scholarly journals Neural Response to Trauma-Related and Trauma-Unrelated Negative Stimuli in Remitted and Persistent Pediatric Posttraumatic Stress Disorder

2020 ◽  
Author(s):  
Peng Wang ◽  
Zulai Peng ◽  
Lu Liu ◽  
Li An ◽  
Yuxin Liu ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Neural Activity ◽  
Stress Disorder ◽  
Related Condition ◽  
Unrelated Condition ◽  
Significant Difference ◽  
Left Hippocampus ◽  
Middle Occipital Gyrus ◽  
The Right

Abstract Background: Most youths who suffer from posttraumatic stress disorder (PTSD) lose their diagnosis in the first 1-2 years. However, there are few studies on this brain mechanism, and the heterogeneity of the findings is partially due to the different stimuli applied and the mixed trauma history. Therefore, the use of trauma-related/unrelated stimuli to study the remittance mechanism of earthquake-induced PTSD could advance our knowledge of PTSD and inspire future treatment.Methods: Thirteen youths with PTSD, 18 remitted participants and 18 control participants underwent functional magnetic resonance imaging (fMRI) while viewing trauma-related pictures, trauma-unrelated negative pictures and scrambled pictures.Results: Under trauma-unrelated condition, the neural activity of the left hippocampus in the remitted group was in the middle between the two other groups. Under trauma-related condition, the PTSD and the remitted group exhibited higher neural activity in the right middle occipital gyrus than controls. The remitted group showed higher neural activity in the right parahippocampal gyrus and right lingual gyrus under trauma-related condition than trauma-unrelated condition, while no significant difference was found in PTSD group.Conclusion: PTSD symptom-related group difference is mainly reflected in the left hippocampus under the trauma-unrelated condition, while the hyperactivity in the right middle occipital gyrus under trauma related condition could be an endophenotype for PTSD.

Posttraumatic stress disorder symptom severity is associated with left hippocampal volume reduction: a meta-analytic study

CNS Spectrums ◽  
2016 ◽  
Vol 22 (4) ◽  
pp. 363-372 ◽  
Author(s):  
Michael D. Nelson ◽  
Alecia M. Tumpap
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Effect Size ◽  
Symptom Severity ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Hippocampal Volume ◽  
Volume Reduction ◽  
Left Hippocampus ◽  
The Right

ObjectiveMany studies have reported hippocampal volume reductions associated with posttraumatic stress disorder (PTSD), while others have not. Here we provide an updated meta-analysis of such reductions associated with PTSD and evaluate the association between symptom severity and hippocampal volume.MethodsA total of 37 studies met the criteria for inclusion in the meta-analysis. Mean effect sizes (Hedges’ g) and 95% confidence intervals (CI95%) were computed for each study and then averaged to obtain an overall mean effect size across studies. Meta-regression was employed to examine the relationship between PTSD symptom severity and hippocampal volume.ResultsResults showed that PTSD is associated with significant bilateral reduction of the hippocampus (left hippocampus effect size=–0.400, p<0.001, 5.24% reduction; right hippocampus effect size=–0.462, p<0.001, 5.23% reduction). Symptom severity, as measured by the Clinician-Administered PTSD Scale (CAPS), was significantly associated with decreased left, but not right, hippocampal volume.ConclusionsPTSD was associated with significant bilateral volume reduction of the hippocampus. Increased symptom severity was significantly associated with reduced left hippocampal volume. This finding is consistent with the hypothesis that PTSD is more neurotoxic to the left hippocampus than to the right. However, whether the association between PTSD and lower hippocampal volume reflects a consequence of or a predisposition to PTSD remains unclear. More prospective studies are needed in this area.

Embitterment in war veterans with posttraumatic stress disorder (PTSD)

2017 ◽  
Vol 41 (S1) ◽  
pp. S359-S360 ◽  
Author(s):  
D. Sabic ◽  
A. Sabic
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Health Center ◽  
Rating Scale ◽  
Stress Disorder ◽  
World Health ◽  
Control Group ◽  
War Veterans ◽  
Significant Difference ◽  
And Control

The aim of this study was to analyse frequency of embitterment in war veterans with Posttraumatic stress disorder (PTSD) as well as the potential impact of embitterment on the development of chronic PTSD.Patients and methodsIt was analyzed 174 subjects (from Health Center Zivinice/mental health center) through a survey conducted in the period from March 2015 to June 2016, of which 87 war veterans with PTSD and control subjects 87 war veterans without PTSD. The primary outcome measure was the post-traumatic embitterment disorder self-rating scale (PTED Scale) who contains 19 items designed to assess features of embitterment reactions to negative life events. Secondary efficacy measures included the clinician-administered PTSD scale–V (CAPS), the PTSD checklist (PCL), the combat exposure scale (CES), the Hamilton depression rating scale (HAM-D), the Hamilton anxiety rating scale (HAM-A) and the World health organization quality of life scale (WHOQOL-Bref). All subjects were male. The average age of patients in the group war veterans with PTSD was 52.78 ± 5.99. In the control group, average age was 51.42 ± 5.98. Statistical data were analyzed in SPSS statistical program.ResultsComparing the results, t-tests revealed significant difference between group veterans with PTSD and control group (t = −21,21, P < 0.0001). War veterans group with PTSD (X = 51.41, SD = 8,91), control group (X = 14.39, SD = 13.61).ConclusionEmbitterment is frequent in war veterans with PTSD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Dysregulation of the Right Brain: A Fundamental Mechanism of Traumatic Attachment and the Psychopathogenesis of Posttraumatic Stress Disorder

2002 ◽  
Vol 36 (1) ◽  
pp. 9-30 ◽  
Author(s):  
Allan N Schore
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Developmental Trajectory ◽  
Stress Disorders ◽  
Developmental Stress ◽  
Posttraumatic Stress Disorders ◽  
Autonomic Nervous ◽  
Right Brain ◽  
The Right

Objective: This review integrates recent advances in attachment theory, affective neuroscience, developmental stress research, and infant psychiatry in order to delineate the developmental precursors of posttraumatic stress disorder. Method: Existing attachment, stress physiology, trauma, and neuroscience literatures were collected using Index Medicus/Medline and Psychological Abstracts. This converging interdisciplinary data was used as a theoretical base for modelling the effects of early relational trauma on the developing central and autonomic nervous system activities that drive attachment functions. Results: Current trends that integrate neuropsychiatry, infant psychiatry, and clinical psychiatry are generating more powerful models of the early genesis of a predisposition to psychiatric disorders, including PTSD. Data are presented which suggest that traumatic attachments, expressed in episodes of hyperarousal and dissociation, are imprinted into the developing limbic and autonomic nervous systems of the early maturing right brain. These enduring structural changes lead to the inefficient stress coping mechanisms that lie at the core of infant, child, and adult posttraumatic stress disorders. Conclusions: Disorganised-disoriented insecure attachment, a pattern common in infants abused in the first 2 years of life, is psychologically manifest as an inability to generate a coherent strategy for coping with relational stress. Early abuse negatively impacts the developmental trajectory of the right brain, dominant for attachment, affect regulation, and stress modulation, thereby setting a template for the coping deficits of both mind and body that characterise PTSD symptomatology. These data suggest that early intervention programs can significantly alter the intergenerational transmission of posttraumatic stress disorders.

scholarly journals The Innate Alarm System and Subliminal Threat Presentation in Posttraumatic Stress Disorder: Neuroimaging of the Midbrain and Cerebellum

2019 ◽  
Vol 3 ◽  
pp. 247054701882149 ◽  
Author(s):  
Braeden A. Terpou ◽  
Maria Densmore ◽  
Janine Thome ◽  
Paul Frewen ◽  
Margaret C. McKinnon ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Brain Activation ◽  
Stimulus Presentation ◽  
Neutral Stimulus ◽  
Alarm System ◽  
Imaging Data ◽  
The Right

Background The innate alarm system, a network of interconnected midbrain, other brainstem, and thalamic structures, serves to rapidly detect stimuli in the environment prior to the onset of conscious awareness. This system is sensitive to threatening stimuli and has evolved to process these stimuli subliminally for hastened responding. Despite the conscious unawareness, the presentation of subliminal threat stimuli generates increased activation of limbic structures, including the amygdala and insula, as well as emotionally evaluative structures, including the cerebellum and orbitofrontal cortex. Posttraumatic stress disorder (PTSD) is associated with an increased startle response and decreased extinction learning to conditioned threat. The role of the innate alarm system in the clinical presentation of PTSD, however, remains poorly understood. Methods Here, we compare midbrain, brainstem, and cerebellar activation in persons with PTSD (n = 26) and matched controls (n = 20) during subliminal threat presentation. Subjects were presented with masked trauma-related and neutral stimuli below conscious threshold. Contrasts of subliminal brain activation for the presentation of neutral stimuli were subtracted from trauma-related brain activation. Group differences in activation, as well as correlations between clinical scores and PTSD activation, were examined. Imaging data were preprocessed utilizing the spatially unbiased infratentorial template toolbox within SPM12. Results Analyses revealed increased midbrain activation in PTSD as compared to controls in the superior colliculus, periaqueductal gray, and midbrain reticular formation during subliminal threat as compared to neutral stimulus presentation. Controls showed increased activation in the right cerebellar lobule V during subliminal threat presentation as compared to PTSD. Finally, a negative correlation emerged between PTSD patient scores on the Multiscale Dissociation Inventory for the Depersonalization/Derealization subscale and activation in the right lobule V of the cerebellum during the presentation of subliminal threat as compared to neutral stimuli. Conclusion We interpret these findings as evidence of innate alarm system overactivation in PTSD and of the prominent role of the cerebellum in the undermodulation of emotion observed in PTSD.

scholarly journals Do Acute Benefits of Interpersonal Psychotherapy for Posttraumatic Stress Disorder Endure?

2017 ◽  
Vol 63 (1) ◽  
pp. 37-43 ◽  
Author(s):  
John C. Markowitz ◽  
Tse-Hwei Choo ◽  
Yuval Neria
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Randomised Trial ◽  
Interpersonal Psychotherapy ◽  
Small Sample ◽  
Chronic Ptsd ◽  
Significant Difference

Objective: The Psychotherapies for Chronic PTSD randomised trial found that three 14-week psychotherapies acutely benefitted patients with chronic posttraumatic stress disorder (PTSD). Previous research has reported sustained follow-up benefits for prolonged exposure (PE) and relaxation therapy (RT), but few comparable data exist for interpersonal psychotherapy (IPT). We describe 3-month follow-up for acute responders to all 3 treatments. Method: Acute responders, defined a priori as ≥30% improved from baseline, were reevaluated after 3-month no-treatment follow-up by independent evaluators using the Clinician-Administered PTSD Scale (CAPS). Results: Fifty of 110 initial study entrants met acute responder status at week 14. Forty-three (86%) responders entered follow-up: 23 remitters (CAPS ≤20) and 20 responders. At week 26, 27 had achieved remission status, 10 remained responders, and 6 had relapsed. Of week 14 remitters, 8 of 9 PE, all 8 IPT, and 4 of 6 RT patients remained remitted. Relapse rates were 7% (1/9) for PE, 10% (2/20) for IPT, and 33% (3/9) for RT. At week 26, PE showed greater improvement on CAPS than RT ( P = 0.048) and a trend for superiority over IPT ( P = 0.098), with no significant difference between IPT and RT. Depressive symptoms remained low during follow-up. Conclusions: These are the first systematic data on follow-up responder status and persistence of acute treatment benefits in patients receiving individual IPT for chronic PTSD. Patients generally maintained gains across treatments, fluctuating most in RT. Study limitations include small sample size and brief follow-up interval. PTSD research should employ response and remission criteria.

scholarly journals Spontaneous neural activity differences in posttraumatic stress disorder: A quantitative resting‐state meta‐analysis and fMRI validation

2017 ◽  
Vol 39 (2) ◽  
pp. 837-850 ◽  
Author(s):  
Seth G. Disner ◽  
Craig A. Marquardt ◽  
Bryon A. Mueller ◽  
Philip C. Burton ◽  
Scott R. Sponheim
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Neural Activity ◽  
Resting State ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Spontaneous Neural Activity

scholarly journals Effects of L-Theanine on Posttraumatic Stress Disorder Induced Changes in Rat Brain Gene Expression

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Tomás Eduardo Ceremuga ◽  
Stephanie Martinson ◽  
Jason Washington ◽  
Robert Revels ◽  
Jessica Wojcicki ◽  
...  
Keyword(s):  
Gene Expression ◽  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Molecular Mechanisms ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Pcr Analysis ◽  
Sprague Dawley ◽  
Significant Difference ◽  
Induced Changes

Posttraumatic stress disorder (PTSD) is characterized by the occurrence of a traumatic event that is beyond the normal range of human experience. The future of PTSD treatment may specifically target the molecular mechanisms of PTSD. In the US, approximately 20% of adults report taking herbal products to treat medical illnesses. L-theanine is the amino acid in green tea primarily responsible for relaxation effects. No studies have evaluated the potential therapeutic properties of herbal medications on gene expression in PTSD. We evaluated gene expression in PTSD-induced changes in the amygdala and hippocampus of Sprague-Dawley rats. The rats were assigned to PTSD-stressed and nonstressed groups that received either saline, midazolam, L-theanine, or L-theanine + midazolam. Amygdala and hippocampus tissue samples were analyzed for changes in gene expression. One-way ANOVA was used to detect significant difference between groups in the amygdala and hippocampus. Of 88 genes examined, 17 had a large effect size greater than 0.138. Of these, 3 genes in the hippocampus and 5 genes in the amygdala were considered significant (P<0.05) between the groups. RT-PCR analysis revealed significant changes between groups in several genes implicated in a variety of disorders ranging from PTSD, anxiety, mood disorders, and substance dependence.

scholarly journals Cognitive Functions in Combat Posttraumatic Stress Disorder

2020 ◽  
Vol 44 (4) ◽  
pp. 199-207
Author(s):  
Ana Havelka Meštrović ◽  
Marina Domijan ◽  
Vlatko Mičković ◽  
Zoran Lončar
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Cognitive Functions ◽  
Cognitive Abilities ◽  
Stress Disorder ◽  
Control Group ◽  
Additional Contribution ◽  
Healthy Controls ◽  
Study Results ◽  
Significant Difference

Posttraumatic stress disorder (PTSD) is associated with changes in cognitive functions. The aim of the study was to investigate differences in cognitive abilities between PTSD patients and healthy controls. As PTSD is often accompanied by comorbidity, the PTSD patients with comorbid diagnoses were also included in our study. The study participants included 254 Croatian combat veterans (60 PTSD and 194 PTSD plus comorbidity) and control group of 125 healthy Croatian military and civilian pilots. The diagnosis of PTSD was made by clinical scale for PTSD assessment (CAPS), while cognitive abilities were measured by Wechsler intelligence scale (WAIS-III-R) and Rey test (ROCFT). The study results have confirmed that there is a significant difference in cognitive functions between the PTSD patients and healthy controls regarding age and education. The PTSD patients (PTSD only and PTSD with comorbidity) have shown lower general intellectual abilities, reduced capacity of working, numerical and visual memory, and decreased executive functions when compared to healthy controls. These results are an additional contribution to a better understanding and determination of changes in cognitive functions that occur in combat PTSD as a result of traumatic stress.

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