012, Basel, Switzerland
| | - Lars Schwabe
- Department of Cognitive Psychology, Institute of Psychology, University of Hamburg, 20146 Hamburg, Germany
| | - Benno Roozendaal
- Department of Cognitive Neuroscience, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6525 EN Nijmegen, The Netherlands
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38
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Bennett MR, Arnold J, Hatton SN, Lagopoulos J. Regulation of fear extinction by long-term depression: The roles of endocannabinoids and brain derived neurotrophic factor. Behav Brain Res 2016; 319:148-164. [PMID: 27867101 DOI: 10.1016/j.bbr.2016.11.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 11/10/2016] [Accepted: 11/15/2016] [Indexed: 11/19/2022]
Abstract
The extinction of a conditioned fear response is of great interest in the search for a means of ameliorating adverse neurobiological changes resulting from stress. The discovery that endocannibinoid (EC) levels are inversely related to the extent of such stress, and that the amygdala is a primary site mediating stress, suggests that ECs in this brain region might play a major role in extinction. Supporting this are the observations that the basolateral complex of the amygdala shows an increase in ECs only during extinction and that early clinical trials indicate that cannabinoid-like agents, when taken orally by patients suffering from post traumatic stress disorder (PTSD), reduce insomnia and nightmares. In order to optimize the potential of these agents to ameliorate symptoms of PTSD four important questions need to be answered: first, what is the identity of the cells that release ECs in the amygdala during extinction; second, what are their sites of action; third, what roles do the ECs play in the alleviation of long- depression (LTD), a process central to extinction; and finally, to what extent does brain derived neurotrophic factor (BDNF) facilitate the release of ECs? A review of the relevant literature is presented in an attempt to answer these questions. It is suggested that the principal cell involved in EC synthesis and release during extinction is the so-called excitatory extinction neuron in the basal nucleus of the amygdala. Furthermore that the main site of action of the ECs is the adjacent calcitonin gene-related peptide inhibitory interneurons, whose normal role of blocking the excitatory neurons is greatly diminished. The molecular pathways leading (during extinction trials) to the synthesis and release of ECs from synaptic spines of extinction neurons, that is potentiated by BDNF, are also delineated in this review. Finally, consideration is given to how the autocrine action of BDNF, linked to the release of ECs, can lead to the sustained release of these, so maintaining extinction over long times.
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Affiliation(s)
- Maxwell R Bennett
- The Brain and Mind Centre, University of Sydney, 94 Mallett Street, Camperdown, NSW, Australia.
| | - Jonathon Arnold
- The Brain and Mind Centre, University of Sydney, 94 Mallett Street, Camperdown, NSW, Australia
| | - Sean N Hatton
- The Brain and Mind Centre, University of Sydney, 94 Mallett Street, Camperdown, NSW, Australia
| | - Jim Lagopoulos
- The Brain and Mind Centre, University of Sydney, 94 Mallett Street, Camperdown, NSW, Australia; The Sunshine Coast Mind and Neuroscience, Thompson Institute, The University of the Sunshine Coast, QLD, Australia
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39
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Ryan J, Chaudieu I, Ancelin ML, Saffery R. Biological underpinnings of trauma and post-traumatic stress disorder: focusing on genetics and epigenetics. Epigenomics 2016; 8:1553-1569. [PMID: 27686106 DOI: 10.2217/epi-2016-0083] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Certain individuals are more susceptible to stress and trauma, as well as the physical and mental health consequences following such exposure, including risk for post-traumatic stress disorder (PTSD). This differing vulnerability is likely to be influenced by genetic predisposition and specific characteristics of the stress itself (nature, intensity and duration), as well as epigenetic mechanisms. In this review we provide an overview of research findings in this field. We highlight some of the key genetic risk factors identified for PTSD, and the evidence that epigenetic processes might play a role in the biological response to trauma, as well as being potential biomarkers of PTSD risk. We also discuss important considerations for future research in this area.
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Affiliation(s)
- Joanne Ryan
- Cancer & Disease Epigenetics Group, Murdoch Children's Research Institute, Royal Childrens Hospital, Parkville 3052, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville 3052, Victoria, Australia.,Inserm, U1061, University of Montpellier, Montpellier F-34093, France.,Department of Epidemiology & Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Prahran 3004, Australia
| | - Isabelle Chaudieu
- Inserm, U1061, University of Montpellier, Montpellier F-34093, France
| | | | - Richard Saffery
- Cancer & Disease Epigenetics Group, Murdoch Children's Research Institute, Royal Childrens Hospital, Parkville 3052, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville 3052, Victoria, Australia
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40
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Fudalej S, Kopera M, Wołyńczyk-Gmaj D, Fudalej M, Krajewski P, Wasilewska K, Szymański K, Chojnicka I, Podgórska A, Wojnar M, Płoski R. Association between FKBP5 Functional Polymorphisms and Completed Suicide. Neuropsychobiology 2016; 72:126-31. [PMID: 26630184 DOI: 10.1159/000441659] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 10/11/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis leads to impaired stress response. FK506-binding protein 51 (FKBP5), which influences HPA axis activity via glucocorticoid receptors, is supposed to play an important role in the regulation of negative feedback and glucocorticoid resistance. Since ineffective stress response mechanisms are considered as a biological background of suicide behavior, we aimed to analyze a possible association between FKBP5 functional polymorphisms and completed suicide. METHODS The selected FKBP5 polymorphisms rs1360780 and rs3800373 were genotyped in a sample of 563 suicide victims and 475 controls. RESULTS A significant association between the high-induction rs3800373 C allele and completed suicide was detected (OR = 1.36, p = 0.007). In this polymorphism, genotype distribution supported a codominant model of inheritance. The analyzed SNPs were in strong linkage disequilibrium (D' = 0.916 and r2 = 0.826) with the rs1360780 (T)-rs3800373 (C) haplotype apparently responsible for the observed association (OR = 1.34, p = 0.010). CONCLUSION The results of the present study indicate that genetic alterations in FKBP5 may influence vulnerability to suicide.
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Affiliation(s)
- Sylwia Fudalej
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
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41
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Pape JC, Binder EB. The Role of Genetics and Epigenetics in the Pathogenesis of Posttraumatic Stress Disorder. Psychiatr Ann 2016. [DOI: 10.3928/00485713-20160729-02] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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42
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Zuj DV, Palmer MA, Lommen MJJ, Felmingham KL. The centrality of fear extinction in linking risk factors to PTSD: A narrative review. Neurosci Biobehav Rev 2016; 69:15-35. [PMID: 27461912 DOI: 10.1016/j.neubiorev.2016.07.014] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 07/13/2016] [Accepted: 07/14/2016] [Indexed: 02/08/2023]
Abstract
Recent prospective studies in emergency services have identified impaired fear extinction learning and memory to be a significant predictor of Posttraumatic Stress Disorder (PTSD), complementing a wealth of cross-sectional evidence of extinction deficits associated with the disorder. Additional fields of research show specific risk factors and biomarkers of the disorder, including candidate genotypes, stress and sex hormones, cognitive factors, and sleep disturbances. Studies in mostly nonclinical populations also reveal that the aforementioned factors are involved in fear extinction learning and memory. Here, we provide a comprehensive narrative review of the literature linking PTSD to these risk factors, and linking these risk factors to impaired fear extinction. On balance, the evidence suggests that fear extinction may play a role in the relationship between risk factors and PTSD. Should this notion hold true, this review carries important implications for the improvement of exposure-based treatments, as well as strategies for the implementation of treatment.
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Affiliation(s)
- Daniel V Zuj
- Division of Psychology, School of Medicine, University of Tasmania, Tasmania, Australia.
| | - Matthew A Palmer
- Division of Psychology, School of Medicine, University of Tasmania, Tasmania, Australia
| | - Miriam J J Lommen
- Department of Psychology, University of Groningen, Groningen, The Netherlands
| | - Kim L Felmingham
- Division of Psychology, School of Medicine, University of Tasmania, Tasmania, Australia
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43
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Castro-Vale I, van Rossum EF, Machado JC, Mota-Cardoso R, Carvalho D. Genetics of glucocorticoid regulation and posttraumatic stress disorder—What do we know? Neurosci Biobehav Rev 2016; 63:143-57. [DOI: 10.1016/j.neubiorev.2016.02.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Revised: 11/30/2015] [Accepted: 02/05/2016] [Indexed: 02/05/2023]
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44
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Gene-Stress-Epigenetic Regulation of FKBP5: Clinical and Translational Implications. Neuropsychopharmacology 2016; 41:261-74. [PMID: 26250598 PMCID: PMC4677131 DOI: 10.1038/npp.2015.235] [Citation(s) in RCA: 342] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 07/06/2015] [Accepted: 07/07/2015] [Indexed: 12/13/2022]
Abstract
Stress responses and related outcomes vary markedly across individuals. Elucidating the molecular underpinnings of this variability is of great relevance for developing individualized prevention strategies and treatments for stress-related disorders. An important modulator of stress responses is the FK506-binding protein 51 (FKBP5/FKBP51). FKBP5 acts as a co-chaperone that modulates not only glucocorticoid receptor activity in response to stressors but also a multitude of other cellular processes in both the brain and periphery. Notably, the FKBP5 gene is regulated via complex interactions among environmental stressors, FKBP5 genetic variants, and epigenetic modifications of glucocorticoid-responsive genomic sites. These interactions can result in FKBP5 disinhibition that has been shown to contribute to a number of aberrant phenotypes in both rodents and humans. Consequently, FKBP5 blockade may hold promise as treatment intervention for stress-related disorders, and recently developed selective FKBP5 blockers show encouraging results in vitro and in rodent models. Although risk for stress-related disorders is conferred by multiple environmental and genetic factors, the findings related to FKBP5 illustrate how a deeper understanding of the molecular and systemic mechanisms underlying specific gene-environment interactions may provide insights into the pathogenesis of stress-related disorders.
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45
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Divergent regulation of distinct glucocorticoid systems in alcohol dependence. Alcohol 2015; 49:811-6. [PMID: 26003866 DOI: 10.1016/j.alcohol.2015.04.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 04/11/2015] [Accepted: 04/12/2015] [Indexed: 11/23/2022]
Abstract
Chronic alcohol consumption disrupts glucocorticoid signaling at multiple physiological levels to interact with several disease-related processes associated with neuroendocrine and psychiatric disorders. Excessive alcohol use produces stress-related neuroadaptations at the level of the hypothalamic-pituitary-adrenal (HPA) axis as well as within central (extra-hypothalamic) neural circuitry, including the central amygdala (CeA) and prefrontal cortex (PFC). Altered glucocorticoid receptor (GR) signaling in these areas following excessive alcohol exposure is postulated to mediate the transition from recreational drinking to dependence, as well as the manifestation of a host of cognitive and neurological deficits. Specifically, a bidirectional regulation of stress systems by glucocorticoids leads to the development of an HPA axis tolerance and a concomitant sensitization of cortical and subcortical circuitries. A greater understanding of how hypothalamic and extra-hypothalamic glucocorticoid systems interact to mediate excessive drinking and related pathologies will lead to more effective therapeutic strategies for alcohol use disorder (AUD) and closely related comorbidities.
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46
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Roberts S, Keers R, Lester KJ, Coleman JRI, Breen G, Arendt K, Blatter-Meunier J, Cooper P, Creswell C, Fjermestad K, Havik OE, Herren C, Hogendoorn SM, Hudson JL, Krause K, Lyneham HJ, Morris T, Nauta M, Rapee RM, Rey Y, Schneider S, Schneider SC, Silverman WK, Thastum M, Thirlwall K, Waite P, Eley TC, Wong CCY. HPA AXIS RELATED GENES AND RESPONSE TO PSYCHOLOGICAL THERAPIES: GENETICS AND EPIGENETICS. Depress Anxiety 2015; 32:861-70. [PMID: 26647360 PMCID: PMC4982063 DOI: 10.1002/da.22430] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 09/02/2015] [Accepted: 09/03/2015] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Hypothalamic-pituitary-adrenal (HPA) axis functioning has been implicated in the development of stress-related psychiatric diagnoses and response to adverse life experiences. This study aimed to investigate the association between genetic and epigenetics in HPA axis and response to cognitive behavior therapy (CBT). METHODS Children with anxiety disorders were recruited into the Genes for Treatment project (GxT, N = 1,152). Polymorphisms of FKBP5 and GR were analyzed for association with response to CBT. Percentage DNA methylation at the FKBP5 and GR promoter regions was measured before and after CBT in a subset (n = 98). Linear mixed effect models were used to investigate the relationship between genotype, DNA methylation, and change in primary anxiety disorder severity (treatment response). RESULTS Treatment response was not associated with FKBP5 and GR polymorphisms, or pretreatment percentage DNA methylation. However, change in FKBP5 DNA methylation was nominally significantly associated with treatment response. Participants who demonstrated the greatest reduction in severity decreased in percentage DNA methylation during treatment, whereas those with little/no reduction in severity increased in percentage DNA methylation. This effect was driven by those with one or more FKBP5 risk alleles, with no association seen in those with no FKBP5 risk alleles. No significant association was found between GR methylation and response. CONCLUSIONS Allele-specific change in FKBP5 methylation was associated with treatment response. This is the largest study to date investigating the role of HPA axis related genes in response to a psychological therapy. Furthermore, this is the first study to demonstrate that DNA methylation changes may be associated with response to psychological therapies in a genotype-dependent manner.
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Affiliation(s)
- Susanna Roberts
- MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Robert Keers
- MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Kathryn J Lester
- MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- School of Psychology, University of Sussex, United Kingdom
| | - Jonathan R I Coleman
- MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Gerome Breen
- MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- National Institute for Health Research Biomedical Research Centre, South London and Maudsley National Health Service Trust, United Kingdom
| | - Kristian Arendt
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | | | - Peter Cooper
- School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom
- Department of Psychology, Stellenbosch University, South Africa
| | - Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom
| | - Krister Fjermestad
- Anxiety Disorders Research Network, Haukeland University Hospital, Bergen, Norway
| | - Odd E Havik
- Anxiety Disorders Research Network, Haukeland University Hospital, Bergen, Norway
| | - Chantal Herren
- Department of Forensic Psychiatry, University of Basel Psychiatric Clinics, Basel, Switzerland
| | - Sanne M Hogendoorn
- Department of Child and Adolescent Psychiatry/De Bascule, Academic Medical Centre, Amsterdam, The Netherlands
| | - Jennifer L Hudson
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Karen Krause
- Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Heidi J Lyneham
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Talia Morris
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Maaike Nauta
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, The Netherlands
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Yasmin Rey
- Child Anxiety and Phobia Program, Department of Psychology, Florida International University, Miami, USA
| | - Silvia Schneider
- Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Sophie C Schneider
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Wendy K Silverman
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Mikael Thastum
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Kerstin Thirlwall
- School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom
| | - Polly Waite
- School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom
| | - Thalia C Eley
- MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Chloe C Y Wong
- MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Pluess M. Vantage Sensitivity: Environmental Sensitivity to Positive Experiences as a Function of Genetic Differences. J Pers 2015; 85:38-50. [PMID: 26271007 DOI: 10.1111/jopy.12218] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A large number of gene-environment interaction studies provide evidence that some people are more likely to be negatively affected by adverse experiences as a function of specific genetic variants. However, such "risk" variants are surprisingly frequent in the population. Evolutionary analysis suggests that genetic variants associated with increased risk for maladaptive development under adverse environmental conditions are maintained in the population because they are also associated with advantages in response to different contextual conditions. These advantages may include (a) coexisting genetic resilience pertaining to other adverse influences, (b) a general genetic susceptibility to both low and high environmental quality, and (c) a coexisting propensity to benefit disproportionately from positive and supportive exposures, as reflected in the recent framework of vantage sensitivity. After introducing the basic properties of vantage sensitivity and highlighting conceptual similarities and differences with diathesis-stress and differential susceptibility patterns of gene-environment interaction, selected and recent empirical evidence for the notion of vantage sensitivity as a function of genetic differences is reviewed. The unique contribution that the new perspective of vantage sensitivity may make to our understanding of social inequality will be discussed after suggesting neurocognitive and molecular mechanisms hypothesized to underlie the propensity to benefit disproportionately from benevolent experiences.
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