Circuits and systems in stress. II. Applications to neurobiology and treatment in posttraumatic stress disorder

Abstract

This paper follows the preclinical work on the effects of stress on neurobiological and neuroendocrine systems and provides a comprehensive working model for understanding the pathophysiology of posttraumatic stress disorder (PTSD). Studies of the neurobiology of PTSD in clinical populations are reviewed. Specific brain areas that play an important role in a variety of types of memory are also preferentially affected by stress, including hippocampus, amygdala, medial prefrontal cortex, and cingulate. This review indicates the involvement of these brain systems in the stress response, and in learning and memory. Affected systems in the neural circuitry of PTSD are reviewed (hypothalamic-pituitary-adrenal axis (HPA-axis), catecholaminergic and serotonergic systems, endogenous benzodiazepines, neuropeptides, hypothalamic-pituitary-thyroid axis (HPT-axis), and neuro-immunological alterations) as well as changes found with structural and functional neuroimaging methods. Converging evidence has emphasized the role of early-life trauma in the development of PTSD and other trauma-related disorders. Current and new targets for systems that play a role in the neural circuitry of PTSD are discussed. This material provides a basis for understanding the psychopathology of stress-related disorders, in particular PTSD.

Delayed suppression of hippocampal cell proliferation in rats following inescapable shocks

“…The etiology of a number of important forms of clinical psychopathology, including posttraumatic stress disorder (PTSD), major depression, and schizophrenia, in many cases, involve initial exposure to traumatic conditions (biological or social/environmental) (for reviews see, Kendler et al, 1999;Paykel, 2001;Vermetten and Bremner, 2002;Davidson et al, 2004;Dinan, 2005;Yeap and Thakore, 2005). The manifestation of this early experience is often not observed until some time later (frequently years or even decades).…”

The Psychobiology of Neglect

“…Necessarily, these systems are interconnected to modulate response to acute and chronic stressors. The sympathetic nervous system or catecholamine system, the limbichypothalamic-pituitary-adrenal (LHPA) axis, and the serotonin system are the three major neurobiological stress response systems implicated in mood, anxiety, and impulse control disorders (for review, see Vermetten & Bremner, 2002). Arousal, stress response, behavioral, and emotional regulation are all dependent on these systems.…”

A környezeti terhelések és patomechanizmusok kapcsolata

“…-impulzív (reaktív, ellenséges, affektív), -kontrollált (proaktív, instrumentális, ragadozó) agresszió [14].…”