Post Traumatic Stress Disorder (PTSD) as an Over Activation of Sympathetic Nervous System: An Alternative View

Lipov, Eugene

doi:10.4172/2167-1222.1000181

Cited by 10 publications

(14 citation statements)

References 35 publications

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“…This difference might have been caused by differences in study design, but could also indicate that oxytocin-mediated activation of the PNS might be altered in PTSD patients. This supposition is supported by previous studies showing that, besides the SNS [ 54 ], the PNS also plays a role in PTSD. For example, parasympathetic activity was found to influence basal HR in PTSD patients [ 55 ] and to be lower in Croatian combat veterans [ 56 ].…”

Section: Discussionsupporting

confidence: 78%

“…For example, parasympathetic activity was found to influence basal HR in PTSD patients [ 55 ] and to be lower in Croatian combat veterans [ 56 ]. In contrast, it is well accepted that the SNS is overactive in PTSD [ 54 ]. Of note, only little of the intranasally administered oxytocin reaches the brain.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, previous studies found that oxytocin attenuated avoidance behavior in rodents [ 59 , 60 ]. Because our experiments revealed that oxytocin treatment trend-wise reduced avoidance behavior despite enhancing HR and sympathetic cardiac control (Table 2 ), we speculate that PTSD-associated avoidance behavior is not causally linked to PTSD-associated SNS overactivity [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, even though we did not observe any unintended effects of oxytocin treatment in addition to its positive chronotropic effects, there is still the possibility of unknown unintended long-term consequences. Future experiments will have to clarify whether the beneficial effects of oxytocin in PTSD treatment described here (Table 2 ) outweigh the fact that oxytocin stimulates both HR and sympathetic activity (Additional file 1 : Tables S2, S3 and [ 32 ]), which are both known to be already enhanced in PTSD [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

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Intranasal oxytocin reduces provoked symptoms in female patients with posttraumatic stress disorder despite exerting sympathomimetic and positive chronotropic effects in a randomized controlled trial

Sack

Spieler

Wizelman

et al. 2017

BMC Med

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BackgroundPosttraumatic stress disorder (PTSD) is a severe psychiatric disease accompanied by neuroendocrine changes such as adrenergic overdrive and hence an elevated cardiovascular morbidity. Current pharmacotherapeutic options for PTSD are less than suboptimal, necessitating the development of PTSD-specific drugs. Although the neuropeptide oxytocin has been repeatedly suggested to be effective in PTSD treatment, there are, to our knowledge, only three studies that have assessed its efficacy on the intensity of PTSD symptoms in PTSD patients – among them one symptom provocation study in male veterans.MethodsTo evaluate for the first time how oxytocin influences the intensity of provoked PTSD symptoms and, furthermore, cardiac control in female PTSD patients, we assessed their psychic and cardiac response to trauma-script exposure with and without oxytocin pretreatment in a double-blind randomized placebo-controlled study. We used a within-subject design to study 35 female PTSD patients who received oxytocin and placebo in a 2-week interval. Furthermore, we performed a small pilot study to get an idea of the relation of the stress-modulated endogenous oxytocin levels and heart rate - we correlated oxytocin serum levels with the heart rate of 10 healthy individuals before and after exposure to the Trier Social Stress Test (TSST).ResultsIntranasal oxytocin treatment was followed by a reduction of provoked total PTSD symptoms, in particular of avoidance, and by an elevation in baseline and maximum heart rate together with a drop in the pre-ejection period, a marker for sympathetic cardiac control. Furthermore, we found a positive correlation between endogenous oxytocin levels and heart rate both before and after TSST challenge in healthy control subjects.ConclusionsThis study provides the first evidence that oxytocin treatment reduces the intensity of provoked PTSD symptoms in female PTSD patients. The small size of both samples and the heterogeneity of the patient sample restrict the generalizability of our findings. Future studies have to explore the gender dependency and the tolerability of the oxytocin-mediated increase in heart rate.This randomized controlled trial was retrospectively registered at the German Trials Register (DRKS00009399) on the 02 October 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-017-0801-0) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Intranasal oxytocin reduces provoked symptoms in female patients with posttraumatic stress disorder despite exerting sympathomimetic and positive chronotropic effects in a randomized controlled trial

Sack

Spieler

Wizelman

et al. 2017

BMC Med

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“…Although, further testing is still required, this research has the potential to have a profound impact in mental health. Typically, individuals who suffer from trauma or pain have increased SNS activation [51]. Using music therapy, with the help of predictions of the psychophysiological effects, specific music can be played to increase a PSNS activation (i.e.…”

Section: Hrv/valence/vagal Powermentioning

confidence: 99%

Predicting the psycho-physiological effects of pre-selected music� A feasibility Study (Preprint)

Patel¹,

Rauch²,

Sice³

et al. 2018

Preprint

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Background:The use of music therapy in healthcare, including mental health and general wellbeing has become common in many parts of the world, and is usually supported by clinical validation and supervision. In the last decades, research into music therapy and music medicine has advanced rapidly in step with advances in music neuroscience, brain imaging, neuroendocrinology and increasingly easy access to physiological measurements through a new generation of sensors.X-System has developed algorithms predicated upon these developments. These algorithms are intended to model areas and functions of the brain relating to the processing of music, in order to predict the differing neurophysiological effects of different music, and to stream music to achieve desired states of mind and body. XSystem has been able to verify these results by both subjective measures and physiological measures including, heart rate and galvanic skin conductance. However, predictions of valence, leading to predictions of mood and emotion, are important for work in mental health but have been difficult to verify physiologically. In this context, Heart Rate Variability (HRV) has proved to be a very promising way forward. Objectives:This study had two main objectives 1) Understanding the impact of different types of music on heart rate variability as a means of understanding the effects on the subject, and 2)Exploring the potentials of the X-System algorithm to predict psychophysiological effects of music by comparing the output data to HRV data, and where possible offering validation of existing algorithms Methods:Six participants listened to four such pre-selected pieces (two "happy" and two "sad", according to internet-sourced popular curations) and one self-selected song in a random order whilst ECG data was recorded continuously throughout. After each song, participants were asked to fill a valence questionnaire.The pre-selected songs were analysed by X-system software to predict the effects of songs on the subjects, and the results were compared to the corresponding HRV data. Results:Results showed that song 4 (happy song), had the largest significant impact on HRV (P=.05), in particular the total power domain where an average increase of 574 ms 2 was seen.Promising potential correlations were identified between X-System predictions for both arousal and valence on the one hand and subjective responses of participants on the other. Both arousal and valence, X-System predictions and subjective rankings correlated with HR and HRV rankings for three out of four songs. In the cases that deviated there appeared to be possible bases for prediction in X-System analyses Conclusions:There were some tentative, identifiable correlations between the X-System predictions, subjective responses and HRV data that suggest that further work should be undertaken, directed towards improving X-System mood predictions and developing treatments for autonomic and mood disorders based on music streaming.

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The relevance of accounting for parasympathetic as well as sympathetic arousal in threat conditioning: methodological and clinical considerations

Jaswetz¹,

Voogd²,

Becker³

et al. 2023

Preprint

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Alterations in associative threat learning have been thought to underlie the aetiology and maintenance of anxiety disorders. Recent insights into the facilitatory role of parasympathetic arousal for threat coping have raised the question whether individual differences in parasympathetic versus sympathetic dominance during threat learning may explain the unstable relationship with anxiety vulnerability versus resilience. We applied an established threat-conditioning paradigm in 78 neurotypical individuals and assessed parasympathetic responses (relative bradycardia), as well as sympathetic response patterns (relative tachycardia and increased skin conductance responses -SCR). We observed threat-induced bradycardia as well as tachycardia during associative learning. Additionally, participants not showing conditioned SCR still exhibit significant conditioned threat responses expressed in parasympathetically driven threat bradycardia. Critically, tachycardia, rather than bradycardia, was linked to stronger initial conditioned SCRs and higher trait anxiety. These results suggest individual differences in sympathetic versus parasympathetic dominance may underlie anxiety vulnerability versus resilience.

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Post Traumatic Stress Disorder (PTSD) as an Over Activation of Sympathetic Nervous System: An Alternative View

Cited by 10 publications

References 35 publications

Intranasal oxytocin reduces provoked symptoms in female patients with posttraumatic stress disorder despite exerting sympathomimetic and positive chronotropic effects in a randomized controlled trial

Intranasal oxytocin reduces provoked symptoms in female patients with posttraumatic stress disorder despite exerting sympathomimetic and positive chronotropic effects in a randomized controlled trial

Predicting the psycho-physiological effects of pre-selected music� A feasibility Study (Preprint)

The relevance of accounting for parasympathetic as well as sympathetic arousal in threat conditioning: methodological and clinical considerations

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