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Korem N, Duek O, Spiller T, Ben-Zion Z, Levy I, Harpaz-Rotem I. Emotional State Transitions in Trauma-Exposed Individuals With and Without Posttraumatic Stress Disorder. JAMA Netw Open 2024; 7:e246813. [PMID: 38625701 PMCID: PMC11022112 DOI: 10.1001/jamanetworkopen.2024.6813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/16/2024] [Indexed: 04/17/2024] Open
Abstract
Importance Posttraumatic stress disorder (PTSD) is marked by the contrasting symptoms of hyperemotional reactivity and emotional numbing (ie, reduced emotional reactivity). Comprehending the mechanism that governs the transition between neutral and negative emotional states is crucial for developing targeted therapeutic strategies. Objectives To explore whether individuals with PTSD experience a more pronounced shift between neutral and negative emotional states and how the intensity of emotional numbing symptoms impacts this shift. Design, Setting, and Participants This cross-sectional study used hierarchical bayesian modeling to fit a 5-parameter logistic regression to analyze the valence ratings of images. The aim was to compare the curve's slope between groups and explore its association with the severity of emotional numbing symptoms. The study was conducted online, using 35 images with a valence range from highly negative to neutral. The rating of these images was used to assess the emotional responses of the participants. The study recruited trauma-exposed individuals (witnessed or experienced life-threatening incident, violent assault, or someone being killed) between January 17 and March 8, 2023. Participants completed the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) (PCL-5). Exposure On the basis of DSM-5 criteria (endorsing at least 1 symptom from clusters B and C and 2 from D and E), participants were categorized as having probable PTSD (pPTSD) or as trauma-exposed controls (TECs). Main Outcomes and Measures The main outcome was the slope parameter (b) of the logistic curve fitted to the valence rating. The slope parameter indicates the rate at which emotional response intensity changes with stimulus valence, reflecting how quickly the transition occurs between neutral and negatively valenced states. The secondary outcome was the association between emotional numbing (PCL-5 items 12-14) and the slope parameter. Results A total of 1440 trauma-exposed individuals were included. The pPTSD group (n = 445) was younger (mean [SD] age, 36.1 [10.9] years) compared with the TEC group (mean [SD] age, 41.5 [13.3] years; P < .001). Sex distribution (427 women in the TEC group vs 230 in the pPTSD group) did not significantly differ between groups (P = .67). The pPTSD group exhibited a steeper slope (mean slope difference, -0.255; 89% highest posterior density [HPD], -0.340 to -0.171) compared with the controls. Across all individuals (n = 1440), a robust association was found between the slope and emotional numbing severity (mean [SD] additive value, 0.100 [0.031]; 89% HPD, 0.051-0.15). Additional analysis controlling for age confirmed the association between emotional numbing and transition sharpness (mean [SD] additive value, 0.108 [0.032]; 89% HPD, 0.056-0.159), without evidence of an age-related association (mean [SD] additive value, 0.031 [0.033]; 89% HPD, -0.022 to 0.083). Conclusions and Relevance These findings support that individuals with PTSD undergo rapid transitions between neutral and negative emotional states, a phenomenon intensified by the severity of emotional numbing symptoms. Therapeutic interventions aimed at moderating these swift emotional transitions could potentially alleviate PTSD symptoms.
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Affiliation(s)
- Nachshon Korem
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
- Department of Comparative Medicine, Yale University School of Medicine, New Haven, Connecticut
- US Department of Veterans Affairs (VA) National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven
| | - Or Duek
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
- Department of Epidemiology, Biostatistics, and Community Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Tobias Spiller
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
- US Department of Veterans Affairs (VA) National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Ziv Ben-Zion
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
- Department of Comparative Medicine, Yale University School of Medicine, New Haven, Connecticut
- US Department of Veterans Affairs (VA) National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven
| | - Ifat Levy
- Department of Comparative Medicine, Yale University School of Medicine, New Haven, Connecticut
- Department of Psychology, Yale University, New Haven, Connecticut
- Department of Neuroscience, Yale University, New Haven, Connecticut
- Wu Tsai Institute, Yale University New Haven, New Haven, Connecticut
| | - Ilan Harpaz-Rotem
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
- US Department of Veterans Affairs (VA) National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven
- Department of Psychology, Yale University, New Haven, Connecticut
- Wu Tsai Institute, Yale University New Haven, New Haven, Connecticut
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Stevens L, Bregulla M, Scheele D. Out of touch? How trauma shapes the experience of social touch - Neural and endocrine pathways. Neurosci Biobehav Rev 2024; 159:105595. [PMID: 38373642 DOI: 10.1016/j.neubiorev.2024.105595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/20/2024] [Accepted: 02/15/2024] [Indexed: 02/21/2024]
Abstract
Trauma can shape the way an individual experiences the world and interacts with other people. Touch is a key component of social interactions, but surprisingly little is known about how trauma exposure influences the processing of social touch. In this review, we examine possible neurobiological pathways through which trauma can influence touch processing and lead to touch aversion and avoidance in trauma-exposed individuals. Emerging evidence indicates that trauma may affect sensory touch thresholds by modulating activity in the primary sensory cortex and posterior insula. Disturbances in multisensory integration and oxytocin reactivity combined with diminished reward-related and anxiolytic responses may induce a bias towards negative appraisal of touch contexts. Furthermore, hippocampus deactivation during social touch may reflect a dissociative state. These changes depend not only on the type and severity of the trauma but also on the features of the touch. We hypothesise that disrupted touch processing may impair social interactions and confer elevated risk for future stress-related disorders.
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Affiliation(s)
- Laura Stevens
- Social Neuroscience, Research Center One Health Ruhr of the University Alliance Ruhr, Faculty of Medicine, Ruhr University Bochum, Germany; Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Germany
| | - Madeleine Bregulla
- Social Neuroscience, Research Center One Health Ruhr of the University Alliance Ruhr, Faculty of Medicine, Ruhr University Bochum, Germany; Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Germany
| | - Dirk Scheele
- Social Neuroscience, Research Center One Health Ruhr of the University Alliance Ruhr, Faculty of Medicine, Ruhr University Bochum, Germany; Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Germany.
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Flores A, Nguyen NM, Pendyala G. Developmental outcomes with perinatal exposure (DOPE) to prescription opioids. NEUROIMMUNE PHARMACOLOGY AND THERAPEUTICS 2023; 2:339-351. [PMID: 38058996 PMCID: PMC10696573 DOI: 10.1515/nipt-2023-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/07/2023] [Indexed: 12/08/2023]
Abstract
Researchers have found considerable evidence in the past 20 years that perinatal opioid exposure leads to an increased risk of developmental disorders in offspring that persist into adulthood. The use of opioids to treat pain concerning pregnancy, delivery, and postpartum complications has been rising. As a result, communities have reported a 300-400 % increase in Neonatal Opioid Withdrawal Syndrome (NOWS). NOWS represents the initial stage of several behavioral, phenotypic, and synaptic deficits. This review article summarizes the Developmental Outcomes of Perinatal Exposure (DOPE) to prescription opioids. Moreover, we also seek to connect these findings to clinical research that describes DOPE at multiple stages of life. Since specific mechanisms that underlie DOPE remain unclear, this article aims to provide a framework for conceptualizing across all ages and highlight the implications they may have for longevity.
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Affiliation(s)
- Adrian Flores
- Department of Anesthesiology, University of Nebraska Medical Center (UNMC), Omaha, NE, USA
- Department of Cellular and Integrative Physiology, UNMC, Omaha, NE, USA
| | - Nghi M. Nguyen
- Department of Anesthesiology, University of Nebraska Medical Center (UNMC), Omaha, NE, USA
- Department of Genetics, Cell Biology and Anatomy, UNMC, Omaha, NE, USA
| | - Gurudutt Pendyala
- Department of Anesthesiology, University of Nebraska Medical Center (UNMC), Omaha, NE, USA
- Department of Genetics, Cell Biology and Anatomy, UNMC, Omaha, NE, USA
- Child Health Research Institute, Omaha, NE, USA
- National Strategic Research Institute, UNMC, Omaha, NE, USA
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Amygdala Intercalated Cells: Gate Keepers and Conveyors of Internal State to the Circuits of Emotion. J Neurosci 2022; 42:9098-9109. [PMID: 36639901 PMCID: PMC9761677 DOI: 10.1523/jneurosci.1176-22.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/19/2022] [Accepted: 10/16/2022] [Indexed: 01/09/2023] Open
Abstract
Generating adaptive behavioral responses to emotionally salient stimuli requires evaluation of complex associations between multiple sensations, the surrounding context, and current internal state. Neural circuits within the amygdala parse this emotional information, undergo synaptic plasticity to reflect learned associations, and evoke appropriate responses through their projections to the brain regions orchestrating these behaviors. Information flow within the amygdala is regulated by the intercalated cells (ITCs), which are densely packed clusters of GABAergic neurons that encircle the basolateral amygdala (BLA) and provide contextually relevant feedforward inhibition of amygdala nuclei, including the central and BLA. Emerging studies have begun to delineate the unique contribution of each ITC cluster and establish ITCs as key loci of plasticity in emotional learning. In this review, we summarize the known connectivity and function of individual ITC clusters and explore how different neuromodulators conveying internal state act via ITC gates to shape emotionally motivated behavior. We propose that the behavioral state-dependent function of ITCs, their unique genetic profile, and rich expression of neuromodulator receptors make them potential therapeutic targets for disorders, such as anxiety, schizophrenia spectrum, and addiction.
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Korem N, Duek O, Ben-Zion Z, Kaczkurkin AN, Lissek S, Orederu T, Schiller D, Harpaz-Rotem I, Levy I. Emotional numbing in PTSD is associated with lower amygdala reactivity to pain. Neuropsychopharmacology 2022; 47:1913-1921. [PMID: 35945274 PMCID: PMC9485255 DOI: 10.1038/s41386-022-01405-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/01/2022] [Accepted: 07/15/2022] [Indexed: 11/09/2022]
Abstract
Posttraumatic stress disorder (PTSD) is associated with altered pain perception, namely increased pain threshold and higher pain response. While pain consists of physiological and affective components, affective components are often overlooked. Similar patterns of increased threshold-high response in PTSD were shown in response to emotional stimuli, i.e., emotional numbing. As both emotional numbing and pain processing are modulated by the amygdala, we aimed to examine whether individuals diagnosed with PTSD show lower amygdala activation to pain compared with combat controls, and whether the amygdala responses to pain correlates with emotional numbing. To do so, two independent samples of veterans (original study: 44 total (20 PTSD); conceptual replication study: 40 total (20 PTSD)) underwent threat conditioning, where a conditioned stimulus (CS+; visual stimulus) was paired with an unconditioned stimulus (US; electric-shock). We contrasted the amygdala activity to the CS + US pairing with the CS+ presented alone and correlated it with emotional numbing severity. In both samples, the PTSD group showed a robust reduction in amygdala reactivity to shock compared to the Combat Controls group. Furthermore, amygdala activation was negatively correlated with emotional numbing severity. These patterns were unique to the amygdala, and did not appear in comparison to a control region, the insula, a pivotal region for the processing of pain. To conclude, amygdala response to pain is lower in individuals with PTSD, and is associated with emotional numbing symptoms. Lower amygdala reactivity to mild pain may contribute to the "all-or-none" reaction to stressful situations often observed in PTSD.
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Affiliation(s)
- Nachshon Korem
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, 06511, USA.
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA.
- Yale University School of Medicine, Departments of Comparative Medicine and Neuroscience, New Haven, CT, 06511, USA.
| | - Or Duek
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, 06511, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Ziv Ben-Zion
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, 06511, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | | | - Shmuel Lissek
- Department of Psychology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Temidayo Orederu
- The Nash Family Department of Neuroscience, Department of Psychiatry, and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Daniela Schiller
- The Nash Family Department of Neuroscience, Department of Psychiatry, and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Ilan Harpaz-Rotem
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, 06511, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Yale University Department of Psychology, New Haven, CT, 06511, USA
- Wu Tsai Institute, Yale University New Haven, New Haven, CT, 06510, USA
| | - Ifat Levy
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Yale University School of Medicine, Departments of Comparative Medicine and Neuroscience, New Haven, CT, 06511, USA
- Yale University Department of Psychology, New Haven, CT, 06511, USA
- Wu Tsai Institute, Yale University New Haven, New Haven, CT, 06510, USA
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Bagues A, Girón R, Abalo R, Goicoechea C, Martín-Fontelles MI, Sánchez-Robles EM. SHORT-TERM STRESS SIGNIFICANTLY DECREASES MORPHINE ANALGESIA IN TRIGEMINAL BUT NOT IN SPINAL INNERVATED AREAS IN RATS. Behav Brain Res 2022; 435:114046. [PMID: 35933048 DOI: 10.1016/j.bbr.2022.114046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/26/2022] [Accepted: 08/02/2022] [Indexed: 11/15/2022]
Abstract
Plenty information exists regarding the effects of chronic stress, although few data exist on the effects of short-lasting stressors, which would mimic daily challenges. Differences in craniofacial and spinal nociception have been observed, thus those observations obtained in spinally innervated areas cannot be directly applied to the orofacial region. Although, opioids are considered amongst the most effective analgesics, their use is sometimes hampered by the constipation they induce. Thus, our aims were to study if a short-lasting stressor, forced swim stress (FSS), modifies nociception, morphine antinociception and constipation in rats. Animals were submitted to 10-20min of FSS for three days, nociception and gastrointestinal transit were studied 24h after the last swimming session. Nociception and morphine (0.6-5mg/kg) antinociception were evaluated in the formalin and hypertonic saline tests in the orofacial area and limbs. Morphine-induced modifications in the GI transit were studied through radiographic techniques. Naloxone was administered, before each swimming session, to analyse the involvement of the endogenous opioid system on the effect of stress. Overall, stress did not alter nociception, although interestingly it reduced the effect of morphine in the orofacial tests and in the inflammatory phase of the formalin tests. Naloxone antagonized the effect of stress and normalized the effect of morphine. Stress did not modify the constipation induced by morphine. Opioid treatment may be less effective under a stressful situation, whilst adverse effects, such as constipation, are maintained. The prevention of stress may improve the level of opioid analgesia. Keywords.
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Affiliation(s)
- Ana Bagues
- Área de Farmacología, Nutrición y Bromatología, Dpto. C.C. Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Unidad Asociada I+D+i al Instituto de Química Médica (CSIC), Alcorcón, Spain; High Performance Research Group in Experimental Pharmacology (PHARMAKOM).
| | - Rocío Girón
- Área de Farmacología, Nutrición y Bromatología, Dpto. C.C. Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Unidad Asociada I+D+i al Instituto de Química Médica (CSIC), Alcorcón, Spain; High Performance Research Group in Experimental Pharmacology (PHARMAKOM).
| | - Raquel Abalo
- Área de Farmacología, Nutrición y Bromatología, Dpto. C.C. Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Unidad Asociada I+D+i al Instituto de Química Médica (CSIC), Alcorcón, Spain; High Performance Research Group in Physiopathology and Pharmacology of the Digestive System (NeuGut-URJC); Working Group of Basic Sciences in Pain and Analgesia of the Sociedad Española del Dolor.
| | - Carlos Goicoechea
- Área de Farmacología, Nutrición y Bromatología, Dpto. C.C. Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Unidad Asociada I+D+i al Instituto de Química Médica (CSIC), Alcorcón, Spain; High Performance Research Group in Experimental Pharmacology (PHARMAKOM); Working Group of Basic Sciences in Pain and Analgesia of the Sociedad Española del Dolor.
| | - Ma Isabel Martín-Fontelles
- Área de Farmacología, Nutrición y Bromatología, Dpto. C.C. Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Unidad Asociada I+D+i al Instituto de Química Médica (CSIC), Alcorcón, Spain; High Performance Research Group in Experimental Pharmacology (PHARMAKOM); Working Group of Basic Sciences in Pain and Analgesia of the Sociedad Española del Dolor.
| | - Eva Ma Sánchez-Robles
- Área de Farmacología, Nutrición y Bromatología, Dpto. C.C. Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Unidad Asociada I+D+i al Instituto de Química Médica (CSIC), Alcorcón, Spain; High Performance Research Group in Experimental Pharmacology (PHARMAKOM).
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Casello SM, Flores RJ, Yarur HE, Wang H, Awanyai M, Arenivar MA, Jaime-Lara RB, Bravo-Rivera H, Tejeda HA. Neuropeptide System Regulation of Prefrontal Cortex Circuitry: Implications for Neuropsychiatric Disorders. Front Neural Circuits 2022; 16:796443. [PMID: 35800635 PMCID: PMC9255232 DOI: 10.3389/fncir.2022.796443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 04/27/2022] [Indexed: 01/08/2023] Open
Abstract
Neuropeptides, a diverse class of signaling molecules in the nervous system, modulate various biological effects including membrane excitability, synaptic transmission and synaptogenesis, gene expression, and glial cell architecture and function. To date, most of what is known about neuropeptide action is limited to subcortical brain structures and tissue outside of the central nervous system. Thus, there is a knowledge gap in our understanding of neuropeptide function within cortical circuits. In this review, we provide a comprehensive overview of various families of neuropeptides and their cognate receptors that are expressed in the prefrontal cortex (PFC). Specifically, we highlight dynorphin, enkephalin, corticotropin-releasing factor, cholecystokinin, somatostatin, neuropeptide Y, and vasoactive intestinal peptide. Further, we review the implication of neuropeptide signaling in prefrontal cortical circuit function and use as potential therapeutic targets. Together, this review summarizes established knowledge and highlights unknowns of neuropeptide modulation of neural function underlying various biological effects while offering insights for future research. An increased emphasis in this area of study is necessary to elucidate basic principles of the diverse signaling molecules used in cortical circuits beyond fast excitatory and inhibitory transmitters as well as consider components of neuropeptide action in the PFC as a potential therapeutic target for neurological disorders. Therefore, this review not only sheds light on the importance of cortical neuropeptide studies, but also provides a comprehensive overview of neuropeptide action in the PFC to serve as a roadmap for future studies in this field.
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Affiliation(s)
- Sanne M. Casello
- Unit on Neuromodulation and Synaptic Integration, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Rodolfo J. Flores
- Unit on Neuromodulation and Synaptic Integration, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Hector E. Yarur
- Unit on Neuromodulation and Synaptic Integration, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Huikun Wang
- Unit on Neuromodulation and Synaptic Integration, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Monique Awanyai
- Unit on Neuromodulation and Synaptic Integration, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Miguel A. Arenivar
- Unit on Neuromodulation and Synaptic Integration, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Rosario B. Jaime-Lara
- Unit on Neuromodulation and Synaptic Integration, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, United States
| | - Hector Bravo-Rivera
- Unit on Neuromodulation and Synaptic Integration, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Hugo A. Tejeda
- Unit on Neuromodulation and Synaptic Integration, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
- *Correspondence: Hugo A. Tejeda,
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Kapfhammer HP. [Comorbidity of posttraumatic stress disorder and addiction from a biopsychosocial perspective]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2022; 36:1-18. [PMID: 33439473 PMCID: PMC8916999 DOI: 10.1007/s40211-020-00384-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/16/2020] [Indexed: 11/18/2022]
Abstract
Posttraumatic stress disorder and substance use disorder often co-occur within the health care system. Their comorbidity is associated with more serious acute clinical symptomatology, more frequent hospital admissions in state of emergency and significantly lower chances of improvement by psychological and pharmacological treatment. Their comorbidity contributes to dramatically unfavourable courses of illness as regards all biopsychosocial levels. The survey presented will discuss empirical findings from various perspectives: general epidemiology, substance use disorder as risk factor of trauma and PTSD, trauma and PTSD as risk factor of SUD, neurobiological effects of SUD converging towards neurobiology of PTSD, shared common factors of genetics/epigenetics, personality traits, and early developmental stress and trauma. The main focus of analysis will be put on processes that are intrinsically linked to the development and course of both disorders.
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Affiliation(s)
- Hans-Peter Kapfhammer
- Universitätsklinik für Psychiatrie und Psychotherapeutische Medizin, Medizinische Universität Graz, Auenbruggerplatz 31, 8036, Graz, Österreich.
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Graph theory analysis of whole brain functional connectivity to assess disturbances associated with suicide attempts in bipolar disorder. Transl Psychiatry 2022; 12:7. [PMID: 35013103 PMCID: PMC8748935 DOI: 10.1038/s41398-021-01767-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 10/25/2021] [Accepted: 11/12/2021] [Indexed: 12/22/2022] Open
Abstract
Brain targets to lower the high risk of suicide in Bipolar Disorder (BD) are needed. Neuroimaging studies employing analyses dependent on regional assumptions could miss hubs of dysfunction critical to the pathophysiology of suicide behaviors and their prevention. This study applied intrinsic connectivity distribution (ICD), a whole brain graph-theoretical approach, to identify hubs of functional connectivity (FC) disturbances associated with suicide attempts in BD. ICD, from functional magnetic resonance imaging data acquired while performing a task involving implicit emotion regulation processes important in BD and suicide behaviors, was compared across 40 adults with BD with prior suicide attempts (SAs), 49 with BD with no prior attempts (NSAs) and 51 healthy volunteers (HVs). Areas of significant group differences were used as seeds to identify regional FC differences and explore associations with suicide risk-related measures. ICD was significantly lower in SAs than in NSAs and HVs in bilateral ventromedial prefrontal cortex (vmPFC) and right anterior insula (RaIns). Seed connectivity revealed altered FC from vmPFC to bilateral anteromedial orbitofrontal cortex, left ventrolateral PFC (vlPFC) and cerebellum, and from RaIns to right vlPFC and temporopolar cortices. VmPFC and RaIns ICD were negatively associated with suicidal ideation severity, and vmPFC ICD with hopelessness and attempt lethality severity. The findings suggest that SAs with BD have vmPFC and RaIns hubs of dysfunction associated with altered FC to other ventral frontal, temporopolar and cerebellar cortices, and with suicidal ideation, hopelessness, and attempt lethality. These hubs may be targets for novel therapeutics to reduce suicide risk in BD.
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Gasparyan A, Navarrete F, Manzanares J. The administration of sertraline plus naltrexone reduces ethanol consumption and motivation in a long-lasting animal model of post-traumatic stress disorder. Neuropharmacology 2021; 189:108552. [PMID: 33819457 DOI: 10.1016/j.neuropharm.2021.108552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
This study was aimed to evaluate the effects of sertraline (STR) and/or naltrexone (NTX) on ethanol consumption and motivation in an animal model of post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD). Male C57BL/6J mice were submitted to an intermittent and progressively increasing stressful stimuli simulating PTSD behavioural features. Behavioural alterations were explored by the fear conditioning (FC), novelty suppressed feeding test (NSFT) and acoustic startle response (ASR) paradigms. Afterwards, mice were evaluated in the voluntary ethanol consumption (VC) and the oral ethanol self-administration (OEA) paradigms. The effects of STR (10 mg/kg) and/or NTX (0.7 mg/kg) on ethanol consumption and motivation were analysed in the OEA. Furthermore, relative gene expression analyses of tyrosine hydroxylase (Th), mu-opioid receptor (Oprm1) and 5-hydroxitryptamine transporter (Slc6a4) were performed in the ventral tegmental area (VTA), nucleus accumbens (NAcc) and dorsal raphe nucleus (DR), respectively. PTSD-like mice presented increased fear-related memory, anxiety-like behaviours, and startle response, as well as enhanced ethanol consumption and motivation in the VC and OEA paradigms. Interestingly, STR plus NTX combination significantly reduced ethanol intake and motivation in the OEA. Gene expression analyses revealed reduced Th and Oprm1 whereas Slc6a4 gene expression increased in PTSD-like mice. STR and/or NTX modulated Th and Slc6a4 gene expression changes in PTSD-like mice. Furthermore, NTX increased Oprm1 gene expression revealing a synergistic action when combined with STR. These results provide evidence about the efficacy of the STR plus NTX to attenuate ethanol reinforcement and motivation in an animal model of PTSD and AUD dual pathology.
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Affiliation(s)
- Ani Gasparyan
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal S/n, San Juan de Alicante, 03550, Alicante, Spain; Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
| | - Francisco Navarrete
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal S/n, San Juan de Alicante, 03550, Alicante, Spain; Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
| | - Jorge Manzanares
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal S/n, San Juan de Alicante, 03550, Alicante, Spain; Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain.
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11
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Seidemann R, Duek O, Jia R, Levy I, Harpaz-Rotem I. The Reward System and Post-Traumatic Stress Disorder: Does Trauma Affect the Way We Interact With Positive Stimuli? CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2021; 5:2470547021996006. [PMID: 33718742 PMCID: PMC7917421 DOI: 10.1177/2470547021996006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/31/2021] [Indexed: 12/17/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a highly prevalent disorder and a highly debilitating condition. Although anhedonia is an important construct of the disorder, the relationship between PTSD and reward functioning is still under-researched. To date, the majority of research on PTSD has focused on fear: fear learning, maintenance, and extinction. Here we review the relevant literature-including clinical observations, self-report data, neuroimaging research, and animal studies-in order to examine the potential effects of post-traumatic stress disorder on the reward system. Our current lack of sufficient insight into how trauma affects the reward system is one possible hindrance to clinical progress. The current review highlights the need for further investigation into the complex relationship between exposure to trauma and the reward system to further our understandings of the ethology of PTSD.
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Affiliation(s)
- Rebecca Seidemann
- Yale University School of Medicine, New Haven, CT, USA
- National Center for PTSD, West Haven, CT, USA
| | - Or Duek
- Yale University School of Medicine, New Haven, CT, USA
- National Center for PTSD, West Haven, CT, USA
| | - Ruonan Jia
- Yale University School of Medicine, New Haven, CT, USA
| | - Ifat Levy
- Yale University School of Medicine, New Haven, CT, USA
| | - Ilan Harpaz-Rotem
- Yale University School of Medicine, New Haven, CT, USA
- National Center for PTSD, West Haven, CT, USA
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12
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Nummenmaa L, Karjalainen T, Isojärvi J, Kantonen T, Tuisku J, Kaasinen V, Joutsa J, Nuutila P, Kalliokoski K, Hirvonen J, Hietala J, Rinne J. Lowered endogenous mu-opioid receptor availability in subclinical depression and anxiety. Neuropsychopharmacology 2020; 45:1953-1959. [PMID: 32473595 PMCID: PMC7608336 DOI: 10.1038/s41386-020-0725-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/08/2020] [Accepted: 05/22/2020] [Indexed: 11/09/2022]
Abstract
Major depressive disorder is associated with lowered mood, anxiety, anhedonia, sleep problems, and cognitive impairments. Many of these functions are regulated by μ-opioid receptor (MOR) system. Preclinical, in vivo, and post-mortem studies have however yielded inconclusive results regarding the role of the MOR in depression and anxiety. Moreover, it is not known whether alterations in MOR are already present in subclinical depression and anxiety. In a large-scale retrospective cross-sectional study we pooled data from 135 (113 males and 22 females) healthy subjects whose brain's MOR availability was measured with positron emission tomography (PET) using an agonist radioligand [11C]carfentanil that has high affinity for MORs. Depressive and anxious symptomology was addressed with BDI-II and STAI-X questionnaires, respectively. Both anxiety and depression scores in the subclinical range were negatively associated with MOR availability in cortical and subcortical areas, notably in amygdala, hippocampus, ventral striatum, and orbitofrontal and cingulate cortices. We conclude that dysregulated MOR availability is involved in altered mood and pathophysiology of depression and anxiety disorders.
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Affiliation(s)
- Lauri Nummenmaa
- Turku PET Centre, University of Turku, Turku, Finland.
- Department of Psychology, University of Turku, Turku, Finland.
- Turku University Hospital University of Turku, Turku, Finland.
| | | | | | - Tatu Kantonen
- Turku PET Centre, University of Turku, Turku, Finland
- Clinical Neurosciences, University of Turku and Turku University Hospital, Turku, Finland
| | - Jouni Tuisku
- Turku PET Centre, University of Turku, Turku, Finland
| | - Valtteri Kaasinen
- Turku PET Centre, University of Turku, Turku, Finland
- Clinical Neurosciences, University of Turku and Turku University Hospital, Turku, Finland
| | - Juho Joutsa
- Turku PET Centre, University of Turku, Turku, Finland
- Clinical Neurosciences, University of Turku and Turku University Hospital, Turku, Finland
- Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Pirjo Nuutila
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Endocrinology, Turku University Hospital, Turku, Finland
| | | | - Jussi Hirvonen
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Radiology, Turku University Hospital, Turku, Finland
| | - Jarmo Hietala
- Turku University Hospital University of Turku, Turku, Finland
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Juha Rinne
- Turku PET Centre, University of Turku, Turku, Finland
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13
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Kantonen T, Karjalainen T, Isojärvi J, Nuutila P, Tuisku J, Rinne J, Hietala J, Kaasinen V, Kalliokoski K, Scheinin H, Hirvonen J, Vehtari A, Nummenmaa L. Interindividual variability and lateralization of μ-opioid receptors in the human brain. Neuroimage 2020; 217:116922. [PMID: 32407992 DOI: 10.1016/j.neuroimage.2020.116922] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/29/2020] [Accepted: 05/01/2020] [Indexed: 12/19/2022] Open
Abstract
Alterations in the brain's μ-opioid receptor (MOR) system have been associated with several neuropsychiatric disorders. Central MOR availability also varies considerably in healthy individuals. Multiple epidemiological factors have been proposed to influence the MOR system, but due to small sample sizes the magnitude of their influence remains inconclusive. We compiled [11C]carfentanil positron emission tomography scans from 204 individuals with no neurologic or psychiatric disorders, and estimated the effects of sex, age, body mass index (BMI) and smoking on [11C]carfentanil binding potential using between-subject regression analysis. We also examined hemispheric differences in MOR availability. Older age was associated with increase in MOR availability in frontotemporal areas but decrease in amygdala, thalamus, and nucleus accumbens. The age-dependent increase was stronger in males. MOR availability was globally lowered in smokers but independent of BMI. Finally, MOR availability was higher in the right versus the left hemisphere. The presently observed variation in MOR availability may explain why some individuals are prone to develop MOR-linked pathological states, such as chronic pain or psychiatric disorders. Lateralized MOR system may reflect hemispheric work specialization in central emotion and pain processes.
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Affiliation(s)
- Tatu Kantonen
- Turku PET Centre, University of Turku, Finland; Clinical Neurosciences, University of Turku and Turku University Hospital, Finland.
| | - Tomi Karjalainen
- Turku PET Centre, University of Turku, Finland; Turku PET Centre, Turku University Hospital, Finland
| | | | - Pirjo Nuutila
- Turku PET Centre, University of Turku, Finland; Department of Endocrinology, Turku University Hospital, Finland
| | | | - Juha Rinne
- Turku PET Centre, University of Turku, Finland; Clinical Neurosciences, University of Turku and Turku University Hospital, Finland
| | - Jarmo Hietala
- Turku PET Centre, University of Turku, Finland; Department of Psychiatry, University of Turku and Turku University Hospital, Finland
| | - Valtteri Kaasinen
- Turku PET Centre, University of Turku, Finland; Clinical Neurosciences, University of Turku and Turku University Hospital, Finland
| | | | | | | | - Aki Vehtari
- Helsinki Institute for Information Technology HIIT, Department of Computer Science, Aalto University, Finland
| | - Lauri Nummenmaa
- Turku PET Centre, University of Turku, Finland; Department of Psychology, University of Turku, Finland
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14
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María-Ríos CE, Morrow JD. Mechanisms of Shared Vulnerability to Post-traumatic Stress Disorder and Substance Use Disorders. Front Behav Neurosci 2020; 14:6. [PMID: 32082127 PMCID: PMC7006033 DOI: 10.3389/fnbeh.2020.00006] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/13/2020] [Indexed: 12/11/2022] Open
Abstract
Psychoactive substance use is a nearly universal human behavior, but a significant minority of people who use addictive substances will go on to develop an addictive disorder. Similarly, though ~90% of people experience traumatic events in their lifetime, only ~10% ever develop post-traumatic stress disorder (PTSD). Substance use disorders (SUD) and PTSD are highly comorbid, occurring in the same individual far more often than would be predicted by chance given the respective prevalence of each disorder. Some possible reasons that have been proposed for the relationship between PTSD and SUD are self-medication of anxiety with drugs or alcohol, increased exposure to traumatic events due to activities involved in acquiring illegal substances, or addictive substances altering the brain's stress response systems to make users more vulnerable to PTSD. Yet another possibility is that some people have an intrinsic vulnerability that predisposes them to both PTSD and SUD. In this review, we integrate clinical and animal data to explore these possible etiological links between SUD and PTSD, with an emphasis on interactions between dopaminergic, adrenocorticotropic, GABAergic, and glutamatergic neurobehavioral mechanisms that underlie different emotional learning styles.
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Affiliation(s)
| | - Jonathan D. Morrow
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
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15
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Affiliation(s)
- Marlene A Wilson
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, United States
- Columbia VA Health Care System, Columbia, SC, United States
| | - Alexander J McDonald
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, United States
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16
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Jeong H, Chung YA, Ma J, Kim J, Hong G, Oh JK, Kim M, Ha E, Hong H, Yoon S, Lyoo IK. Diverging roles of the anterior insula in trauma-exposed individuals vulnerable or resilient to posttraumatic stress disorder. Sci Rep 2019; 9:15539. [PMID: 31664062 PMCID: PMC6820768 DOI: 10.1038/s41598-019-51727-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 10/04/2019] [Indexed: 11/29/2022] Open
Abstract
Distinct brain alterations in response to traumatic events may render trauma-exposed individuals either resilient or vulnerable to posttraumatic stress disorder (PTSD). This study compared regional cerebral metabolic rate of glucose (rCMRglu) among trauma-exposed individuals with current PTSD (PTSD group, n = 61), those without current PTSD (Resilience/Recovery group, n = 26), and trauma-unexposed controls (Control group, n = 54). All participants underwent brain [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) scans. Voxel-wise group differences in rCMRglu among the three groups were evaluated. Associations between rCMRglu and both PTSD severity and resilience were examined. The rCMRglu in the right anterior insula and adjacent prefrontal and striatal areas was lower in the PTSD group, while higher in the Resilience/Recovery group, compared to the Control group. In addition, the lower glucose metabolism of these areas was associated with higher severity and less improvement in PTSD symptoms in the PTSD group, while the higher levels of rCMRglu were correlated with stronger resilience in the Resilience/Recovery group. This study suggests distinct roles of the anterior insula in response to trauma between the PTSD and Resilience/Recovery groups. Heightened rCMRglu in the anterior insular regions may reflect an underlying mechanism of resilience against traumatic stress, while reduced rCMRglu may indicate vulnerability to PTSD.
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Affiliation(s)
- Hyeonseok Jeong
- Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Yong-An Chung
- Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jiyoung Ma
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
| | - Jungyoon Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Gahae Hong
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
| | - Jin Kyoung Oh
- Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Myeongju Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Eunji Ha
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Haejin Hong
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Sujung Yoon
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea. .,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea.
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea. .,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea. .,Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea. .,The Brain Institute and Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA.
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17
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Colom M, Vidal B, Zimmer L. Is There a Role for GPCR Agonist Radiotracers in PET Neuroimaging? Front Mol Neurosci 2019; 12:255. [PMID: 31680859 PMCID: PMC6813225 DOI: 10.3389/fnmol.2019.00255] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/02/2019] [Indexed: 12/30/2022] Open
Abstract
Positron emission tomography (PET) is a molecular imaging modality that enables in vivo exploration of metabolic processes and especially the pharmacology of neuroreceptors. G protein-coupled receptors (GPCRs) play an important role in numerous pathophysiologic disorders of the central nervous system. Thus, they are targets of choice in PET imaging to bring proof concept of change in density in pathological conditions or in pharmacological challenge. At present, most radiotracers are antagonist ligands. In vitro data suggest that properties differ between GPCR agonists and antagonists: antagonists bind to receptors with a single affinity, whereas agonists are characterized by two different affinities: high affinity for receptors that undergo functional coupling to G-proteins, and low affinity for those that are not coupled. In this context, agonist radiotracers may be useful tools to give functional images of GPCRs in the brain, with high sensitivity to neurotransmitter release. Here, we review all existing PET radiotracers used from animals to humans and their role for understanding the ligand-receptor paradigm of GPCR in comparison with corresponding antagonist radiotracers.
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Affiliation(s)
- Matthieu Colom
- Lyon Neuroscience Research Center, INSERM, CNRS, Université de Lyon, Lyon, France.,CERMEP, Hospices Civils de Lyon, Bron, France
| | - Benjamin Vidal
- Lyon Neuroscience Research Center, INSERM, CNRS, Université de Lyon, Lyon, France
| | - Luc Zimmer
- Lyon Neuroscience Research Center, INSERM, CNRS, Université de Lyon, Lyon, France.,CERMEP, Hospices Civils de Lyon, Bron, France.,Institut National des Sciences et Techniques Nucléaires, CEA Saclay, Gif-sur-Yvette, France
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18
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Carrero JP, Kaigler KF, Hartshorn GH, Fadel JR, Wilson MA. Mu opioid receptor regulation of glutamate efflux in the central amygdala in response to predator odor. Neurobiol Stress 2019; 11:100197. [PMID: 31832510 PMCID: PMC6888766 DOI: 10.1016/j.ynstr.2019.100197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/23/2019] [Accepted: 10/09/2019] [Indexed: 12/24/2022] Open
Abstract
The amygdala plays an important role in the responses to predator threat. Glutamatergic processes in amygdala regulate the behavioral responses to predator stress, and we have found that exposure to ferret odor activates glutamatergic neurons of the basolateral amygdala [BLA] which are known to project to the central amygdala [CeA]. Therefore, we tested if predator stress would increase glutamate release in the rat CeA using in vivo microdialysis, while monitoring behavioral responses during a 1 h exposure to ferret odor. Since injections of mu opioid receptor [MOR] agonists and antagonists into the CeA modulate behavioral responses to predator odor, we locally infused the MOR agonist DAMGO or the MOR antagonist CTAP into the CeA during predator stress to examine effects on glutamate efflux and behavior. We found that ferret odor exposure increased glutamate, but not GABA, efflux in the CeA, and this effect was attenuated by tetrodotoxin. Interestingly, increases in glutamate efflux elicited by ferret odor exposure were blocked by infusion of CTAP, but CTAP did not alter the behavioral responses during predator stress. DAMGO alone enhanced glutamate efflux, but did not modulate glutamate efflux during predator stress. These studies demonstrate that ferret odor exposure, like other stressors, enhances glutamate efflux in the CeA. Further, they suggest that activation of MOR in the CeA may help shape the defensive response to predator odor and other threats. Predator odor stress increased glutamate efflux in the central amygdala. Predator stress-induced increases in glutamate were blocked by a mu opioid receptor antagonist. Blocking glutamate efflux in the amygdala did not alter behavioral responses to predator odor. Infusion of a mu opioid receptor agonist also increased glutamate efflux in the central amygdala.
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Affiliation(s)
- Jeffrey Parrilla Carrero
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, 29208, USA.,Columbia VA Health Care System, Columbia, SC, 29209, USA
| | - Kris F Kaigler
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, 29208, USA.,Columbia VA Health Care System, Columbia, SC, 29209, USA
| | - George H Hartshorn
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, 29208, USA.,Columbia VA Health Care System, Columbia, SC, 29209, USA
| | - Jim R Fadel
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, 29208, USA.,Columbia VA Health Care System, Columbia, SC, 29209, USA
| | - Marlene A Wilson
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, 29208, USA.,Columbia VA Health Care System, Columbia, SC, 29209, USA
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19
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Terpou BA, Harricharan S, McKinnon MC, Frewen P, Jetly R, Lanius RA. The effects of trauma on brain and body: A unifying role for the midbrain periaqueductal gray. J Neurosci Res 2019; 97:1110-1140. [PMID: 31254294 DOI: 10.1002/jnr.24447] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/09/2019] [Accepted: 05/06/2019] [Indexed: 12/18/2022]
Abstract
Post-traumatic stress disorder (PTSD), a diagnosis that may follow the experience of trauma, has multiple symptomatic phenotypes. Generally, individuals with PTSD display symptoms of hyperarousal and of hyperemotionality in the presence of fearful stimuli. A subset of individuals with PTSD; however, elicit dissociative symptomatology (i.e., depersonalization, derealization) in the wake of a perceived threat. This pattern of response characterizes the dissociative subtype of the disorder, which is often associated with emotional numbing and hypoarousal. Both symptomatic phenotypes exhibit attentional threat biases, where threat stimuli are processed preferentially leading to a hypervigilant state that is thought to promote defensive behaviors during threat processing. Accordingly, PTSD and its dissociative subtype are thought to differ in their proclivity to elicit active (i.e., fight, flight) versus passive (i.e., tonic immobility, emotional shutdown) defensive responses, which are characterized by the increased and the decreased expression of the sympathetic nervous system, respectively. Moreover, active and passive defenses are accompanied by primarily endocannabinoid- and opioid-mediated analgesics, respectively. Through critical review of the literature, we apply the defense cascade model to better understand the pathological presentation of defensive responses in PTSD with a focus on the functioning of lower-level midbrain and extended brainstem systems.
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Affiliation(s)
- Braeden A Terpou
- Department of Neuroscience, Western University, London, Ontario, Canada
| | | | - Margaret C McKinnon
- Mood Disorders Program, St. Joseph's Healthcare, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada
| | - Paul Frewen
- Department of Psychology, Western University, London, Ontario, Canada
| | - Rakesh Jetly
- Canadian Forces, Health Services, Ottawa, Canada
| | - Ruth A Lanius
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
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20
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Torres-Berrio A, Nava-Mesa MO. The opioid system in stress-induced memory disorders: From basic mechanisms to clinical implications in post-traumatic stress disorder and Alzheimer's disease. Prog Neuropsychopharmacol Biol Psychiatry 2019; 88:327-338. [PMID: 30118823 DOI: 10.1016/j.pnpbp.2018.08.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/25/2018] [Accepted: 08/13/2018] [Indexed: 02/07/2023]
Abstract
Cognitive and emotional impairment are a serious consequence of stress exposure and are core features of neurological and psychiatric conditions that involve memory disorders. Indeed, acute and chronic stress are high-risk factors for the onset of post-traumatic stress disorder (PTSD) and Alzheimer's disease (AD), two devastating brain disorders associated with memory dysfunction. Besides the sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis, stress response also involves the activation of the opioid system in brain regions associated with stress regulation and memory processing. In this context, it is possible that stress-induced memory disorders may be attributed to alterations in the interaction between the neuroendocrine stress system and the opioid system. In this review, we: (1) describe the effects of acute and chronic stress on memory, and the modulatory role of the opioid system, (2) discuss the contribution of the opioid system to the pathophysiology of PTSD and AD, and (3) present evidence of current and potential therapies that target the opioid receptors to treat PTSD- and AD-associated symptoms.
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Affiliation(s)
| | - Mauricio O Nava-Mesa
- Neuroscience Research Group (NEUROS), School of Medicine, Universidad del Rosario, Bogotá, Colombia.
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21
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A Review of the Neurobiological Basis of Trauma-Related Dissociation and Its Relation to Cannabinoid- and Opioid-Mediated Stress Response: a Transdiagnostic, Translational Approach. Curr Psychiatry Rep 2018; 20:118. [PMID: 30402683 DOI: 10.1007/s11920-018-0983-y] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Dissociative experiences have been associated with increased disease severity, chronicity, and, in some cases, reduced treatment response across trauma-related and other psychiatric disorders. A better understanding of the neurobiological mechanisms through which dissociative experiences occur may assist in identifying novel pharmacological and non-pharmacological treatment approaches. Here, we review emerging work on the dissociative subtype of posttraumatic stress disorder (PTSD), and other trauma-related disorders providing evidence for two related overarching neurobiological models of dissociation, the defense cascade model of dissociation and Mobb's threat detection model. In particular, we review neuroimaging studies highlighting alterations in functional connectivity of key brain regions associated with these models, including connectivity between the prefrontal cortex, the amygdala and its complexes, the insula, and the periaqueductal gray. Work implicating the kappa-opioid and endocannabinoid systems in trauma-related dissociative experiences is also reviewed. Finally, we hypothesize mechanisms by which pharmacological modulation of these neurochemical systems may serve as promising transdiagnostic treatment modalities for individuals experiencing clinically significant levels of dissociation. Specifically, whereas kappa-opioid receptor antagonists may serve as a pharmacological vehicle for the selective targeting of dissociative symptoms and associated emotion overmodulation in the dissociative subtype of posttraumatic stress disorder and transdiagnostically, modulation of the endocannabinoid system may reduce symptoms associated with emotional undermodulation of the fight or flight components of the defense cascade model.
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22
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Elman I, Upadhyay J, Langleben DD, Albanese M, Becerra L, Borsook D. Reward and aversion processing in patients with post-traumatic stress disorder: functional neuroimaging with visual and thermal stimuli. Transl Psychiatry 2018; 8:240. [PMID: 30389908 PMCID: PMC6214971 DOI: 10.1038/s41398-018-0292-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/27/2018] [Accepted: 09/26/2018] [Indexed: 12/12/2022] Open
Abstract
In patients with post-traumatic stress disorder (PTSD), a decrease in the brain reward function was reported in behavioral- and in neuroimaging studies. While pathophysiological mechanisms underlying this response are unclear, there are several lines of evidence suggesting over-recruitment of the brain reward regions by aversive stimuli rendering them unavailable to respond to reward-related content. The purpose of this study was to juxtapose brain responses to functional neuroimaging probes that reliably produce rewarding and aversive experiences in PTSD subjects and in healthy controls. The stimuli used were pleasant, aversive and neutral images selected from the International Affective Picture System (IAPS) along with pain-inducing heat applied to the dorsum of the left hand; all were administered during 3 T functional magnetic resonance imaging. Analyses of IAPS responses for the pleasant images revealed significantly decreased subjective ratings and brain activations in PTSD subjects that included striatum and medial prefrontal-, parietal- and temporal cortices. For the aversive images, decreased activations were observed in the amygdala and in the thalamus. PTSD and healthy subjects provided similar subjective ratings of thermal sensory thresholds and each of the temperatures. When 46 °C (hot) and 42 °C (neutral) temperatures were contrasted, voxelwise between-group comparison revealed greater activations in the striatum, amygdala, hippocampus and medial prefrontal cortex in the PTSD subjects. These latter findings were for the most part mirrored by the 44 vs. 42 °C contrast. Our data suggest different brain alterations patterns in PTSD, namely relatively diminished corticolimbic response to pleasant and aversive psychosocial stimuli in the face of exaggerated response to heat-related pain. The present findings support the hypothesis that brain sensitization to pain in PTSD may interfere with the processing of psychosocial stimuli whether they are of rewarding or aversive valence.
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Affiliation(s)
- Igor Elman
- Department of Psychiatry, Cooper Medical School, Rowan University, Glassboro, NJ, USA.
| | - Jaymin Upadhyay
- 000000041936754Xgrid.38142.3cCenter for Pain and the Brain, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - Daniel D. Langleben
- 0000 0004 1936 8972grid.25879.31Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Mark Albanese
- 000000041936754Xgrid.38142.3cCambridge Health Alliance, Harvard Medical School, Boston, MA USA
| | - Lino Becerra
- 000000041936754Xgrid.38142.3cCenter for Pain and the Brain, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - David Borsook
- 000000041936754Xgrid.38142.3cCenter for Pain and the Brain, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
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Nummenmaa L, Tuominen L. Opioid system and human emotions. Br J Pharmacol 2018; 175:2737-2749. [PMID: 28394427 PMCID: PMC6016642 DOI: 10.1111/bph.13812] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/07/2017] [Accepted: 03/24/2017] [Indexed: 12/31/2022] Open
Abstract
Emotions are states of vigilant readiness that guide human and animal behaviour during survival-salient situations. Categorical models of emotions posit neurally and physiologically distinct basic human emotions (anger, fear, disgust, happiness, sadness and surprise) that govern different survival functions. Opioid receptors are expressed abundantly in the mammalian emotion circuit, and the opioid system modulates a variety of functions related to arousal and motivation. Yet, its specific contribution to different basic emotions has remained poorly understood. Here, we review how the endogenous opioid system and particularly the μ receptor contribute to emotional processing in humans. Activation of the endogenous opioid system is consistently associated with both pleasant and unpleasant emotions. In general, exogenous opioid agonists facilitate approach-oriented emotions (anger, pleasure) and inhibit avoidance-oriented emotions (fear, sadness). Opioids also modulate social bonding and affiliative behaviour, and prolonged opioid abuse may render both social bonding and emotion recognition circuits dysfunctional. However, there is no clear evidence that the opioid system is able to affect the emotions associated with surprise and disgust. Taken together, the opioid systems contribute to a wide array of positive and negative emotions through their general ability to modulate the approach versus avoidance motivation associated with specific emotions. Because of the protective effects of opioid system-mediated prosociality and positive mood, the opioid system may constitute an important factor contributing to psychological and psychosomatic resilience. LINKED ARTICLES This article is part of a themed section on Emerging Areas of Opioid Pharmacology. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.14/issuetoc.
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Affiliation(s)
- Lauri Nummenmaa
- Turku PET Centre and Department of PsychologyUniversity of TurkuTurkuFinland
| | - Lauri Tuominen
- Department of PsychiatryMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
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Ferdousi M, Finn DP. Stress-induced modulation of pain: Role of the endogenous opioid system. PROGRESS IN BRAIN RESEARCH 2018; 239:121-177. [DOI: 10.1016/bs.pbr.2018.07.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Browne CA, Falcon E, Robinson SA, Berton O, Lucki I. Reversal of Stress-Induced Social Interaction Deficits by Buprenorphine. Int J Neuropsychopharmacol 2017; 21:164-174. [PMID: 29020387 PMCID: PMC5793841 DOI: 10.1093/ijnp/pyx079] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 08/22/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Patients with post-traumatic stress disorder frequently report persistent problems with social interactions, emerging after a traumatic experience. Chronic social defeat stress is a widely used rodent model of stress that produces robust and sustained social avoidance behavior. The avoidance of other rodents can be reversed by 28 days of treatment with selective serotonin reuptake inhibitors, the only pharmaceutical class approved by the U.S. Food and Drug Administration for treating post-traumatic stress disorder. In this study, the sensitivity of social interaction deficits evoked by 10 days of chronic social defeat stress to prospective treatments for post-traumatic stress disorder was examined. METHODS The effects of acute and repeated treatment with a low dose of buprenorphine (0.25 mg/kg/d) on social interaction deficits in male C57BL/6 mice by chronic social defeat stress were studied. Another cohort of mice was used to determine the effects of the selective serotonin reuptake inhibitor fluoxetine (10 mg/kg/d), the NMDA antagonist ketamine (10 mg/kg/d), and the selective kappa opioid receptor antagonist CERC-501 (1 mg/kg/d). Changes in mRNA expression of Oprm1 and Oprk1 were assessed in a separate cohort. RESULTS Buprenorphine significantly reversed social interaction deficits produced by chronic social defeat stress following 7 days of administration, but not after acute injection. Treatment with fluoxetine for 7 days, but not 24 hours, also reinstated social interaction behavior in mice that were susceptible to chronic social defeat. In contrast, CERC-501 and ketamine failed to reverse social avoidance. Gene expression analysis found: (1) Oprm1 mRNA expression was reduced in the hippocampus and increased in the frontal cortex of susceptible mice and (2) Oprk1 mRNA expression was reduced in the amygdala and increased in the frontal cortex of susceptible mice compared to non-stressed controls and stress-resilient mice. CONCLUSIONS Short-term treatment with buprenorphine and fluoxetine normalized social interaction after chronic social defeat stress. In concert with the changes in opioid receptor expression produced by chronic social defeat stress, we speculate that buprenorphine's efficacy in this model of post-traumatic stress disorder may be associated with the ability of this compound to engage multiple opioid receptors.
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Affiliation(s)
| | | | | | | | - Irwin Lucki
- Departments of Psychiatry, Philadelphia, Pennsylvania,Systems Pharmacology and Translational Therapeutics, Philadelphia, Pennsylvania,University of Pennsylvania, Philadelphia, Pennsylvania,Correspondence: Irwin Lucki, PhD, Department of Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 ()
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Enkephalins: Endogenous Analgesics with an Emerging Role in Stress Resilience. Neural Plast 2017; 2017:1546125. [PMID: 28781901 PMCID: PMC5525068 DOI: 10.1155/2017/1546125] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/15/2017] [Accepted: 05/24/2017] [Indexed: 12/20/2022] Open
Abstract
Psychological stress is a state of mental or emotional strain or tension that results from adverse or demanding circumstances. Chronic stress is well known to induce anxiety disorders and major depression; it is also considered a risk factor for Alzheimer's disease. Stress resilience is a positive outcome that is associated with preserved cognition and healthy aging. Resilience presents psychological and biological characteristics intrinsic to an individual conferring protection against the development of psychopathologies in the face of adversity. How can we promote or improve resilience to chronic stress? Numerous studies have proposed mechanisms that could trigger this desirable process. The roles of enkephalin transmission in the control of pain, physiological functions, like respiration, and affective disorders have been studied for more than 30 years. However, their role in the resilience to chronic stress has received much less attention. This review presents the evidence for an emerging involvement of enkephalin signaling through its two associated opioid receptors, μ opioid peptide receptor and δ opioid peptide receptor, in the natural adaptation to stressful lifestyles.
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Savulich G, Riccelli R, Passamonti L, Correia M, Deakin JFW, Elliott R, Flechais RSA, Lingford-Hughes AR, McGonigle J, Murphy A, Nutt DJ, Orban C, Paterson LM, Reed LJ, Smith DG, Suckling J, Tait R, Taylor EM, Sahakian BJ, Robbins TW, Ersche KD. Effects of naltrexone are influenced by childhood adversity during negative emotional processing in addiction recovery. Transl Psychiatry 2017; 7:e1054. [PMID: 28267152 PMCID: PMC5416677 DOI: 10.1038/tp.2017.34] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 01/25/2017] [Accepted: 01/25/2017] [Indexed: 12/12/2022] Open
Abstract
Naltrexone is an opioid receptor antagonist used in the management of alcohol dependence. Although the endogenous opioid system has been implicated in emotion regulation, the effects of mu-opioid receptor blockade on brain systems underlying negative emotional processing are not clear in addiction. Individuals meeting criteria for alcohol dependence alone (n=18, alcohol) and in combination with cocaine and/or opioid dependence (n=21, alcohol/drugs) and healthy individuals without a history of alcohol or drug dependence (n=21) were recruited. Participants were alcohol and drug abstinent before entered into this double-blind, placebo-controlled, randomized, crossover study. Functional magnetic resonance imaging was used to investigate brain response while viewing aversive and neutral images relative to baseline on 50 mg of naltrexone and placebo. We found that naltrexone modulated task-related activation in the medial prefrontal cortex and functional connectivity between the anterior cingulate cortex and the hippocampus as a function of childhood adversity (for aversive versus neutral images) in all groups. Furthermore, there was a group-by-treatment-by-condition interaction in the right amygdala, which was mainly driven by a normalization of response for aversive relative to neutral images under naltrexone in the alcohol/drugs group. We conclude that early childhood adversity is one environmental factor that influences pharmacological response to naltrexone. Pharmacotherapy with naltrexone may also have some ameliorative effects on negative emotional processing in combined alcohol and drug dependence, possibly due to alterations in endogenous opioid transmission or the kappa-opioid receptor antagonist actions of naltrexone.
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Affiliation(s)
- G Savulich
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - R Riccelli
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK,Department of Medical and Surgical Sciences, University Magna Graecia, Catanzaro, Italy
| | - L Passamonti
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - M Correia
- Cognition and Brain Sciences Unit, Medical Research Council, Cambridge, UK
| | - J F W Deakin
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - R Elliott
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - R S A Flechais
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | | | - J McGonigle
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | - A Murphy
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - D J Nutt
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | - C Orban
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | - L M Paterson
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | - L J Reed
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | - D G Smith
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - J Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - R Tait
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - E M Taylor
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - B J Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - T W Robbins
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK,Department of Psychology, University of Cambridge, Cambridge, UK
| | - K D Ersche
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK,Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK. E-mail:
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Dysfunctional Pain Modulation in Torture Survivors: The Mediating Effect of PTSD. THE JOURNAL OF PAIN 2017; 18:1-10. [DOI: 10.1016/j.jpain.2016.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 09/09/2016] [Accepted: 09/14/2016] [Indexed: 11/18/2022]
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Hill EM, Hunt L, Duryea DG. Evolved Vulnerability to Addiction: The Problem of Opiates. EVOLUTIONARY PSYCHOLOGY 2017. [DOI: 10.1007/978-3-319-60576-0_6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Im JJ, Namgung E, Choi Y, Kim JY, Rhie SJ, Yoon S. Molecular Neuroimaging in Posttraumatic Stress Disorder. Exp Neurobiol 2016; 25:277-295. [PMID: 28035179 PMCID: PMC5195814 DOI: 10.5607/en.2016.25.6.277] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 11/11/2016] [Accepted: 11/14/2016] [Indexed: 01/10/2023] Open
Abstract
Over the past decade, an increasing number of neuroimaging studies have provided insight into the neurobiological mechanisms of posttraumatic stress disorder (PSTD). In particular, molecular neuroimaging techniques have been employed in examining metabolic and neurochemical processes in PTSD. This article reviews molecular neuroimaging studies in PTSD and focuses on findings using three imaging modalities including positron emission tomography (PET), single photon emission computed tomography (SPECT), and magnetic resonance spectroscopy (MRS). Although there were some inconsistences in the findings, patients with PTSD showed altered cerebral metabolism and perfusion, receptor bindings, and metabolite profiles in the limbic regions, medial prefrontal cortex, and temporal cortex. Studies that have investigated brain correlates of treatment response are also reviewed. Lastly, the limitations of the molecular neuroimaging studies and potential future research directions are discussed.
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Affiliation(s)
- Jooyeon Jamie Im
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea.; Interdisciplinary Program in Neuroscience, College of Natural Sciences, Seoul National University, Seoul 08826, Korea
| | - Eun Namgung
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea.; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea
| | - Yejee Choi
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea.; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea
| | - Jung Yoon Kim
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea.; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea
| | - Sandy Jeong Rhie
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea.; College of Pharmacy and Division of Life and Pharmaceutical Sciences, Ewha Womans University, Seoul 03760, Korea
| | - Sujung Yoon
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea.; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea
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Abstract
AbstractVariation in the quality of parental care has a tremendous impact on a child's social–emotional development. Research investigating the predictors of this variability in human caregiving behavior has mostly focused on learning mechanisms. Evidence is currently accumulating for the complementary underlying role of steroid hormones and neuropeptides. An overview is provided of the hormones and neuropeptides relevant for human caregiving behavior. Then the developmental factors are described that stimulate variability in sensitivity to these hormones and neuropeptides, which may result in variability in the behavioral repertoire of caregiving. The role of genetic variation in neuropeptide and steroid receptors, the role of testosterone and oxytocin during fetal development and parturition, and the impact of experienced caregiving in childhood on functioning of the neuroendocrine stress and oxytocin system are discussed. Besides providing a heuristic framework for further research on the ontogenetic development of human caregiving, a neuroendocrine model is also presented for the intergenerational transmission of caregiving practices. Insight into the underlying biological mechanisms that bring about maladaptive caregiving behavior, such as neglect and insensitive parenting, will hopefully result in more efficient approaches to reduce the high prevalence of such behavior and to minimize the impact on those affected.
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McKinnon MC, Boyd JE, Frewen PA, Lanius UF, Jetly R, Richardson JD, Lanius RA. A review of the relation between dissociation, memory, executive functioning and social cognition in military members and civilians with neuropsychiatric conditions. Neuropsychologia 2016; 90:210-34. [DOI: 10.1016/j.neuropsychologia.2016.07.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 06/16/2016] [Accepted: 07/16/2016] [Indexed: 01/01/2023]
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Knoll AT, Halladay LR, Holmes AJ, Levitt P. Quantitative Trait Loci and a Novel Genetic Candidate for Fear Learning. J Neurosci 2016; 36:6258-68. [PMID: 27277803 PMCID: PMC4899527 DOI: 10.1523/jneurosci.0177-16.2016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 04/15/2016] [Accepted: 05/02/2016] [Indexed: 01/10/2023] Open
Abstract
UNLABELLED Trauma- and stress-related disorders are clinically heterogeneous and associated with substantial genetic risk. Understanding the biological origins of heterogeneity of key intermediate phenotypes such as cognition and emotion can provide novel mechanistic insights into disorder pathogenesis. Performing quantitative genetics in animal models is a tractable strategy for examining both the genetic basis of intermediate phenotypes and functional testing of candidate quantitative traits genes (QTGs). Here, existing and newly collected data were used for collaborative genome-wide mapping of cued fear acquisition and expression in 65 mouse strains from the BXD genetic reference panel. For fear acquisition, we identified a significant locus on chromosome (Chr) 10 and eight suggestive loci on Chr 2, 4, 5, 11, 13, and 15. For fear expression, we identified one significant and another highly suggestive locus on Chr 13, as well as four suggestive loci on Chr 10, 11, and X. Across these loci, 60 putative QTGs were identified. The quantitative trait locus on distal Chr 13 contained a single, highly promising gene at the location of the peak likelihood ratio statistic score. The gene, hyperpolarization-activated cyclic nucleotide-gated channel 1 (Hcn1), regulates neuronal excitability. Validation experiments using behavioral pharmacology revealed that functional Hcn channels in the basolateral amygdala are necessary for conditioned fear acquisition and expression. Hcn1, together with the other candidate QTGs, thus provide new targets for neurobiological and treatment studies of fear learning and trauma- and stress-related disorders. SIGNIFICANCE STATEMENT There is a knowledge gap in understanding the genetic contributions to behavioral heterogeneity in typical and atypical populations. Mouse genetic reference panels (GRPs) provide one approach for identifying genetic sources of variation. Here, we identified three loci for conditioned fear acquisition and expression in a mouse GRP. Each locus contained candidate quantitative trait genes (QTGs). One locus had a single QTG, Hcn1 (hyperpolarization-activated cyclic nucleotide-gated channel 1), which has been implicated in neuronal excitability and learning. This discovery was validated using behavioral pharmacology, revealing that Hcn channels in the basolateral amygdala are required for fear acquisition and expression. The study thus identifies novel candidate QTGs that may contribute to variation in emotional learning and highlight the utility of mouse GRPs for the identification of genes underlying complex traits.
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Affiliation(s)
- Allison T Knoll
- Program in Developmental Neurogenetics, Institute for the Developing Mind, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, California 90027
| | - Lindsay R Halladay
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland 20814
| | - Andrew J Holmes
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland 20814
| | - Pat Levitt
- Program in Developmental Neurogenetics, Institute for the Developing Mind, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, California 90027, Department of Pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, California 90089, and
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Danovitch I. Post-traumatic stress disorder and opioid use disorder: A narrative review of conceptual models. J Addict Dis 2016; 35:169-79. [PMID: 27010975 DOI: 10.1080/10550887.2016.1168212] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Post-traumatic stress disorder is highly prevalent among individuals who suffer from opioid use disorder. Compared to individuals with opioid use disorder alone, those with post-traumatic stress disorder have a worse course of illness, occupational functioning, and physical health. The neurobiological pathways underlying each disorder overlap substantially, and there are multiple pathways through which these disorders may interact. This narrative review explores evidence underpinning 3 explanatory perspectives on comorbid post-traumatic stress disorder and opioid use disorder: The opioid susceptibility model (a.k.a.: the Self-Medication Hypothesis), the post-traumatic stress disorder susceptibility model, and the common factors model. Diagnostic implications, treatment implications, and directions for future research are discussed.
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Affiliation(s)
- Itai Danovitch
- a Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center , Los Angeles , California , USA
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Defrin R, Schreiber S, Ginzburg K. Paradoxical Pain Perception in Posttraumatic Stress Disorder: The Unique Role of Anxiety and Dissociation. THE JOURNAL OF PAIN 2015; 16:961-70. [PMID: 26168878 DOI: 10.1016/j.jpain.2015.06.010] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 06/07/2015] [Accepted: 06/18/2015] [Indexed: 11/16/2022]
Abstract
UNLABELLED Posttraumatic stress disorder (PTSD) and chronic pain often co-occur and exacerbate each other. Elucidating the mechanism of this co-occurrence therefore has clinical importance. Previously, patients with PTSD with chronic pain were found to demonstrate a unique paradoxical pain profile: hyperresponsiveness together with hyposensitivity to pain. Our aim was to examine whether 2 seemingly paradoxical facets of PTSD (anxiety and dissociation) underlie this paradoxical profile. Patients with PTSD (n = 32) and healthy control individuals (n = 43) underwent psychophysical testing and completed questionnaires. Patients with PTSD had higher pain thresholds and higher pain ratings to suprathreshold stimuli than control individuals. Pain thresholds were positively associated with dissociation levels and negatively associated with anxiety sensitivity levels. Experimental pain ratings were positively associated with anxiety sensitivity and negatively related to dissociation levels. Chronic pain intensity was associated with anxiety, anxiety sensitivity, and pain catastrophizing. It appears that reduced conscious attention toward incoming stimuli, resulting from dissociation, causes delayed response in pain threshold measurement, whereas biases toward threatening stimuli and decreased inhibition, possibly caused by increased anxiety, are responsible for the intensification of experimental and chronic pain. The paradoxical facets of PTSD and their particular influences over pain perception seem to reinforce the coexistence of PTSD and chronic pain, and should be considered when treating traumatized individuals. PERSPECTIVE This article provides new information regarding the underlying mechanism of the coexistence of PTSD and chronic pain. This knowledge could help to provide better management of PTSD and chronic pain among individuals in the aftermath of trauma.
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Affiliation(s)
- Ruth Defrin
- Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.
| | - Shaul Schreiber
- Department of Psychiatry, Sourasky Medical Center, Tel-Aviv University, Tel-Aviv, Israel; Department of Psychiatry, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Karni Ginzburg
- Bob Shapell School of Social Work, Tel-Aviv University, Tel-Aviv, Israel
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Laredo SA, Steinman MQ, Robles CF, Ferrer E, Ragen BJ, Trainor BC. Effects of defeat stress on behavioral flexibility in males and females: modulation by the mu-opioid receptor. Eur J Neurosci 2015; 41:434-41. [PMID: 25615538 DOI: 10.1111/ejn.12824] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 12/05/2014] [Indexed: 02/01/2023]
Abstract
Behavioral flexibility is a component of executive functioning that allows individuals to adapt to changing environmental conditions. Independent lines of research indicate that the mu opioid receptor (MOR) is an important mediator of behavioral flexibility and responses to psychosocial stress. The current study bridges these two lines of research and tests the extent to which social defeat and MOR affect behavioral flexibility and whether sex moderates these effects in California mice (Peromyscus californicus). Males and females assigned to social defeat or control conditions were tested in a Barnes maze. In males, defeat impaired behavioral flexibility but not acquisition. Female performance was unaffected by defeat. MOR binding in defeated and control mice in the orbitofrontal cortex (OFC), striatum and hippocampus was examined via autoradiography. Stressed males had reduced MOR binding in the OFC whereas females were unaffected. The MOR antagonist beta-funaltrexamine (1 mg/kg) impaired performance in males naïve to defeat during the reversal phase but had no effect on females. Finally, we examined the effects of the MOR agonist morphine (2.5 and 5 mg/kg) on stressed mice. As expected, morphine improved behavioral flexibility in stressed males. The stress-induced deficits in behavioral flexibility in males are consistent with a proactive coping strategy, including previous observations that stressed male California mice exhibit strong social approach and aggression. Our pharmacological data suggest that a down-regulation of MOR signaling in males may contribute to sex differences in behavioral flexibility following stress. This is discussed in the framework of coping strategies for individuals with mood disorders.
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Affiliation(s)
- Sarah A Laredo
- Department of Psychology, University of California, Davis, CA, USA; Animal Behavior Graduate Group, University of California, Davis, CA, USA
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Kip KE, Rosenzweig L, Hernandez DF, Shuman A, Diamond DM, Girling SA, Sullivan KL, Wittenberg T, Witt AM, Lengacher CA, Anderson B, McMillan SC. Accelerated Resolution Therapy for treatment of pain secondary to symptoms of combat-related posttraumatic stress disorder. Eur J Psychotraumatol 2014; 5:24066. [PMID: 24959325 PMCID: PMC4014659 DOI: 10.3402/ejpt.v5.24066] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 04/12/2014] [Accepted: 04/12/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND As many as 70% of veterans with chronic pain treated within the US Veterans Administration (VA) system may have posttraumatic stress disorder (PTSD), and conversely, up to 80% of those with PTSD may have pain. We describe pain experienced by US service members and veterans with symptoms of PTSD, and report on the effect of Accelerated Resolution Therapy (ART), a new, brief exposure-based therapy, on acute pain reduction secondary to treatment of symptoms of PTSD. METHODS A randomized controlled trial of ART versus an attention control (AC) regimen was conducted among 45 US service members/veterans with symptoms of combat-related PTSD. Participants received a mean of 3.7 sessions of ART. RESULTS Mean age was 41.0 + 12.4 years and 20% were female. Most veterans (93%) reported pain. The majority (78%) used descriptive terms indicative of neuropathic pain, with 29% reporting symptoms of a concussion or feeling dazed. Mean pre-/post-change on the Pain Outcomes Questionnaire (POQ) was -16.9±16.6 in the ART group versus -0.7±14.2 in the AC group (p=0.0006). Among POQ subscales, treatment effects with ART were reported for pain intensity (effect size = 1.81, p=0.006), pain-related impairment in mobility (effect size = 0.69, p=0.01), and negative affect (effect size = 1.01, p=0.001). CONCLUSIONS Veterans with symptoms of combat-related PTSD have a high prevalence of significant pain, including neuropathic pain. Brief treatment of symptoms of combat-related PTSD among veterans by use of ART appears to acutely reduce concomitant pain.
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Affiliation(s)
- Kevin E Kip
- College of Nursing, University of South Florida, Tampa, FL, USA
| | | | | | - Amy Shuman
- Western New England University, Springfield, MA, USA
| | - David M Diamond
- Department of Psychology, University of South Florida, Tampa, FL, USA ; Department of Molecular Pharmacology and Physiology, Center for Preclinical/Clinical Research on PTSD, University of South Florida, Tampa, FL, USA
| | - Sue Ann Girling
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - Kelly L Sullivan
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | | | | | | | - Brian Anderson
- Pasco County Veterans Service Office, Port Richey, FL, USA
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Wei D, Wang K, Shen Y, Du X, Li W, Dupuis-Roy N, Qiu J, Zhang Q. Exposure to traumatic experiences is associated with abnormal neural mechanism during charitable donation. Psychiatry Res 2013; 214:42-7. [PMID: 23920149 DOI: 10.1016/j.pscychresns.2013.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 12/21/2012] [Accepted: 07/04/2013] [Indexed: 10/26/2022]
Abstract
Previous studies suggested that posttraumatic stress disorder (PTSD) might be associated with dysfunctional reward processing. At present, little is known about the neural mechanisms of reward-related processing during a charitable donation task in trauma survivors who do not go on to develop PTSD. We used functional magnetic resonance imaging (fMRI) to investigate the neural basis of charitable donation in non-PTSD survivors of the Sichuan earthquake. Results showed that activations in the striatum of trauma survivors were reduced in both the low donation (donated a small amount to the Red Cross) and the high donation conditions (donated a large amount to the Red Cross) compared with the healthy controls. Furthermore, the trauma survivors also exhibited less activity in the insula than the healthy controls in the high donation condition. These findings suggest that abnormal reward-related activations might be associated with dysfunctions in the reward pathway of trauma survivors. Also, we discuss the possibility that traumatic experiences attenuate the reactivity of reward-related brain areas to positive emotions (as induced by advantageous donations).
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Affiliation(s)
- Dongtao Wei
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China
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Ly HG, Dupont P, Geeraerts B, Bormans G, Van Laere K, Tack J, Van Oudenhove L. Lack of endogenous opioid release during sustained visceral pain: A [11C]carfentanil PET study. Pain 2013; 154:2072-2077. [DOI: 10.1016/j.pain.2013.06.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 06/17/2013] [Indexed: 11/26/2022]
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Association of trauma, posttraumatic stress disorder, and experimental pain response in healthy young women. Clin J Pain 2013. [PMID: 23183263 DOI: 10.1097/ajp.0b013e31825e454e] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Evidence of pain alterations in trauma-exposed individuals has been found. The presence of posttraumatic stress disorder (PTSD) may be explaining these alterations, as some of the psychological characteristics of PTSD are hypothesized to increase pain response. OBJECTIVES To examine differences in pain response and in certain psychological variables between trauma-exposed women (TEW) with PTSD, TEW without PTSD, and non-trauma-exposed women (NTEW) and to explore the role of these psychological variables in the differences in pain response between the groups. METHODS A total of 122 female students completed a cold pressor task (42 TEW with PTSD, 40 TEW without PTSD, and 40 NTEW). Anxiety sensitivity, experiential avoidance, trait and state dissociation, depressive symptoms, state anxiety, catastrophizing, and arousal were assessed. RESULTS TEW with PTSD reported significantly higher pain unpleasantness than NTEW, but not more than that of TEW without PTSD. They also presented higher trait dissociation, state anxiety, depressive symptoms, and skin conductance than the other 2 groups and higher anxiety sensitivity than TEW without PTSD. TEW without PTSD reported more pain unpleasantness than NTEW, but they recovered faster from pain. However, these differences were not explained by any psychological variable. CONCLUSIONS The results suggest that although trauma-exposed individuals are not more sensitive to painful stimulation, they evaluate pain in a more negative way. Exposure to trauma itself, but not to PTSD, may explain the differences found in pain unpleasantness.
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Pedler A, Sterling M. Patients with chronic whiplash can be subgrouped on the basis of symptoms of sensory hypersensitivity and posttraumatic stress. Pain 2013; 154:1640-1648. [DOI: 10.1016/j.pain.2013.05.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 05/01/2013] [Accepted: 05/01/2013] [Indexed: 12/28/2022]
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Sokolowska E, Hovatta I. Anxiety genetics - findings from cross-species genome-wide approaches. BIOLOGY OF MOOD & ANXIETY DISORDERS 2013; 3:9. [PMID: 23659354 PMCID: PMC3655048 DOI: 10.1186/2045-5380-3-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 04/16/2013] [Indexed: 12/02/2022]
Abstract
Anxiety disorders are complex diseases, which often occur in combination with major depression, alcohol use disorder, or general medical conditions. Anxiety disorders were the most common mental disorders within the EU states in 2010 with 14% prevalence. Anxiety disorders are triggered by environmental factors in genetically susceptible individuals, and therefore genetic research offers a great route to unravel molecular basis of these diseases. As anxiety is an evolutionarily conserved response, mouse models can be used to carry out genome-wide searches for specific genes in a setting that controls for the environmental factors. In this review, we discuss translational approaches that aim to bridge results from unbiased genome-wide screens using mouse models to anxiety disorders in humans. Several methods, such as quantitative trait locus mapping, gene expression profiling, and proteomics, have been used in various mouse models of anxiety to identify genes that regulate anxiety or play a role in maintaining pathological anxiety. We first discuss briefly the evolutionary background of anxiety, which justifies cross-species approaches. We then describe how several genes have been identified through genome-wide methods in mouse models and subsequently investigated in human anxiety disorder samples as candidate genes. These studies have led to the identification of completely novel biological pathways that regulate anxiety in mice and humans, and that can be further investigated as targets for therapy.
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Affiliation(s)
- Ewa Sokolowska
- Department of Biosciences, Viikki Biocenter, University of Helsinki, Helsinki, Finland.
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A randomized controlled trial of cognitive-behavioral therapy for the treatment of PTSD in the context of chronic whiplash. Clin J Pain 2013; 28:755-65. [PMID: 22209798 DOI: 10.1097/ajp.0b013e318243e16b] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Whiplash-associated disorders (WAD) are common and involve both physical and psychological impairments. Research has shown that persistent posttraumatic stress symptoms are associated with poorer functional recovery and physical therapy outcomes. Trauma-focused cognitive-behavioral therapy (TF-CBT) has shown moderate effectiveness in chronic pain samples. However, to date, there have been no clinical trials within WAD. Thus, this study will report on the effectiveness of TF-CBT in individuals meeting the criteria for current chronic WAD and posttraumatic stress disorder (PTSD). METHOD Twenty-six participants were randomly assigned to either TF-CBT or a waitlist control, and treatment effects were evaluated at posttreatment and 6-month follow-up using a structured clinical interview, self-report questionnaires, and measures of physiological arousal and sensory pain thresholds. RESULTS Clinically significant reductions in PTSD symptoms were found in the TF-CBT group compared with the waitlist at postassessment, with further gains noted at the follow-up. The treatment of PTSD was also associated with clinically significant improvements in neck disability, physical, emotional, and social functioning and physiological reactivity to trauma cues, whereas limited changes were found in sensory pain thresholds. DISCUSSION This study provides support for the effectiveness of TF-CBT to target PTSD symptoms within chronic WAD. The finding that treatment of PTSD resulted in improvements in neck disability and quality of life and changes in cold pain thresholds highlights the complex and interrelating mechanisms that underlie both WAD and PTSD. Clinical implications of the findings and future research directions are discussed.
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Malcolm-Smith S, Thomas KGF, Ipser J, Stein D, van Honk J, Solms M. Opioid Function Is Dysregulated Subsequent to Early Social Trauma: Healthy Young Adults’ Response to a Buprenorphine Challenge. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/15294145.2013.10799826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Ipser JC, Terburg D, Syal S, Phillips N, Solms M, Panksepp J, Malcolm-Smith S, Thomas K, Stein DJ, van Honk J. Reduced fear-recognition sensitivity following acute buprenorphine administration in healthy volunteers. Psychoneuroendocrinology 2013; 38:166-70. [PMID: 22651957 DOI: 10.1016/j.psyneuen.2012.05.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 05/01/2012] [Accepted: 05/03/2012] [Indexed: 12/13/2022]
Abstract
In rodents, the endogenous opioid system has been implicated in emotion regulation, and in the reduction of fear in particular. In humans, while there is evidence that the opioid antagonist naloxone acutely enhances the acquisition of conditioned fear, there are no corresponding data on the effect of opioid agonists in moderating responses to fear. We investigated whether a single 0.2mg administration of the mu-opioid agonist buprenorphine would decrease fear sensitivity with an emotion-recognition paradigm. Healthy human subjects participated in a randomized placebo-controlled within-subject design, in which they performed a dynamic emotion recognition task 120min after administration of buprenorphine and placebo. In the recognition task, basic emotional expressions were morphed between their full expression and neutral in 2% steps, and presented as dynamic video-clips with final frames of different emotional intensity for each trial, which allows for a fine-grained measurement of emotion sensitivity. Additionally, visual analog scales were used to investigate acute effects of buprenorphine on mood. Compared to placebo, buprenorphine resulted in a significant reduction in the sensitivity for recognizing fearful facial expressions exclusively. Our data demonstrate, for the first time in humans, that acute up-regulation of the opioid system reduces fear recognition sensitivity. Moreover, the absence of an effect of buprenorphine on mood provides evidence of a direct influence of opioids upon the core fear system in the human brain.
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Affiliation(s)
- Jonathan C Ipser
- Department of Psychiatry, University of Cape Town, South Africa.
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47
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OPRM1 and diagnosis-related posttraumatic stress disorder in binge-drinking patients living with HIV. AIDS Behav 2012; 16:2171-80. [PMID: 22143634 DOI: 10.1007/s10461-011-0095-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Posttraumatic stress disorder (PTSD) has been linked to numerous negative outcomes in persons living with HIV (PLH) and there is evidence that PTSD symptoms may play a role in maintaining alcohol use problems. The opioid receptor mu-1 (OPRM1) gene may play a role in both PTSD and alcohol use. We examined the association between PTSD and drinking motives as well as variation in the OPRM1 as a predictor of both PTSD and drinking motives in a sample of 201 PLH reporting recent binge drinking. Self-reported PTSD symptom severity was significantly associated with drinking motives for coping, enhancement, and socialization. OPRM1 variation was associated with decreased PTSD symptom severity as well as enhancement motives for drinking.
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Pitman RK, Rasmusson AM, Koenen KC, Shin LM, Orr SP, Gilbertson MW, Milad MR, Liberzon I. Biological studies of post-traumatic stress disorder. Nat Rev Neurosci 2012; 13:769-87. [PMID: 23047775 PMCID: PMC4951157 DOI: 10.1038/nrn3339] [Citation(s) in RCA: 962] [Impact Index Per Article: 80.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Post-traumatic stress disorder (PTSD) is the only major mental disorder for which a cause is considered to be known: that is, an event that involves threat to the physical integrity of oneself or others and induces a response of intense fear, helplessness or horror. Although PTSD is still largely regarded as a psychological phenomenon, over the past three decades the growth of the biological PTSD literature has been explosive, and thousands of references now exist. Ultimately, the impact of an environmental event, such as a psychological trauma, must be understood at organic, cellular and molecular levels. This Review attempts to present the current state of this understanding on the basis of psychophysiological, structural and functional neuroimaging, and endocrinological, genetic and molecular biological studies in humans and in animal models.
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Affiliation(s)
- Roger K Pitman
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. roger_pitman@hms. harvard.edu
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Ramage AE, Laird AR, Eickhoff SB, Acheson A, Peterson AL, Williamson DE, Telch MJ, Fox PT. A coordinate-based meta-analytic model of trauma processing in posttraumatic stress disorder. Hum Brain Mapp 2012; 34:3392-9. [PMID: 22936519 DOI: 10.1002/hbm.22155] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 06/01/2012] [Accepted: 06/02/2012] [Indexed: 01/29/2023] Open
Abstract
Posttraumatic stress disorder (PTSD) has a well-defined set of symptoms that can be elicited during traumatic imagery tasks. For this reason, trauma imagery tasks are often employed in functional neuroimaging studies. Here, coordinate-based meta-analysis (CBM) was used to pool eight studies applying traumatic imagery tasks to identify sites of task-induced activation in 170 PTSD patients and 104 healthy controls. In this way, right anterior cingulate (ACC), right posterior cingulate (PCC), and left precuneus (Pcun) were identified as regions uniquely active in PTSD patients relative to healthy controls. To further characterize these regions, their normal interactions, and their typical functional roles, meta-analytic connectivity modeling (MACM) with behavioral filtering was applied. MACM indicated that the PCC and Pcun regions were frequently co-active and associated with processing of cognitive information, particularly in explicit memory tasks. Emotional processing was particularly associated with co-activity of the ACC and PCC, as mediated by the thalamus. By narrowing the regions of interest to those commonly active across multiple studies (using CBM) and developing a priori hypotheses about directed probabilistic dependencies amongst these regions, this proposed model-when applied in the context of graphical and causal modeling-should improve model fit and thereby increase statistical power for detecting differences between subject groups and between treatments in neuroimaging studies of PTSD.
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Affiliation(s)
- Amy E Ramage
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, Texas; Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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Tuominen L, Salo J, Hirvonen J, Någren K, Laine P, Melartin T, Isometsä E, Viikari J, Raitakari O, Keltikangas-Järvinen L, Hietala J. Temperament trait Harm Avoidance associates with μ-opioid receptor availability in frontal cortex: a PET study using [(11)C]carfentanil. Neuroimage 2012; 61:670-6. [PMID: 22484309 DOI: 10.1016/j.neuroimage.2012.03.063] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 03/12/2012] [Accepted: 03/20/2012] [Indexed: 10/28/2022] Open
Abstract
Harm Avoidance is a temperament trait that associates with sensitivity to aversive and non-rewarding stimuli, higher anticipated threat and negative emotions during stress as well as a higher risk for affective disorders. The neurobiological correlates of interindividual differences in Harm Avoidance are largely unknown. We hypothesized that variability in Harm Avoidance trait would be explained by differences in the activity of μ-opioid system as the opioid system is known to regulate affective states and stress sensitivity. Brain μ-opioid receptor availability was measured in 22 healthy subjects using positron emission tomography and [(11)C]carfentanil, a selective μ-opioid receptor agonist. The subjects were selected from a large Finish population-based cohort (N=2075) on the basis of their pre-existing Temperament and Character Scores. Subjects scoring consistently in the upper (10) and lower (12) quartiles for the Harm Avoidance trait were studied. High Harm Avoidance score associated with high μ-opioid receptor availability (i.e. lower endogenous μ-opioid drive) in anterior cingulate cortex, ventromedial and dorsolateral prefrontal cortices and anterior insular cortex. These associations were driven by two subscales of Harm Avoidance; Shyness with Strangers and Fatigability and Asthenia. In conclusion, higher Harm Avoidance score in healthy subjects is associated with higher μ-opioid availability in regions involved in the regulation of anxiety as well as in the control of emotions, affective component of pain and interoceptive awareness. The results have relevance in the research of vulnerability factors for affective disorders.
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