Posttraumatic Stress Disorder: Clinical Features, Pathophysiology, and Treatment

Vieweg, W. Victor R.; Julius, Demetrios A.; Fernandez, Antony; Beatty-Brooks, Mary; Hettema, John M.; Pandurangi, Anand K.

doi:10.1016/j.amjmed.2005.09.027

Cited by 138 publications

(91 citation statements)

References 20 publications

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“…Highlighting the role of CB 1 R in mood regulation, preclinical studies have indeed shown that its genetic and pharmacological blockade rendered animals more emotionally reactive and anxious (Haller et al, 2002(Haller et al, , 2004Martin et al, 2002), susceptible to chronic stress-induced anhedonia (Martin et al, 2002), and liable to impairments in hypothalamic-pituitary-adrenal regulation ) reminiscent of neuroendocrine dysfunction observed in depression. Interestingly, CB 1 R knock-out mice presented impaired extinction of aversive memories (Marsicano et al, 2002), invoking the pathological hallmark of posttraumatic stress disorder, a condition possessing overlapping symptomatology and high rate of comorbidity with major depression (Vieweg et al, 2006). Antidepressant-like effects in the FST have also been reported previously with the endocannabinoid reuptake inhibitor AM404 [N-(4-hydroxyphenyl)-arachidonamide] and the direct CB 1 R agonist HU-210 Jiang et al, 2005).…”

Section: Discussionmentioning

confidence: 79%

Cannabinoids Elicit Antidepressant-Like Behavior and Activate Serotonergic Neurons through the Medial Prefrontal Cortex

Bambico¹,

Katz²,

Debonnel³

et al. 2007

J. Neurosci.

288

213

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Preclinical and clinical studies show that cannabis modulates mood and possesses antidepressant-like properties, mediated by the agonistic activity of cannabinoids on central CB 1 receptors (CB 1 Rs). The action of CB 1 R agonists on the serotonin (5-HT) system, the major transmitter system involved in mood control and implicated in the mechanism of action of antidepressants, remains however poorly understood. In this study, we demonstrated that, at low doses, the CB 1 R agonist WIN55, 212-2 [R(ϩ)-[2,3-dihydro-5-methyl-3-[(morpholinyl)]pyrrolo[1,2,3-de]-1,4-benzoxazinyl]-(1-naphthalenyl) methanone mesylate] exerts potent antidepressant-like properties in the rat forced-swim test (FST). This effect is CB 1 R dependent because it was blocked by the CB 1 R antagonist rimonabant and is 5-HT mediated because it was abolished by pretreatment with the 5-HT-depleting agent parachlorophenylalanine. Then, using in vivo electrophysiology, we showed that low doses of WIN55,212-2 dose dependently enhanced dorsal raphe nucleus 5-HT neuronal activity through a CB 1 R-dependent mechanism. Conversely, high doses of WIN55,212-2 were ineffective in the FST and decreased 5-HT neuronal activity through a CB 1 R-independent mechanism. The CB 1 R agonist-induced enhancement of 5-HT neuronal activity was abolished by total or medial prefrontocortical, but not by lateral prefrontocortical, transection. Furthermore, 5-HT neuronal activity was enhanced by the local microinjection of WIN55,212-2 into the ventromedial prefrontal cortex (mPFCv) but not by the local microinjection of WIN55,212-2 into the lateral prefrontal cortex. Similarly, the microinjection of WIN55,212-2 into the mPFCv produced a CB 1 R-dependent antidepressantlike effect in the FST. These results demonstrate that CB 1 R agonists possess antidepressant-like properties and modulate 5-HT neuronal activity via the mPFCv.

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Section: Discussionmentioning

confidence: 79%

Cannabinoids Elicit Antidepressant-Like Behavior and Activate Serotonergic Neurons through the Medial Prefrontal Cortex

Bambico¹,

Katz²,

Debonnel³

et al. 2007

J. Neurosci.

288

213

View full text Add to dashboard Cite

show abstract

“…1,2,50,51 Understanding the reasons for elevated PTSD risk may lead to improved screening methods and the development of interventions targeted to low-income urban women. General interventions for PTSD in primary care settings include medication, short-term psychotherapy, and referral to psychiatric clinics, 52,53 yet urban women may have unique needs. Social support, 54 spiritual well-being, 55 and integrated treatment for alcohol and drug abuse 56,57 have been identified as needs of traumatized urban women.…”

Section: Discussionmentioning

confidence: 99%

Experiences of Traumatic Events and Associations with PTSD and Depression Development in Urban Health Care-seeking Women

et al. 2008

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Posttraumatic stress disorder (PTSD) is an anxiety disorder that occurs after a traumatic event and has been linked to psychiatric and physical health declines. Rates of PTSD are far higher in individuals with low incomes and who reside in urban areas compared to the general population. In this study, 250 urban health care-seeking women were interviewed for a diagnosis of PTSD, major depressive disorder, and also the experience of traumatic events. Multivariate logistic regressions were used to determine the associations between traumatic events and PTSD development. Survival analysis was used to determine if PTSD developed from assaultive and nonassaultive events differed in symptom duration. Eighty-six percent of women reported at least one traumatic event, 14.8% of women were diagnosed with current PTSD, and 19.6% with past PTSD. More than half of women with PTSD had comorbid depression. Assaultive traumatic events were most predictive of PTSD development. More than two thirds of the women who developed PTSD developed chronic PTSD. Women who developed PTSD from assaultive events experienced PTSD for at least twice the duration of women who developed PTSD from nonassaultive events. In conclusion, PTSD was very prevalent in urban health care-seeking women. Assaultive violence was most predictive of PTSD development and also nonremittance.

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“…Hyperarousal is a core feature of PSTD, 14 and acoustic startle response is increased in human subjects with PTSD. [15][16][17][18] We measured response to acoustic startle and prepulse inhibition as measures of auditory function and sensory gating.…”

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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Posttraumatic Stress Disorder: Clinical Features, Pathophysiology, and Treatment

Cited by 138 publications

References 20 publications

Cannabinoids Elicit Antidepressant-Like Behavior and Activate Serotonergic Neurons through the Medial Prefrontal Cortex

Cannabinoids Elicit Antidepressant-Like Behavior and Activate Serotonergic Neurons through the Medial Prefrontal Cortex

Experiences of Traumatic Events and Associations with PTSD and Depression Development in Urban Health Care-seeking Women

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

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