Alterations in brain activation in posttraumatic stress disorder patients with severe hyperarousal symptoms and impulsive aggressiveness

Pavić, Luka; Gregurek, Rudolf; Petrović, Ratimir; Petrović, Damir; Varda, Robert; Vukušić, Herman; Crnković-Marković, Suncana

doi:10.1007/s00406-003-0411-z

Cited by 37 publications

(18 citation statements)

References 27 publications

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“…Nevertheless, it did lower progressive ratio break points for cigarette reinforcement, indicating that people with reduced DA synthesis showed a reduced willingness to work for cigarettes. Furthermore, imaging research has demonstrated that the human nucleus accumbens/ventral striatum is not only responsive to appetivite stimuli, but also responds to stress, aversion and hyperarousal/irritability (Liberzon et al, 1999; Pavic, 2003; Phan et al, 2004; Pruessner et al, 2004; Levita et al, 2009; Delgado et al, 2011). Taken together, these studies suggest that there are many similarities between findings generated from animal models and those obtained from human research, in terms of many of the motivational functions of mesostriatal DA systems.…”

Section: Translational and Clinical Implicationsmentioning

confidence: 99%

The Mysterious Motivational Functions of Mesolimbic Dopamine

Salamone

Correa

2012

Neuron

1,148

983

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Summary Nucleus accumbens dopamine is known to play a role in motivational processes, and dysfunctions of mesolimbic dopamine may contribute to motivational symptoms of depression and other disorders, as well as features of substance abuse. Although it has become traditional to label dopamine neurons as “reward” neurons, this is an over-generalization, and it is important to distinguish between aspects of motivation that are differentially affected by dopaminergic manipulations. For example, accumbens dopamine does not mediate primary food motivation or appetite, but is involved in appetitive and aversive motivational processes including behavioral activation, exertion of effort, approach behavior, sustained task engagement, Pavlovian processes and instrumental learning. In this review, we discuss the complex roles of dopamine in behavioral functions related to motivation.

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Section: Translational and Clinical Implicationsmentioning

confidence: 99%

The Mysterious Motivational Functions of Mesolimbic Dopamine

Salamone

Correa

2012

Neuron

1,148

983

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“…There is considerable evidence that striatal mechanisms in general, and mesolimbic DA in particular, also participate in aspects of aversive learning and aversive motivation (Salamone, 1994; Munro and Kokkinidis, 1997; Blazquez et al, 2002; Pezze and Feldon, 2004; Delgado et al, 2008; Faure et al, 2008; Martinez et al, 2008). Although imaging studies often are used to support the idea that nucleus accumbens mediates pleasure (e.g., Sarchiapone et al, 2006; Wacker et al, 2009), this appears to be oversimplified; indeed, research employing various imaging methods has demonstrated that the human nucleus accumbens also responds to stress, aversion and hyperarousal/irritability (Liberzon et al, 1999; Jensen et al, 2003; Pavic, 2003; Phan et al, 2004; Pruessner et al, 2004; Levita et al, 2009). Physiological and neurochemical studies in animals clearly indicate that DA neuron activity is not simply tied to the delivery of primary reinforcers or pleasurable stimuli.…”

Section: Limitations Of the Reward Hypothesis Of Dopaminergic Functionmentioning

confidence: 99%

Dopamine, Behavioral Economics, and Effort

Salamone

Correa

Farrar

et al. 2009

Front. Behav. Neurosci.

252

213

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There are numerous problems with the hypothesis that brain dopamine (DA) systems, particularly in the nucleus accumbens, directly mediate the rewarding or primary motivational characteristics of natural stimuli such as food. Research and theory related to the functions of mesolimbic DA are undergoing a substantial conceptual restructuring, with the traditional emphasis on hedonia and primary reward yielding to other concepts and lines of inquiry. The present review is focused upon the involvement of nucleus accumbens DA in behavioral activation and effort-related processes. Viewed from the framework of behavioral economics, the effects of accumbens DA depletions and antagonism on food-reinforced behavior are highly dependent upon the work requirements of the instrumental task, and DA depleted rats are more sensitive to increases in response costs (i.e., ratio requirements). Moreover, interference with accumbens DA transmission exerts a powerful influence over effort-related choice behavior. Rats with accumbens DA depletions or antagonism reallocate their instrumental behavior away from food-reinforced tasks that have high response requirements, and instead these rats select a less-effortful type of food-seeking behavior. Nucleus accumbens DA and adenosine interact in the regulation of effort-related functions, and other brain structures (anterior cingulate cortex, amygdala, ventral pallidum) also are involved. Studies of the brain systems regulating effort-based processes may have implications for understanding drug abuse, as well as energy-related disorders such as psychomotor slowing, fatigue or anergia in depression and other neurological disorders.

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“…However, some neurobiological evidence points to broader brain structures associated with hyperarousal symptoms. One imaging study looked at regional cerebral blood flow in PTSD patients who presented with high levels of hyperarousal symptoms, including severe aggression and irritability, and found greater activation in the nucleus accumbens 119. A case study of a Croatian combat veteran with PTSD predominantly manifesting hyperarousal symptoms found that pretreatment hyperactivation of the amygdala and nucleus accumbens was normalized after a year of psychotherapy 120…”

Section: Hyperarousal Symptomsmentioning

confidence: 99%

Tailoring therapeutic strategies for treating posttraumatic stress disorder symptom clusters

Norrholm

Jovanović²

2010

NDT

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According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, posttraumatic stress disorder (PTSD) is characterized by three major symptom clusters following an event that elicited fear, helplessness, or horror. This review will examine each symptom cluster of PTSD separately, giving case study examples of patients who exhibit a preponderance of a given symptom domain. We use a translational approach in describing the underlying neurobiology that is relevant to particular symptoms and treatment options, thus showing how clinical practice can benefit from current research. By focusing on symptom clusters, we provide a more specific view of individual patient’s clinical presentations, in order to better address treatment needs. Finally, the review will also address potential genetic approaches to treatment as another form of individualized treatment.

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Alterations in brain activation in posttraumatic stress disorder patients with severe hyperarousal symptoms and impulsive aggressiveness

Cited by 37 publications

References 27 publications

The Mysterious Motivational Functions of Mesolimbic Dopamine

The Mysterious Motivational Functions of Mesolimbic Dopamine

Dopamine, Behavioral Economics, and Effort

Tailoring therapeutic strategies for treating posttraumatic stress disorder symptom clusters

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