Low posttrauma GABA plasma levels as a predictive factor in the development of acute posttraumatic stress disorder

Vaïva, Guillaume; Thomas, Pierre; Ducrocq, François; Fontaine, Monique; Boss, Virginie; Devos, Patrick; Rascle, Claire; Cottencin, Olivier; Brunet, Alain; Laffargue, P; Goudemand, M.

doi:10.1016/j.biopsych.2003.08.009

Cited by 148 publications

(82 citation statements)

References 39 publications

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“…These explanations are consistent with other clinical studies that have suggested altered GABAergic function in PTSD. 1,7,10 A reduced GABAergic function can also be explained by the presence of increased levels of GABA.…”

Section: Discussionmentioning

confidence: 99%

“…GABA plays an important role in homeostasis during stress and alterations in GABAergic systems have been implicated in the pathogenesis of anxiety disorders, including posttraumatic stress disorder (PTSD) and depression. Low plasma GABA levels after a traumatic event are predictive of subsequent development of PTSD, 1 suggesting that the GABA system is involved in the pathophysiology of PTSD. Involvement of the GABA system in PTSD has been examined using a variety of different paradigms, including preclinical studies, pharmacologic studies and neuroimaging techniques.…”

Section: Introductionmentioning

confidence: 99%

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Reduced GABAA benzodiazepine receptor binding in veterans with post-traumatic stress disorder

et al. 2007

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c-Aminobutyric acid (GABA A ) receptors are thought to play an important role in modulating the central nervous system in response to stress. Animal data have shown alterations in the GABA A receptor complex by uncontrollable stressors. SPECT imaging with benzodiazepine ligands showed lower distribution volumes of the benzodiazepine-GABA A receptor in the prefrontal cortex of patients with post-traumatic stress disorder (PTSD) in one, but not in another study. The objective of the present study was to assess differences in the benzodiazepine-GABA A receptor complex in veterans with and without PTSD using [ 11 C]flumazenil and positron emission tomography (PET). Nine drug naive male Dutch veterans with deployment related PTSD and seven male Dutch veterans without PTSD were recruited, and matched for age, region and year of deployment. Each subject received a [ 11 C]flumazenil PET scan and a structural magnetic resonance imaging scan. Dynamic 3D PET scans with a total duration of 60 min were acquired, and binding in template based and manually defined regions of interest (ROI) was quantified using validated plasma input and reference tissue models. In addition, parametric binding potential images were compared on a voxel-by-voxel basis using statistical parametric mapping (SPM2). ROI analyses using both template based and manual ROIs showed significantly reduced [ 11 C]flumazenil binding in PTSD subjects throughout the cortex, hippocampus and thalamus. SPM analysis confirmed these results. The observed global reduction of [ 11 C]flumazenil binding in patients with PTSD provides circumstantial evidence for the role of the benzodiazepine-GABA A receptor in the pathophysiology of PTSD and is consistent with previous animal research and clinical psychopharmacological studies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reduced GABAA benzodiazepine receptor binding in veterans with post-traumatic stress disorder

et al. 2007

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“…Recent longitudinal studies of PTSD have included many different groups of subjects, such as exposed disaster workers (1), refugees (2), a community sample (3), survivors of terrorists attacks (4), soldiers hospitalized following serious combat injury (5), patients with myocardial infarction (6), and victims of sexual and physical assault (7). Above all, longitudinal studies of patients following severe injury, especially those involved in motor vehicle accidents (MVAs), comprise one of the largest number of population samples studied (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Objectives Of the Studymentioning

confidence: 99%

Are patients after severe injury who drop out of a longitudinal study at high risk of mental disorder?

Nishi

Matsuoka

Nakajima

et al. 2008

Comprehensive Psychiatry

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Are patients after severe injury who drop out of a longitudinal study at high risk of mental disorder? Are patients after severe injury who drop out of a longitudinal study at high risk of mental disorder? AbstractIn longitudinal studies of traumatic stress, it is particularly important to examine the data for any differences between those who drop out and those who continue to participate, because reluctance to participate might reflect symptoms of avoidance frequently seen in posttraumatic stress disorder (PTSD). However, whether those who drop out are at high risk of PTSD remains unclear. Over a 25-month period, 188 consecutive patients with motor vehicle accident (MVA)-related injuries admitted emergently were enrolled and followed for 4 to 6 weeks. Baseline characteristics were compared between subjects who did and did not participate in the follow-up study. At 4 to 6 weeks, 66 (35.1%) of the participants had dropped out. Bivariate analyses revealed that those who dropped out were likely to be men, alcohol drinkers, smokers, and unconscious just after MVA and to have fewer years of education, less severe injuries, less posttraumatic symptoms, and lower cooperativeness as assessed by the Temperament and Character Inventory. Logistic regression analysis revealed that male sex, unconsciousness during MVA, low cooperativeness, and less severe injuries were significant predictors of dropout. The literature says that male sex and unconsciousness just after MVA might be protective factors against MVA-related PTSD, whereas low cooperativeness is a risk factor for general mental problems. To summarize, it is expected that those who drop from the follow-up are unlikely to have MVA-related PTSD, but might have mental problems independent of injury. In longitudinal studies of traumatic stress, it is particularly important to examine the data for any differences between those who drop out and those who continue to participate, because reluctance to participate might reflect symptoms of avoidance frequently seen in posttraumatic stress disorder (PTSD). However, whether or not those who drop out are at high risk for PTSD remains unclear. Over a 25-month period, 188 TITLE:consecutive patients with motor vehicle accident (MVA)-related injuries admitted emergently were enrolled and followed for 4-6 weeks. Baseline characteristics were compared between subjects who did and did not participate in the follow-up study. At 4-6 weeks, 66 (35.1%) of the participants had dropped out. Bivariate analyses revealed those who dropped out were likely to be men, alcohol drinkers, smokers, unconscious just after MVA, to have fewer years of education, less severe injuries, less posttraumatic symptoms, and lower cooperativeness as assessed by the Temperament and Cognitive

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“…An enhanced elevation of catecholamines in the immediate aftermath of a traumatic event may increase the probability of intrusive recollections in the first few days and weeks post-trauma. Relevant to this proposition's recent evidence that low GABA plasma levels immediately after trauma are predictive of subsequent PTSD (Vaiva et al, 2004). In light of evidence that GABA modulates the HPA axis and that GABA agonists reduce fear reactions (Zangrossi et al, 1999), this finding suggests that lower GABA levels shortly after trauma may suppress glutamatergic functioning.…”

Section: Core Predictors and Hypothesized Mechanisms Of Chronic Dysfumentioning

confidence: 99%

“…For example, to the extent that panic reactions are associated with increased catecholamine responses at the time of trauma, aggressive intervention with adrenergic blocking agents such as propranolol (Pitman et al, 2002;Vaiva et al, 2004) or cognitive behavioral stress management techniques emphasizing relaxation rather than any form of 'retelling' (ie reexposure, as in 'debriefing') may be the most appropriate immediate interventions for persons who panic in the hours immediately following a traumatic experience. For persons who are not in a position to receive intervention within several hours or days post-trauma, it will be necessary to determine the impact of post-traumatic risk factors such as lack of social support on the longitudinal course of pathologic responses to trauma.…”

Section: Core Predictors and Hypothesized Mechanisms Of Chronic Dysfumentioning

confidence: 99%

Pathological Responses to Terrorism

Yehuda¹,

Bryant²,

Marmar³

et al. 2005

Neuropsychopharmacol

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Many important gains have been made in understanding PTSD and other responses to trauma as a result of neuroscience-based observations. Yet there are many gaps in our knowledge that currently impede our ability to predict those who will develop pathologic responses. Such knowledge is essential for developing appropriate strategies for mounting a mental health response in the aftermath of terrorism and for facilitating the recovery of individuals and society. This paper reviews clinical and biological studies that have led to an identification of pathologic responses following psychological trauma, including terrorism, and highlights areas of future-research. It is important to not only determine risk factors for the development of short-and long-term mental health responses to terrorism, but also apply these risk factors to the prediction of such responses on an individual level. It is also critical to consider the full spectrum of responses to terrorism, as well as the interplay between biological and psychological variables that contribute to these responses. Finally, it is essential to remove the barriers to collecting data in the aftermath of trauma by creating a culture of education in which the academic community can communicate to the public what is and is not known so that survivors of trauma and terrorism will understand the value of their participation in research to the generation of useful knowledge, and by maintaining the acquisition of knowledge as a priority for the government and those involved in the immediate delivery of services in the aftermath of large-scale disaster or trauma.

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Low posttrauma GABA plasma levels as a predictive factor in the development of acute posttraumatic stress disorder

Cited by 148 publications

References 39 publications

Reduced GABAA benzodiazepine receptor binding in veterans with post-traumatic stress disorder

Reduced GABAA benzodiazepine receptor binding in veterans with post-traumatic stress disorder

Are patients after severe injury who drop out of a longitudinal study at high risk of mental disorder?

Pathological Responses to Terrorism

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