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Azevedo M, Martinho R, Oliveira A, Correia-de-Sá P, Moreira-Rodrigues M. Molecular pathways underlying sympathetic autonomic overshooting leading to fear and traumatic memories: looking for alternative therapeutic options for post-traumatic stress disorder. Front Mol Neurosci 2024; 16:1332348. [PMID: 38260808 PMCID: PMC10800988 DOI: 10.3389/fnmol.2023.1332348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
The sympathoadrenal medullary system and the hypothalamic-pituitary-adrenal axis are both activated upon stressful events. The release of catecholamines, such as dopamine, norepinephrine (NE), and epinephrine (EPI), from sympathetic autonomic nerves participate in the adaptive responses to acute stress. Most theories suggest that activation of peripheral β-adrenoceptors (β-ARs) mediates catecholamines-induced memory enhancement. These include direct activation of β-ARs in the vagus nerve, as well as indirect responses to catecholamine-induced glucose changes in the brain. Excessive sympathetic activity is deeply associated with memories experienced during strong emotional stressful conditions, with catecholamines playing relevant roles in fear and traumatic memories consolidation. Recent findings suggest that EPI is implicated in fear and traumatic contextual memories associated with post-traumatic stress disorder (PTSD) by increasing hippocampal gene transcription (e.g., Nr4a) downstream to cAMP response-element protein activation (CREB). Herein, we reviewed the literature focusing on the molecular mechanisms underlying the pathophysiology of memories associated with fear and traumatic experiences to pave new avenues for the treatment of stress and anxiety conditions, such as PTSD.
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Affiliation(s)
- Márcia Azevedo
- Laboratory of General Physiology, Department of Immuno-Physiology and Pharmacology and Center for Drug Discovery and Innovative Medicines (MedInUP), School of Medicine and Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal
| | - Raquel Martinho
- Laboratory of General Physiology, Department of Immuno-Physiology and Pharmacology and Center for Drug Discovery and Innovative Medicines (MedInUP), School of Medicine and Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal
| | - Ana Oliveira
- Laboratory of General Physiology, Department of Immuno-Physiology and Pharmacology and Center for Drug Discovery and Innovative Medicines (MedInUP), School of Medicine and Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal
| | - Paulo Correia-de-Sá
- Laboratory of Pharmacology and Neurobiology, Department of Immuno-Physiology and Pharmacology and Center for Drug Discovery and Innovative Medicines (MedInUP), School of Medicine and Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal
| | - Mónica Moreira-Rodrigues
- Laboratory of General Physiology, Department of Immuno-Physiology and Pharmacology and Center for Drug Discovery and Innovative Medicines (MedInUP), School of Medicine and Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal
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Uccellini O, Benlodi A, Caroppo E, Cena L, Esposito G, Fernandez I, Ghazanfar M, Imbasciati A, Longo F, Mazza M, Marano G, Nacinovich R, Pignatto A, Rolnick A, Trivelli M, Spada E, Vanzini C. 1000 Days: The "WeCare Generation" Program-The Ultimate Model for Improving Human Mental Health and Economics: The Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16741. [PMID: 36554625 PMCID: PMC9779238 DOI: 10.3390/ijerph192416741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The COVID-19 pandemic stressed the necessity of a new resilience of the human population and health system. The "WeCare Generation" program is a new proposal of territorial intervention, with a new paradigm, on the diseases of the human body and mind. BACKGROUND In recent decades, the independent strands of investigation on brain plasticity and early trauma consequences have demonstrated that traumatic experiences in the period from pregnancy to the age of 3 years have an enormous impact on an individual's future development, and both physical and mental health. Research shows that adverse child experiences (ACEs) are associated with a strong risk of conditions such as: harmful alcohol use, smoking, illicit drug use, high body-mass index, depression, anxiety, interpersonal violence, cancer, type 2 diabetes, cardiovascular diseases, stroke respiratory diseases and, as a consequence, to a high financial cost in Italy and also across Europe (1-9% GDP) and the USA (total annual costs estimated to be USD 581 billion in Europe and USD 748 billion in North America). All this suggests that an early intervention on that traumatized-slice of population leads to multiplied savings. METHODS A multi-center, randomized, controlled trial was designed. The parents of the future neonatal population (from pregnancy to delivery) with trauma will be enrolled, and randomized to treatment, or control arm. The article describes in detail how the primary outpoint (cost to the national health system), and some secondary outpoints, will be collected. DISCUSSION An overall rate of return on investment (ROI) statistically significant 13.0% per annum with an associated benefit/cost ratio (BCR) of 6.3 is expected as the primary outcome of the "WeCare Generation" program. Our proposed model predicts a new medical paradigm aiming to empower new generations, with a strong return on economy and health.
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Affiliation(s)
| | - Andrea Benlodi
- Clinical Psychology Unit Carlo Poma Hospital, ASST Mantova, 46100 Mantua, Italy
| | - Emanuele Caroppo
- Department of Mental Health, Local Health Authority Roma 2, 00159 Rome, Italy
| | - Loredana Cena
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, 38122 Trent, Italy
| | | | - Maria Ghazanfar
- Maternal and Child Department, ASST Brianza, 20871 Vimercate, Italy
| | - Antonio Imbasciati
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Francesco Longo
- Cergas Center for Research on Health and Social Care Management, SDA Bocconi University, 20136 Milan, Italy
| | - Marianna Mazza
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universita’ Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giuseppe Marano
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universita’ Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Renata Nacinovich
- Child and Adolescent Neuropsichiatry, ASST Monza, NeuroMI—Milan Center for Neuroscience, University of Milano Bicocca, 20126 Milan, Italy
| | - Antonio Pignatto
- Department of Psychology, IUSTO—Salesian University Institute Torino Rebaudengo, 10155 Turin, Italy
| | - Arthur Rolnick
- Department of Economics, Humphrey School of Public Affairs, University of Minnesota, Minneapolis, MN 55455, USA
| | - Marco Trivelli
- General and Economic Direction, ASST Brianza, 20871 Vimercate, Italy
| | | | - Cinzia Vanzini
- Training Sector Management, ASST Brianza, 20871 Vimercate, Italy
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Rodriguez de Behrends M. Treating Cognitive Symptoms of Generalized Anxiety Disorder Using EMDR Therapy With Bilateral Alternating Tactile Stimulation. JOURNAL OF EMDR PRACTICE AND RESEARCH 2021. [DOI: 10.1891/emdr-d-20-00026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article reports preliminary evidence for the effectiveness of eye movement desensitization and reprocessing psychotherapy (EMDR) therapy, applying bilateral alternating tactile stimulation in treating cognitive symptoms in patients with generalized anxiety disorder (GAD). A single-case experimental design was used in seven clinical cases. The Penn State Worry Questionnaire, Intolerance of Uncertainty, Cognitive Avoidance Questionnaire, and Negative Problem Orientation Questionnaire were administered at five points during pretreatment (which established the baseline phase serving as each participant's control), at three points during the treatment phase, at the end of it, and at the 3- and 6-month follow-ups. Each participant received 16 treatment sessions. Visual, statistical, and clinical significance analyses were conducted. The cognitive symptoms treated were: excessive worry, intolerance of uncertainty, cognitive avoidance, and negative orientation to problems. All four cognitive symptoms subsided, with large effect sizes in all cases, between pre- and posttreatment, which can be observed in the visual and statistical analysis of each case. Pre- and post-cognitions are specified in each case. According to the clinical significance analysis, all participants evidenced a change towards an improvement. Finally, evidence is given in favor of the usefulness of EMDR therapy for the treatment of cognitive symptoms in participants diagnosed with GAD. However, these results must be considered cautiously when generalizing data.
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Harricharan S, McKinnon MC, Tursich M, Densmore M, Frewen P, Théberge J, van der Kolk B, Lanius RA. Overlapping frontoparietal networks in response to oculomotion and traumatic autobiographical memory retrieval: implications for eye movement desensitization and reprocessing. Eur J Psychotraumatol 2019; 10:1586265. [PMID: 30949304 PMCID: PMC6442104 DOI: 10.1080/20008198.2019.1586265] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 02/08/2019] [Accepted: 02/13/2019] [Indexed: 02/06/2023] Open
Abstract
Background: Oculomotor movements have been shown to aid in the retrieval of episodic memories, serving as sensory cues that engage frontoparietal brain regions to reconstruct visuospatial details of a memory. Frontoparietal brain regions not only are involved in oculomotion, but also mediate, in part, the retrieval of autobiographical episodic memories and assist in emotion regulation. Objective: We sought to investigate how oculomotion influences retrieval of traumatic memories by examining patterns of frontoparietal brain activation during autobiographical memory retrieval in post-traumatic stress disorder (PTSD) and in healthy controls. Method: Thirty-nine participants (controls, n = 19; PTSD, n = 20) recollected both neutral and traumatic/stressful autobiographical memories while cued simultaneously by horizontal and vertical oculomotor stimuli. The frontal (FEF) and supplementary (SEF) eye fields were used as seed regions for psychophysiological interaction analyses in SPM12. Results: As compared to controls, upon retrieval of a traumatic/stressful memory while also performing simultaneous horizontal eye movements, PTSD showed: i) increased SEF and FEF connectivity with the right dorsolateral prefrontal cortex, ii) increased SEF connectivity with the right dorsomedial prefrontal cortex, and iii) increased SEF connectivity with the right anterior insula. By contrast, as compared to PTSD, upon retrieval of a traumatic/stressful memory while also performing simultaneous horizontal eye movements, controls showed: i) increased FEF connectivity with the right posterior insula and ii) increased SEF connectivity with the precuneus. Conclusions: These findings provide a neurobiological account for how oculomotion may influence the frontoparietal cortical representation of traumatic memories. Implications for eye movement desensitization and reprocessing are discussed.
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Affiliation(s)
- Sherain Harricharan
- Department of Neuroscience, Western University, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
| | - Margaret C. McKinnon
- Mood Disorders Program, St. Joseph’s Healthcare, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Homewood Research Institute, Guelph, ON, Canada
| | | | - Maria Densmore
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Paul Frewen
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Psychology, Western University, London, ON, Canada
| | - Jean Théberge
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
- Department of Medical Imaging, Western University, London, ON, Canada
- Department of Medical Biophysics, Western University, London, ON, Canada
- Department of Diagnostic Imaging, St. Joseph’s Healthcare, London, ON, Canada
| | | | - Ruth A. Lanius
- Department of Neuroscience, Western University, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
- Mood Disorders Program, St. Joseph’s Healthcare, Hamilton, ON, Canada
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