Auditory Startle Response in Trauma Survivors With Posttraumatic Stress Disorder: A Prospective Study

Shalev, Arieh Y.; Peri, Tuvia; Brandes, Dalia; Freedman, Sara; Orr, Scott P.; Pitman, Roger K.

doi:10.1176/appi.ajp.157.2.255

Cited by 241 publications

(201 citation statements)

References 33 publications

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“…From a pathological perspective, neuroimaging studies reveal functional impairment and shrinkage of mPFC in posttraumatic stress disorder (PTSD) (Rauch et al, 2003;Shin et al, 2005) that find a parallel in reports of dendritic atrophy and synapse loss after chronic emotional stress in rodents (Cook and Wellman, 2004;Radley et al, 2004Radley et al, , 2006. PTSD is associated with HPA axis dysregulation that may be variable in nature (for review, see Newport and Nemeroff, 2000;Yehuda, 2001) and consistent increases in cardiovascular reactivity Shalev et al, 2000). In these contexts, and even in Fos-based studies of activational profiles elicited by various stress paradigms, the mPFC has tended to be treated as a unitary structure.…”

Section: Discussionmentioning

confidence: 99%

Regional Differentiation of the Medial Prefrontal Cortex in Regulating Adaptive Responses to Acute Emotional Stress

Radley¹,

Arias²,

Sawchenko³

2006

J. Neurosci.

402

279

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The medial prefrontal cortex (mPFC) is an important neural substrate for integrating cognitive-affective information and regulating the hypothalamo-pituitary-adrenal (HPA) axis response to emotional stress. mPFC modulation of stress responses is effected in part via the paraventricular hypothalamic nucleus (PVH), which houses both autonomic (sympathoadrenal) and neuroendocrine (HPA) effector mechanisms. Although the weight of evidence suggests that mPFC influences on stress-related PVH outputs are inhibitory, discordant findings have been reported, and such work has tended to treat this cortical region as a unitary structure. Here we compared the effects of lesions of the dorsal versus ventral aspects of mPFC, centered in the prelimbic and infralimbic fields, respectively, on acute restraint stress-induced activation of PVH cell groups mediating autonomic and neuroendocrine responses. Lesions to the dorsal mPFC enhanced restraint-induced Fos and corticotropin-releasing factor (CRF) mRNA expression in the neurosecretory region of PVH. Ablation of the ventral mPFC decreased stress-induced Fos protein and CRF mRNA expression in this compartment but increased Fos induction in PVH regions involved in central autonomic control. Repetition of the experiments in rats bearing retrograde tracer deposits to label PVHautonomic projections confirmed that ventral mPFC lesions selectively increased stress-induced Fos expression in identified preautonomic neurons. Finally, hormonal indices of HPA activation in response to acute stress were augmented after dorsal mPFC lesions and attenuated after ventral mPFC lesions. These results suggest that dorsal and ventral aspects of the mPFC differentially regulate neuroendocrine and autonomic PVH outputs in response to emotional stress.

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Section: Discussionmentioning

confidence: 99%

Regional Differentiation of the Medial Prefrontal Cortex in Regulating Adaptive Responses to Acute Emotional Stress

Radley¹,

Arias²,

Sawchenko³

2006

J. Neurosci.

402

279

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“…[15][16][17][18] We measured response to acoustic startle and prepulse inhibition as measures of auditory function and sensory gating. Blast-exposed rats showed an enhanced response to acoustic startle (Fig.…”

Section: Elder Et Almentioning

confidence: 99%

Blast Exposure Induces Post-Traumatic Stress Disorder-Related Traits in a Rat Model of Mild Traumatic Brain Injury

Elder

Dorr²,

Gasperi³

et al. 2012

Journal of Neurotrauma

194

214

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Blast related traumatic brain injury (TBI) has been a major cause of injury in the wars in Iraq and Afghanistan. A striking feature of the mild TBI (mTBI) cases has been the prominent association with post-traumatic stress disorder (PTSD). However, because of the overlapping symptoms, distinction between the two disorders has been difficult. We studied a rat model of mTBI in which adult male rats were exposed to repetitive blast injury while under anesthesia. Blast exposure induced a variety of PTSD-related behavioral traits that were present many months after the blast exposure, including increased anxiety, enhanced contextual fear conditioning, and an altered response in a predator scent assay. We also found elevation in the amygdala of the protein stathmin 1, which is known to influence the generation of fear responses. Because the blast overpressure injuries occurred while animals were under general anesthesia, our results suggest that a blastrelated mTBI exposure can, in the absence of any psychological stressor, induce PTSD-related traits that are chronic and persistent. These studies have implications for understanding the relationship of PTSD to mTBI in the population of veterans returning from the wars in Iraq and Afghanistan.

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“…Participating studies’ follow-up assessments extended from 4 months (Shalev et al, 2000, 2008) to over 2 years (Hepp et al, 2008; Shalev et al, 2012), and therefore match the DSM threshold. PTSD persistence beyond a certain time period may become permanent (Marmar et al, 2015): a 6 year follow-up study showed that more than half of the PTSD patients assessed 12 months after trauma continued to meet PTSD diagnosis at a 6 year follow-up (O’Donnell et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…The International Consortium to Predict PTSD (ICPP) is an effort sponsored by the US National Institute of Mental Health to create a consortium of principal investigators of published and unpublished longitudinal PTSD studies (Bonne et al, 2001; Bryant, Creamer, O’Donnell, Silove, & McFarlane, 2008; deRoon-Cassini, Mancini, Rusch, & Bonanno, 2010; Hepp et al, 2008; Irish et al, 2008; Jenewein, Wittmann, Moergeli, Creutzig, & Schnyder, 2009; Matsuoka et al, 2009a; Mouthaan et al, 2014; Shalev et al, 2012, 2000, 2008; van Zuiden et al, 2017), combine their individual- and item-level data towards carrying out a pooled secondary analysis, and synthesize information about the predictors of PTSD. The ICPP’s goal is to pool and harmonize extant data sets so as to inform PTSD pathogenesis and prediction across trauma types, severity, geography, and clinical circumstances.…”

Section: Introductionmentioning

confidence: 99%

Application of data pooling to longitudinal studies of early post-traumatic stress disorder (PTSD): the International Consortium to Predict PTSD (ICPP) project

Ratanatharathorn

Gevonden

et al. 2018

European Journal of Psychotraumatology

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Background: Understanding the development of post-traumatic stress disorder (PTSD) is a precondition for efficient risk assessment and prevention planning. Studies to date have been site and sample specific. Towards developing generalizable models of PTSD development and prediction, the International Consortium to Predict PTSD (ICPP) compiled data from 13 longitudinal, acute-care based PTSD studies performed in six different countries.Objective: The objectives of this study were to describe the ICPP’s approach to data pooling and harmonization, and present cross-study descriptive results informing the longitudinal course of PTSD after acute trauma.Methods: Item-level data from 13 longitudinal studies of adult civilian trauma survivors were collected. Constructs (e.g. PTSD, depression), measures (questions or scales), and time variables (days from trauma) were identified and harmonized, and those with inconsistent coding (e.g. education, lifetime trauma exposure) were recoded. Administered in 11 studies, the Clinician Administered PTSD Scale (CAPS) emerged as the main measure of PTSD diagnosis and severity.Results: The pooled data set included 6254 subjects (39.9% female). Studies’ average retention rate was 87.0% (range 49.1–93.5%). Participants’ baseline assessments took place within 2 months of trauma exposure. Follow-up durations ranged from 188 to 1110 days. Reflecting studies’ inclusion criteria, the prevalence of baseline PTSD differed significantly between studies (range 3.1–61.6%), and similar differences were observed in subsequent assessments (4.3–38.2% and 3.8–27.0% for second and third assessments, respectively).Conclusion: Pooling data from independently collected studies requires careful curation of individual data sets for extracting and optimizing informative commonalities. However, it is an important step towards developing robust and generalizable prediction models for PTSD and can exceed findings of single studies. The large differences in prevalence of PTSD longitudinally cautions against using any individual study to infer trauma outcome. The multiplicity of instruments used in individual studies emphasizes the need for common data elements in future studies.

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Auditory Startle Response in Trauma Survivors With Posttraumatic Stress Disorder: A Prospective Study

Abstract: Differences in physiological response to startling tones develop along with PTSD in the months that follow a traumatic event. This pattern supports the theories that associate PTSD with progressive neuronal sensitization.

Cited by 241 publications

References 33 publications

Regional Differentiation of the Medial Prefrontal Cortex in Regulating Adaptive Responses to Acute Emotional Stress

Regional Differentiation of the Medial Prefrontal Cortex in Regulating Adaptive Responses to Acute Emotional Stress

Blast Exposure Induces Post-Traumatic Stress Disorder-Related Traits in a Rat Model of Mild Traumatic Brain Injury

Application of data pooling to longitudinal studies of early post-traumatic stress disorder (PTSD): the International Consortium to Predict PTSD (ICPP) project

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