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Yarrington JS, Vinograd M, Williams AL, Wolitzky-Taylor KB, Zinbarg RE, Mineka S, Waters AM, Craske MG. Fear-potentiated startle predicts longitudinal change in transdiagnostic symptom dimensions of anxiety and depression. J Affect Disord 2022; 311:399-406. [PMID: 35597470 DOI: 10.1016/j.jad.2022.05.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 05/04/2022] [Accepted: 05/15/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Elevated defensive responding, through startle reflex (SR) and skin conductance response (SCR), may contribute to onset and maintenance of depression and anxiety. Most work examining SR and SCR has predicted psychiatric diagnoses. There is a paucity of research examining links between SR or SCR and dimensional measures of psychopathology. METHODS We used latent growth curve modeling to predict longitudinal change in three symptom factors (i.e., General Distress, Fears, Anhedonia-Apprehension) from SR and SCR measured during a fear-potentiated startle paradigm among adolescents oversampled for neuroticism (N = 129). RESULTS Elevated SCR in danger phases before and after an unpleasant muscle contraction predicted increasing Fears over time. Elevated SR in safe phases post-contraction also predicted increasing Fears over time. Attenuated SR in safe phases post-contraction predicted elevated General Distress longitudinally. Attenuated SCR pre-contraction in danger phases predicted elevated Anhedonia-Apprehension over time. LIMITATIONS Our non-clinical sample may limit generalizability of results. Additionally, we did not assess change in SR and SCR over time. CONCLUSIONS The present study demonstrates that SR and SCR during a fear-potentiated startle paradigm predict longitudinal change in dimensional anxiety and depression symptom factors and relatedly, that SR and SCR may represent risk factors for the exacerbation of symptomatology.
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Affiliation(s)
- Julia S Yarrington
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Meghan Vinograd
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | | | - Kate B Wolitzky-Taylor
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Richard E Zinbarg
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Susan Mineka
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Allison M Waters
- School of Applied Psychology, Griffith University, Queensland, Australia
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.
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Osuch E, Ursano R, Li H, Webster M, Hough C, Fullerton C, Leskin G. Brain Environment Interactions: Stress, Posttraumatic Stress Disorder, and the Need for a Postmortem Brain Collection. Psychiatry 2022; 85:113-145. [PMID: 35588486 DOI: 10.1080/00332747.2022.2068916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Stress, especially the extreme stress of traumatic events, can alter both neurobiology and behavior. Such extreme environmental situations provide a useful model for understanding environmental influences on human biology and behavior. This paper will review some of the evidence of brain alterations that occur with exposure to environmental stress. This will include recent studies using neuroimaging and will address the need for histological confirmation of imaging study results. We will review the current scientific approaches to understanding brain environment interactions, and then make the case for the collection and study of postmortem brain tissue for the advancement of our understanding of the effects of environment on the brain.Creating a brain tissue collection specifically for the investigation of the effects of extreme environmental stressors fills a gap in the current research; it will provide another of the important pieces to the puzzle that constitutes the scientific investigation of negative effects of environmental exposures. Such a resource will facilitate new discoveries related to the psychiatric illnesses of acute stress disorder and posttraumatic stress disorder, and can enable scientists to correlate structural and functional imaging findings with tissue abnormalities, which is essential to validate the results of recent imaging studies.
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Neria Y. Functional Neuroimaging in PTSD: From Discovery of Underlying Mechanisms to Addressing Diagnostic Heterogeneity. Am J Psychiatry 2021; 178:128-135. [PMID: 33517750 DOI: 10.1176/appi.ajp.2020.20121727] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yuval Neria
- Departments of Psychiatry and Epidemiology and New York State Psychiatric Institute, Columbia University Irving Medical Center, New York
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4
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Gurel NZ, Jiao Y, Wittbrodt MT, Ko YA, Hankus A, Driggers EG, Ladd SL, Shallenberger L, Murrah N, Huang M, Haffar A, Alkhalaf M, Levantsevych O, Nye JA, Vaccarino V, Shah AJ, Inan OT, Bremner JD, Pearce BD. Effect of transcutaneous cervical vagus nerve stimulation on the pituitary adenylate cyclase-activating polypeptide (PACAP) response to stress: A randomized, sham controlled, double blind pilot study. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2020; 4:100012. [PMID: 35755625 PMCID: PMC9216713 DOI: 10.1016/j.cpnec.2020.100012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/17/2020] [Accepted: 10/15/2020] [Indexed: 12/24/2022] Open
Abstract
Pituitary adenylate cyclase-activating peptide (PACAP) is a neuropeptide that plays a key role in the neurobiology of the stress response, and prior studies suggest that its function is dysregulated in post-traumatic stress disorder (PTSD). Transcutaneous cervical vagus nerve stimulation (tcVNS) acts through PACAP and other neurobiological systems to modulate stress responses and/or symptoms of PTSD. In this pilot study, we examined the effects of tcVNS on PACAP in a three day chronic stress laboratory paradigm involving serial traumatic and mental stress exposures in healthy individuals with a history of exposure to psychological trauma (n = 18) and patients with PTSD (n = 12). Methods A total of 30 subjects with a history of exposure to psychological trauma experience were recruited (12 with PTSD diagnosis) for a three-day randomized double-blinded study of tcVNS or sham stimulation. Subjects underwent a protocol that included both personalized trauma recall and non-personalized mental stressors (public speaking, mental arithmetic) paired to tcVNS or sham stimulation over three days. Blood was collected at baseline and multiple time points after exposure to stressors. Linear mixed-effects models were used to assess changes in PACAP over time (in response to stressors) and its relation to active tcVNS or sham stimulation. Results PACAP blood levels increased over the course of three days for both active tcVNS and sham groups. This increase was statistically-significant in the sham group at the end of the second (Cohen’s drm = 0.35, p = 0.04), and third days (drm = 0.41, p = 0.04), but not in the active tcVNS group (drm = 0.21, drm = 0.18, and p > 0.20). Conclusion These pilot findings suggest tcVNS may attenuate this neurobiological stress-response. Larger studies are needed to investigate gender and interaction effects. We examined the effects of tcVNS on PACAP in a three day chronic stress paradigm involving traumatic and mental stress. PACAP levels increased over the course of three days for both groups, the elevation of PACAP was larger in the sham group. These findings suggest that tcVNS may be a potential intervention for stress-related psychiatric disorders.
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Affiliation(s)
- Nil Z. Gurel
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Yunshen Jiao
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Matthew T. Wittbrodt
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, GA, USA
| | - Yi-An Ko
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Allison Hankus
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Emily G. Driggers
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, GA, USA
| | - Stacy L. Ladd
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, GA, USA
- Department of Radiology, Emory School of Medicine, Atlanta, GA, USA
| | - Lucy Shallenberger
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Nancy Murrah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Minxuan Huang
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ammer Haffar
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Mhmtjamil Alkhalaf
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Oleksiy Levantsevych
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jonathon A. Nye
- Department of Radiology, Emory School of Medicine, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Medicine, Division of Cardiology, Emory School of Medicine, Atlanta, GA, USA
| | - Amit J. Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Medicine, Division of Cardiology, Emory School of Medicine, Atlanta, GA, USA
- Atlanta VA Medical Center, Decatur, GA, USA
| | - Omer T. Inan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Coulter Department of Bioengineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - J. Douglas Bremner
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, GA, USA
- Department of Radiology, Emory School of Medicine, Atlanta, GA, USA
- Atlanta VA Medical Center, Decatur, GA, USA
| | - Bradley D. Pearce
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Corresponding author.
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Gowen CL, Khwaounjoo P, Cakmak YO. EMG-Free Monitorization of the Acoustic Startle Reflex with a Mobile Phone: Implications of Sound Parameters with Posture Related Responses. SENSORS 2020; 20:s20215996. [PMID: 33105890 PMCID: PMC7660167 DOI: 10.3390/s20215996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/14/2020] [Accepted: 10/14/2020] [Indexed: 11/16/2022]
Abstract
(1) Background: Acute acoustic (sound) stimulus prompts a state of defensive motivation in which unconscious muscle responses are markedly enhanced in humans. The orbicularis oculi (OO) of the eye is an easily accessed muscle common for acoustic startle reaction/response/reflex (ASR) investigations and is the muscle of interest in this study. Although the ASR can provide insights about numerous clinical conditions, existing methodologies (Electromyogram, EMG) limit the usability of the method in real clinical conditions. (2) Objective: With EMG-free muscle recording in mind, our primary aim was to identify and investigate potential correlations in the responses of individual and cooperative OO muscles to various acoustic stimuli using a mobile and wire-free system. Our secondary aim was to investigate potential altered responses to high and also relatively low intensity acoustics at different frequencies in both sitting and standing positions through the use of biaural sound induction and video diagnostic techniques and software. (3) Methods: This study used a mobile-phone acoustic startle response monitoring system application to collect blink amplitude and velocity data on healthy males, aged 18–28 community cohorts during (n = 30) in both sitting and standing postures. The iPhone X application delivers specific sound parameters and detects blinking responses to acoustic stimulus (in millisecond resolution) to study the responses of the blinking reflex to acoustic sounds in standing and sitting positions by using multiple acoustic test sets of different frequencies and amplitudes introduced as acute sound stimuli (<0.5 s). The single acoustic battery of 15 pure-square wave sounds consisted of frequencies and amplitudes between 500, 1000, 2000, 3000, and 4000 Hz scales using 65, 90, and 105 dB (e.g., 3000 Hz_90 dB). (4) Results: Results show that there was a synchronization of amplitude and velocity between both eyes to all acoustic startles. Significant differences (p = 0.01) in blinking reaction time between sitting vs. standing at the high intensity (105 dB) 500 Hz acoustic test set was discovered. Interestingly, a highly significant difference (p < 0.001) in response times between test sets 500 Hz_105 dB and 4000 Hz_105 dB was identified. (5) Conclusions: To our knowledge, this is the first mobile phone-based acoustic battery used to detect and report significant ASR responses to specific frequencies and amplitudes of sound stimulus with corresponding sitting and standing conditions. The results from this experiment indicate the potential significance of using the specific frequency, amplitude, and postural conditions (as never before identified) which can open new horizons for ASR to be used for diagnosis and monitoring in numerous clinical and remote or isolated conditions.
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Affiliation(s)
- Christopher L. Gowen
- Department of Anatomy, School of Biomedical Sciences, University Of Otago, Po Box 56, Dunedin 9054, New Zealand; (C.L.G.); (P.K.)
| | - Prashanna Khwaounjoo
- Department of Anatomy, School of Biomedical Sciences, University Of Otago, Po Box 56, Dunedin 9054, New Zealand; (C.L.G.); (P.K.)
- Medtech Core, Auckland 1010, New Zealand
| | - Yusuf O. Cakmak
- Department of Anatomy, School of Biomedical Sciences, University Of Otago, Po Box 56, Dunedin 9054, New Zealand; (C.L.G.); (P.K.)
- Medtech Core, Auckland 1010, New Zealand
- Brain Health Research Centre, Dunedin 9054, New Zealand
- Centre for Health Systems and Technology, Dunedin 9054, New Zealand
- Correspondence: ; Tel.: +64-03-479-4030
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Bremner JD, Gurel NZ, Wittbrodt MT, Shandhi MH, Rapaport MH, Nye JA, Pearce BD, Vaccarino V, Shah AJ, Park J, Bikson M, Inan OT. Application of Noninvasive Vagal Nerve Stimulation to Stress-Related Psychiatric Disorders. J Pers Med 2020; 10:E119. [PMID: 32916852 PMCID: PMC7563188 DOI: 10.3390/jpm10030119] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Vagal Nerve Stimulation (VNS) has been shown to be efficacious for the treatment of depression, but to date, VNS devices have required surgical implantation, which has limited widespread implementation. METHODS New noninvasive VNS (nVNS) devices have been developed which allow external stimulation of the vagus nerve, and their effects on physiology in patients with stress-related psychiatric disorders can be measured with brain imaging, blood biomarkers, and wearable sensing devices. Advantages in terms of cost and convenience may lead to more widespread implementation in psychiatry, as well as facilitate research of the physiology of the vagus nerve in humans. nVNS has effects on autonomic tone, cardiovascular function, inflammatory responses, and central brain areas involved in modulation of emotion, all of which make it particularly applicable to patients with stress-related psychiatric disorders, including posttraumatic stress disorder (PTSD) and depression, since dysregulation of these circuits and systems underlies the symptomatology of these disorders. RESULTS This paper reviewed the physiology of the vagus nerve and its relevance to modulating the stress response in the context of application of nVNS to stress-related psychiatric disorders. CONCLUSIONS nVNS has a favorable effect on stress physiology that is measurable using brain imaging, blood biomarkers of inflammation, and wearable sensing devices, and shows promise in the prevention and treatment of stress-related psychiatric disorders.
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Affiliation(s)
- James Douglas Bremner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA; (M.T.W.); (M.H.R.)
- Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322, USA;
- Atlanta VA Medical Center, Decatur, GA 30033, USA; (A.J.S.); (J.P.)
| | - Nil Z. Gurel
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA; (N.Z.G.); (M.H.S.); (O.T.I.)
| | - Matthew T. Wittbrodt
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA; (M.T.W.); (M.H.R.)
| | - Mobashir H. Shandhi
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA; (N.Z.G.); (M.H.S.); (O.T.I.)
| | - Mark H. Rapaport
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA; (M.T.W.); (M.H.R.)
| | - Jonathon A. Nye
- Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322, USA;
| | - Bradley D. Pearce
- Department of Epidemiology, Rollins School of Public Health, Atlanta, GA 30322, USA; (B.D.P.); (V.V.)
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Atlanta, GA 30322, USA; (B.D.P.); (V.V.)
- Department of Medicine, Cardiology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Amit J. Shah
- Atlanta VA Medical Center, Decatur, GA 30033, USA; (A.J.S.); (J.P.)
- Department of Epidemiology, Rollins School of Public Health, Atlanta, GA 30322, USA; (B.D.P.); (V.V.)
- Department of Medicine, Cardiology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Jeanie Park
- Atlanta VA Medical Center, Decatur, GA 30033, USA; (A.J.S.); (J.P.)
- Department of Medicine, Renal Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Marom Bikson
- Department of Biomedical Engineering, City University of New York, New York, NY 10010, USA;
| | - Omer T. Inan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA; (N.Z.G.); (M.H.S.); (O.T.I.)
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
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7
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Radoman M, Akinbo FD, Rospenda KM, Gorka SM. The impact of startle reactivity to unpredictable threat on the relation between bullying victimization and internalizing psychopathology. J Psychiatr Res 2019; 119:7-13. [PMID: 31520836 PMCID: PMC6876702 DOI: 10.1016/j.jpsychires.2019.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/07/2019] [Accepted: 09/05/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Being bullied has detrimental effects on mental health functioning. Individuals who are highly reactive to unpredictable threats (U-threat) may be particularly vulnerable to the negative consequences of being bullied. For them, persistent, unpredictable bullying likely elicits chronic anticipatory anxiety and depression. The aim of the present study was to examine the main and interactive effects of aversive reactivity to U-threat and past-year bullying victimization on current anxiety and depressive symptoms. METHODS Seventy-one young adults (ages 17-19) completed a well-validated threat-of-shock task used to probe reactivity to both U-threat and predictable threat (P-threat). Startle eyeblink potentiation was recorded to index aversive responding. RESULTS We found a main effect of bullying, such that individuals with more bullying experience exhibited greater anxiety and depressive symptoms than individuals with less bullying experience. There was also a bullying by U-threat reactivity interaction such that among individuals with high reactivity to U-threat, more bullying experience was associated with more anxiety and depressive symptoms. Among individuals with low U-threat reactivity, there was no association between bullying and internalizing symptoms. There were no main or interactive effects involving reactivity to P-threat. CONCLUSIONS Together, these results suggest that among individuals who are bullied, those who are sensitive to U-threat are particularly vulnerable to depression and anxiety in young adulthood. These individuals may represent a high-risk group for the development of internalizing psychopathology.
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Affiliation(s)
- Milena Radoman
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL,Department of Anatomy and Cell Biology, and the Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, IL
| | - Fikayo D. Akinbo
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL
| | | | - Stephanie M. Gorka
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL,Department of Psychology, University of Illinois at Chicago, Chicago, IL
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8
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Meteran H, Vindbjerg E, Uldall SW, Glenthøj B, Carlsson J, Oranje B. Startle habituation, sensory, and sensorimotor gating in trauma-affected refugees with posttraumatic stress disorder. Psychol Med 2019; 49:581-589. [PMID: 29769152 DOI: 10.1017/s003329171800123x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Impairments in mechanisms underlying early information processing have been reported in posttraumatic stress disorder (PTSD); however, findings in the existing literature are inconsistent. This current study capitalizes on technological advancements of research on electroencephalographic event-related potential and applies it to a novel PTSD population consisting of trauma-affected refugees. METHODS A total of 25 trauma-affected refugees with PTSD and 20 healthy refugee controls matched on age, gender, and country of origin completed the study. In two distinct auditory paradigms sensory gating, indexed as P50 suppression, and sensorimotor gating, indexed as prepulse inhibition (PPI), startle reactivity, and habituation of the eye-blink startle response were examined. Within the P50 paradigm, N100 and P200 amplitudes were also assessed. In addition, correlations between psychophysiological and clinical measures were investigated. RESULTS PTSD patients demonstrated significantly elevated stimuli responses across the two paradigms, reflected in both increased amplitude of the eye-blink startle response, and increased N100 and P200 amplitudes relative to healthy refugee controls. We found a trend toward reduced habituation in the patients, while the groups did not differ in PPI and P50 suppression. Among correlations, we found that eye-blink startle responses were associated with higher overall illness severity and lower levels of functioning. CONCLUSIONS Fundamental gating mechanisms appeared intact, while the pattern of deficits in trauma-affected refugees with PTSD point toward a different form of sensory overload, an overall neural hypersensitivity and disrupted the ability to down-regulate stimuli responses. This study represents an initial step toward elucidating sensory processing deficits in a PTSD subgroup.
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Affiliation(s)
- Hanieh Meteran
- Competence Centre for Transcultural Psychiatry,Mental Health Services Ballerup,Copenhagen,Denmark
| | - Erik Vindbjerg
- Competence Centre for Transcultural Psychiatry,Mental Health Services Ballerup,Copenhagen,Denmark
| | - Sigurd Wiingaard Uldall
- Competence Centre for Transcultural Psychiatry,Mental Health Services Ballerup,Copenhagen,Denmark
| | - Birte Glenthøj
- Centre for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services Glostrup, University of Copenhagen,Copenhagen,Denmark
| | - Jessica Carlsson
- Competence Centre for Transcultural Psychiatry,Mental Health Services Ballerup,Copenhagen,Denmark
| | - Bob Oranje
- Centre for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services Glostrup, University of Copenhagen,Copenhagen,Denmark
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9
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Hengesch X, Larra MF, Finke JB, Blumenthal TD, Schächinger H. Enhanced startle reflexivity during presentation of visual nurture cues in young adults who experienced parental divorce in early childhood. Int J Psychophysiol 2017; 120:78-85. [PMID: 28712816 DOI: 10.1016/j.ijpsycho.2017.07.004] [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: 02/06/2017] [Revised: 06/27/2017] [Accepted: 07/08/2017] [Indexed: 10/19/2022]
Abstract
Adverse childhood experiences (ACE) may influence stress and affective processing in adulthood. Animal and human studies show enhanced startle reflexivity in adult participants with ACE. This study examined the impact of one of the most common ACE, parental divorce, on startle reflexivity in adulthood. Affective modulation of acoustically-elicited startle eye blink was assessed in a group of 23 young adults with self-reported history of parental divorce, compared to an age- and sex-matched control group (n=18). Foreground pictures were either aversive (e.g. mutilation and injury), standard appetitive (e.g. erotic, recreational sport), or nurture pictures (e.g. related to early life, parental care), intermixed with neutral pictures (e.g. household objects), and organized in three valence blocks delivered in a balanced, pseudo-randomized sequence. During picture viewing startle eye blinks were elicited by binaural white noise bursts (50ms, 105 dB) via headphones and recorded at the left orbicularis oculi muscle via EMG. A significant interaction of group×picture valence (p=0.01) was observed. Contrast with controls revealed blunted startle responsiveness of the ACE group during presentation of aversive pictures, but enhanced startle during presentation of nurture-related pictures. No group differences were found during presentation of standard appetitive pictures. ACE participants rated nurture pictures as more arousing (p=0.02) than did control participants. Results suggest that divorce in childhood led to altered affective context information processing in early adulthood. When exposed to unpleasant (vs. neutral) pictures participants with ACE showed less startle potentiation than controls. Nurture context, however, potentiated startle in ACE participants, suggesting visual cuing to activate protective behavioral responses.
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Affiliation(s)
- Xenia Hengesch
- University of Trier, Institute of Psychobiology, Department of Clinical Psychophysiology, Johanniterufer 15, 54290, Germany.
| | - Mauro F Larra
- University of Trier, Institute of Psychobiology, Department of Clinical Psychophysiology, Johanniterufer 15, 54290, Germany
| | - Johannes B Finke
- University of Trier, Institute of Psychobiology, Department of Clinical Psychophysiology, Johanniterufer 15, 54290, Germany
| | - Terry D Blumenthal
- Department of Psychology, Wake Forest University, Winston-Salem, NC 27109, USA
| | - Hartmut Schächinger
- University of Trier, Institute of Psychobiology, Department of Clinical Psychophysiology, Johanniterufer 15, 54290, Germany.
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Echiverri-Cohen AM, Zoellner LA, Ho W, Husain J. An analysis of inhibitory functioning in individuals with chronic posttraumatic stress disorder. J Anxiety Disord 2016; 37:94-103. [PMID: 26745516 PMCID: PMC4724420 DOI: 10.1016/j.janxdis.2015.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 11/29/2015] [Accepted: 12/03/2015] [Indexed: 02/06/2023]
Abstract
Cognitive abnormalities in posttraumatic stress disorder (PTSD) may be a function of underlying inhibitory deficits. Prepulse inhibition (PPI) and attentional blink (AB) are paradigms thought to assess inhibition. Using a sample of 28 individuals with PTSD compared to 20 trauma-exposed and 19 healthy individuals, PPI was examined using white noise that was preceded by a tone, and AB was examined using a presentation of letters in a stream of numbers. Relative to the control group, the PTSD and trauma-exposed groups did not follow the u-shaped pattern in AB, suggesting trauma-exposure and subsequent PTSD are associated with similar impairment in attention. Individuals with PTSD showed reduced PPI compared to trauma-exposed and healthy individuals, suggesting individuals with PTSD exhibit faulty automatic processing. For individuals with PTSD, PTSD severity was associated with a decline in PPI. These findings suggest a general faulty inhibitory mechanism associated with trauma exposure and PTSD.
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Affiliation(s)
- Aileen M. Echiverri-Cohen
- Department of Psychology, University of Washington, Seattle, Washington, USA,Correspondence concerning this article should be addressed to Aileen M. Echiverri-Cohen Harbor-UCLA Medical Center 1000 W. Carson St. Torrance, CA 90502. Phone: (310) 222-1633,
| | - Lori A. Zoellner
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - William Ho
- Department of Psychology, University of Washington, Seattle, Washington, USA.
| | - Jawad Husain
- Department of Psychology, University of Washington, Seattle, Washington, USA.
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11
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Acheson DT, Geyer MA, Risbrough VB. Psychophysiology in the study of psychological trauma: where are we now and where do we need to be? Curr Top Behav Neurosci 2014; 21:157-183. [PMID: 25158622 DOI: 10.1007/7854_2014_346] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a major public health concern, which has been seeing increased recent attention partly due to the wars in Iraq and Afghanistan. Historically, research attempting to understand the etiology and treatment of PTSD has made frequent use of psychophysiological measures of arousal as they provide a number of advantages in providing objective, non-self-report outcomes that are closely related to proposed neurobiological mechanisms and provide opportunity for cross-species translation. Further, the ongoing shift in classification of psychiatric illness based on symptom clusters to specific biological, physiological, and behavioral constructs, as outlined in the US National Institute of Mental Health (NIMH) Research Domain Criteria project (RDoC), promises that psychophysiological research will continue to play a prominent role in research on trauma-related illnesses. This review focuses on the current state of the knowledge regarding psychophysiological measures and PTSD with a focus on physiological markers associated with current PTSD symptoms, as well as markers of constructs thought to be relevant to PTSD symptomatology (safety signal learning, fear extinction), and psychophysiological markers of risk for developing PTSD following trauma. Future directions and issues for the psychophysiological study of trauma including traumatic brain injury (TBI), treatment outcome studies, and new wearable physiological monitoring technologies are also discussed.
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Affiliation(s)
- D T Acheson
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr. Mail Code 0804, La Jolla, CA, 92093-0804, USA
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12
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Schumacher S, Schnyder U, Furrer M, Mueller-Pfeiffer C, Wilhelm FH, Moergeli H, Oe M, Martin-Soelch C. Startle reactivity in the long-term after severe accidental injury: preliminary data. Psychiatry Res 2013; 210:570-4. [PMID: 23870491 DOI: 10.1016/j.psychres.2013.06.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 06/20/2013] [Accepted: 06/23/2013] [Indexed: 10/26/2022]
Abstract
An exaggerated startle response is one of the core hyperarousal symptoms of posttraumatic stress disorder (PTSD). Heightened startle eye-blink magnitude and reduced habituation of this response in PTSD patients have been reported in several studies. However, it is unclear whether this is an enduring characteristic of individuals vulnerable for PTSD or to which degree trauma-exposed individuals who do not develop PTSD also show exaggerated startle. Thirteen accident survivors with remitted PTSD, 12 trauma controls, and 16 non-trauma controls were examined. Four measures of startle reactivity were analyzed in response to 15 bursts of white noise (95 dB, 50 ms): eye-blink magnitude, eye-blink onset latency, skin conductance response, and heart rate response. The eye-blink reflex was measured over the left musculus orbicularis oculi. Reactivity and habituation were analyzed using linear mixed models. Remitted PTSD subjects did not differ from non-trauma controls regarding any of the startle reactivity or habituation measures. Unexpectedly, trauma controls showed larger eye-blink magnitude than non-trauma controls. These results suggest that the exaggerated startle response disappears after remission from PTSD. Further, they suggest that psychologically resilient trauma survivors might show a PTSD-like pattern of exaggerated physiological startle even many years after a traumatic event.
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Affiliation(s)
- Sonja Schumacher
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Switzerland.
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13
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Zoladz PR, Diamond DM. Current status on behavioral and biological markers of PTSD: a search for clarity in a conflicting literature. Neurosci Biobehav Rev 2013; 37:860-95. [PMID: 23567521 DOI: 10.1016/j.neubiorev.2013.03.024] [Citation(s) in RCA: 188] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 03/23/2013] [Accepted: 03/27/2013] [Indexed: 12/24/2022]
Abstract
Extensive research has identified stereotypic behavioral and biological abnormalities in post-traumatic stress disorder (PTSD), such as heightened autonomic activity, an exaggerated startle response, reduced basal cortisol levels and cognitive impairments. We have reviewed primary research in this area, noting that factors involved in the susceptibility and expression of PTSD symptoms are more complex and heterogeneous than is commonly stated, with extensive findings which are inconsistent with the stereotypic behavioral and biological profile of the PTSD patient. A thorough assessment of the literature indicates that interactions among myriad susceptibility factors, including social support, early life stress, sex, age, peri- and post-traumatic dissociation, cognitive appraisal of trauma, neuroendocrine abnormalities and gene polymorphisms, in conjunction with the inconsistent expression of the disorder across studies, confounds attempts to characterize PTSD as a monolithic disorder. Overall, our assessment of the literature addresses the great challenge in developing a behavioral and biomarker-based diagnosis of PTSD.
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Affiliation(s)
- Phillip R Zoladz
- Department of Psychology, Sociology, & Criminal Justice, Ohio Northern University, 525 S. Main St., Ada, OH, 45810, USA
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Effects of personality trait emotionality on acoustic startle response and prepulse inhibition including N100 and P200 event-related potential. Clin Neurophysiol 2013; 124:292-305. [DOI: 10.1016/j.clinph.2012.07.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Revised: 07/28/2012] [Accepted: 07/31/2012] [Indexed: 11/18/2022]
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Fani N, Tone EB, Phifer J, Norrholm SD, Bradley B, Ressler KJ, Kamkwalala A, Jovanovic T. Attention bias toward threat is associated with exaggerated fear expression and impaired extinction in PTSD. Psychol Med 2012; 42:533-543. [PMID: 21854700 PMCID: PMC3690118 DOI: 10.1017/s0033291711001565] [Citation(s) in RCA: 166] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) develops in a minority of traumatized individuals. Attention biases to threat and abnormalities in fear learning and extinction are processes likely to play a critical role in the creation and/or maintenance of PTSD symptomatology. However, the relationship between these processes has not been established, particularly in highly traumatized populations; understanding their interaction can help inform neural network models and treatments for PTSD. METHOD Attention biases were measured using a dot probe task modified for use with our population; task stimuli included photographs of angry facial expressions, which are emotionally salient threat signals. A fear-potentiated startle paradigm was employed to measure atypical physiological response during acquisition and extinction phases of fear learning. These measures were administered to a sample of 64 minority (largely African American), highly traumatized individuals with and without PTSD. RESULTS Participants with PTSD demonstrated attention biases toward threat; this attentional style was associated with exaggerated startle response during fear learning and early and middle phases of extinction, even after accounting for the effects of trauma exposure. CONCLUSIONS Our findings indicate that an attentional bias toward threat is associated with abnormalities in 'fear load' in PTSD, providing seminal evidence for an interaction between these two processes. Future research combining these behavioral and psychophysiological techniques with neuroimaging will be useful toward addressing how one process may modulate the other and understanding whether these phenomena are manifestations of dysfunction within a shared neural network. Ultimately, this may serve to inform PTSD treatments specifically designed to correct these atypical processes.
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Affiliation(s)
- N Fani
- Department of Psychology, Georgia State University, Atlanta, GA, USA.
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16
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Griffin MG, Resick PA, Galovski TE. Does physiologic response to loud tones change following cognitive-behavioral treatment for posttraumatic stress disorder? J Trauma Stress 2012; 25:25-32. [PMID: 22354505 PMCID: PMC3336195 DOI: 10.1002/jts.21667] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This study examined responses to loud tones before and after cognitive-behavioral treatment for posttraumatic stress disorder (PTSD). Seventy-four women in a PTSD treatment outcome study for rape-related (n = 54) or physical assault-related PTSD (n = 20) were assessed in an auditory loud tone paradigm. Assessments were conducted before and after a 6-week period of cognitive-behavioral therapy. Physiologic responses to loud tones included heart rate (HR), skin conductance (SC), and eye-blink electromyogram (EMG). Groups were formed based upon treatment outcome and included a treatment responder group (no PTSD at posttreatment) and a nonresponder group (PTSD-positive at posttreatment). Treatment was successful for 53 of 74 women (72%) and unsuccessful for 21 women (28%). Responders and nonresponders were not significantly different from each other at pretreatment on the main outcome variables. Treatment responders showed a significant reduction in loud tone-related EMG, HR, and SC responses from pre- to posttreatment (partial η(2) = .24, .31, and .36, respectively; all p < .001) and the EMG and HR responses were significantly smaller than nonresponders at posttreatment (partial η(2) = .11, p = .004 and .19, p < .001, respectively). Successful cognitive-behavioral treatment of PTSD is associated with a quantifiable reduction in physiological responding to loud tones.
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Affiliation(s)
- Michael G. Griffin
- Department of Psychology and Center for Trauma Recovery, University of Missouri-St. Louis, St. Louis, Missouri, USA
| | - Patricia A. Resick
- National Center for PTSD VA Boston Healthcare System and Boston University, Boston, Massachusetts, USA
| | - Tara E. Galovski
- Department of Psychology and Center for Trauma Recovery, University of Missouri-St. Louis, St. Louis, Missouri, USA
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Cannabinoid receptor expression and phosphorylation are differentially regulated between male and female cerebellum and brain stem after repeated stress: Implication for PTSD and drug abuse. Neurosci Lett 2011; 502:5-9. [DOI: 10.1016/j.neulet.2011.05.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Revised: 04/22/2011] [Accepted: 05/04/2011] [Indexed: 12/13/2022]
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Abstract
Developmental adaptations to violent environments involve a multitude of cascading effects spanning many levels of analysis from genes to behavior. In this review, we (a) examine the potentiating effects of violence on genetic vulnerabilities and the functioning of neurotransmitter systems in producing both internalizing and externalizing psychopathology; (b) describe implications of violence exposure for brain development, particularly within the hippocampus and prefrontal cortex; and (c) consider the effects of violence on developing human stress and startle responses. This review integrates literatures on the developmental effects of violence among rodents, nonhuman primates, and humans. Many neurobiological changes that are adaptive for survival in violent contexts become maladaptive in other environments, conferring life-long risk for psychopathology.
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Affiliation(s)
- Hilary K Mead
- University of Washington, Seattle, WA 98195-1525, USA
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Pulliam JV, Dawaghreh AM, Alema-Mensah E, Plotsky PM. Social defeat stress produces prolonged alterations in acoustic startle and body weight gain in male Long Evans rats. J Psychiatr Res 2010; 44:106-11. [PMID: 19573876 PMCID: PMC2813344 DOI: 10.1016/j.jpsychires.2009.05.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2008] [Revised: 05/02/2009] [Accepted: 05/22/2009] [Indexed: 10/20/2022]
Abstract
Individuals exposed to psychological stressors may experience a long-term resetting of behavioral and neuroendocrine aspects of their "stress response" so that they either hyper or hypo-respond to subsequent stressors. These effects of psychological or traumatic stressors may be mimicked in rats using the resident-intruder model of social defeat. The social defeat model has been characterized to model aspects of the physiology and behavior associated with anxiety and depression. The objective of this study was to determine if behaviors elicited following repeated social defeat can also reflect aspects of ethologically relevant stresses associated with existing post traumatic stress disorder (PTSD) models. Socially defeated rats displayed weight loss and an enhanced and prolonged response to acoustic startle which was displayed for up to 10days following repeated social defeat. These data indicate that the severe stress of social defeat can produce physiologic and behavioral outcomes which may reflect aspects of traumatic psychosocial stress.
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Affiliation(s)
- John V.K. Pulliam
- Morehouse School of Medicine, Neuroscience Institute, 720 Westview Drive, SW, Atlanta, GA 30310
| | - Ahmad M. Dawaghreh
- Morehouse School of Medicine, Clinical Research Center, 720 Westview Drive, SW, Atlanta, GA 30310
| | - Ernest Alema-Mensah
- Morehouse School of Medicine, Clinical Research Center, 720 Westview Drive, SW, Atlanta, GA 30310
| | - Paul M. Plotsky
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stress Neurobiology Laboratory, 101 Woodruff Circle, WMB Suite 4000, Atlanta, GA 30322, Office: (404) 727-8258, Fax: (404) 727-3233
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20
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Bijlsma EY, Oosting RS, Olivier B, Groenink L. Disrupted startle modulation in animal models for affective disorders. Behav Brain Res 2009; 208:383-90. [PMID: 20006647 DOI: 10.1016/j.bbr.2009.12.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Accepted: 12/07/2009] [Indexed: 10/20/2022]
Abstract
Affective startle modulation is used to study emotional reactivity in humans, and blunted affective startle modulation has been reported in depressed patients. To determine whether blunted affective startle modulation is also a common feature in animal models for affective disorders, light-enhanced startle was studied in three models: inescapable foot shock (IFS), repeated restraint stress (RRS) and olfactory bulbectomy (OBX). In addition, prepulse inhibition was studied in these models. Light-enhanced startle was blunted following IFS and OBX and RRS decreased overall startle responding. Prepulse inhibition, however, was unaffected. These findings indicate that induction models for affective disorders may be associated with long term effects on affective startle modulation. The lack of changes in sensory motor gating suggests that these changes can be ascribed to alterations in emotional reactivity. In conclusion, our results indicate that the blunted affective startle modulation seen in animal models for affective disorders may be used to examine the mechanisms underlying altered emotional reactivity.
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Affiliation(s)
- E Y Bijlsma
- Department of Psychopharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
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21
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Martinez-Gras I, Rubio G, del Manzano BA, Rodriguez-Jimenez R, Garcia-Sanchez F, Bagney A, Leza JC, Borrell J. The relationship between prepulse inhibition and general psychopathology in patients with schizophrenia treated with long-acting risperidone. Schizophr Res 2009; 115:215-21. [PMID: 19846280 DOI: 10.1016/j.schres.2009.09.035] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Revised: 09/12/2009] [Accepted: 09/27/2009] [Indexed: 11/17/2022]
Abstract
Patients with schizophrenia exhibit impairments in prepulse inhibition (PPI) of the startle response. Available data suggest that atypical antipsychotics may be more effective than typical antipsychotics in improving PPI deficits in schizophrenia. However, previous studies have used between-subjects rather than longitudinal within-subjects designs to demonstrate superiority of particular atypical antipsychotics over typical antipsychotics in improving PPI in patients with schizophrenia. This longitudinal within-subjects test-retest study was designed to evaluate changes in PPI and clinical symptoms in patients with schizophrenia after switching from the conventional antipsychotic zuclopenthixol to long-acting injectable risperidone. PPI was measured in 45 chronic male patients with schizophrenia treated with zuclophentixol depot (session T1), and 12 weeks after switching to long-acting injectable risperidone (session T2). Thirty-six healthy control subjects were also evaluated. Patients with schizophrenia showed a significant improvement in PPI after changing to long-acting risperidone. Improvement of PPI deficits between T1 and T2 assessments correlated significantly with improvements in PANSS general psychopathology subscale scores. Our findings indicate that long-acting risperidone improves PPI deficits in subjects with chronic schizophrenia. These results also suggest that the PPI-restoring effect of risperidone may be related to improvement in symptoms other than positive and negative symptoms.
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22
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Vaidyanathan U, Patrick CJ, Cuthbert BN. Linking dimensional models of internalizing psychopathology to neurobiological systems: affect-modulated startle as an indicator of fear and distress disorders and affiliated traits. Psychol Bull 2009; 135:909-42. [PMID: 19883142 PMCID: PMC2776729 DOI: 10.1037/a0017222] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Integrative hierarchical models have sought to account for the extensive comorbidity between various internalizing disorders in terms of broad individual difference factors these disorders share. However, such models have been developed largely on the basis of self-report and diagnostic symptom data. Toward the goal of linking such models to neurobiological systems, we reviewed studies that have employed variants of the affect-modulated startle paradigm to investigate emotional processing in internalizing disorders as well as personality constructs known to be associated with these disorders. Specifically, we focused on four parameters of startle reactivity: fear-potentiated startle, inhibition of startle in the context of pleasant stimuli, context-potentiated startle, and general startle reactivity. On the basis of available data, we argue that these varying effects index differing neurobiological processes related to mood and anxiety disorders that are interpretable from the standpoint of dimensional models of the internalizing spectrum. Further, we contend that these empirical findings can feed back into and help reshape conceptualizations of internalizing disorders in ways that make them more amenable to neurobiological analysis.
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Affiliation(s)
- Uma Vaidyanathan
- Department of Psychology, University of Minnesota, Elliott Hall, 75 East River Road, Minneapolis, MN 55455, USA.
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23
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Anxiety and prepulse inhibition of acoustic startle in a normative sample: The importance of signal-to-noise ratio. PERSONALITY AND INDIVIDUAL DIFFERENCES 2009. [DOI: 10.1016/j.paid.2008.11.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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24
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Griffin MG. A prospective assessment of auditory startle alterations in rape and physical assault survivors. J Trauma Stress 2008; 21:91-9. [PMID: 18302176 DOI: 10.1002/jts.20300] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study used a prospective design to investigate startle reactivity following trauma exposure. Startle response was evaluated using loud tones during which measures of eyeblink electromyogram (EMG) and heart rate (HR) were collected. Participants were 40 female sexual or physical assault survivors assessed at 1 month and 6 months postassault. There were no significant differences in startle reactivity between posttraumatic stress disorder (PTSD) and non-PTSD groups at the initial assessment. However, at 6 months postassault there was a significantly greater EMG and HR response in the PTSD group as well as a significant increase in startle reactivity from 1 month to 6 months postassault. The findings lend support to a sensitization model of trauma reactivity in which startle response develops over time along with PTSD symptoms.
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Affiliation(s)
- Michael G Griffin
- Department of Psychology & Center for Trauma Recovery, University of Missouri-St. Louis, St. Louis, MO 63121, USA.
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25
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Carson MA, Metzger LJ, Lasko NB, Paulus LA, Morse AE, Pitman RK, Orr SP. Physiologic reactivity to startling tones in female Vietnam nurse veterans with PTSD. J Trauma Stress 2007; 20:657-66. [PMID: 17955532 DOI: 10.1002/jts.20218] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Posttraumatic stress disorder (PTSD) is associated with larger heart rate (HR), skin conductance (SC), and eyeblink responses to sudden, loud tones. The present study tested this association in female nurse veterans with PTSD related to witnessing patients' death, severe injury and/or suffering during their Vietnam service. Nurses with current, past but not current, or who never had PTSD listened to 15 consecutive 95-dB, 500-ms, 1000-Hz tones with sudden onsets, while HR, SC, and eyeblink responses were measured. Nurses with current PTSD produced significantly larger averaged HR, but not SC or eyeblink responses across tone trials. A larger HR response to loud tones is one of the most robust physiologic findings in PTSD and may reflect increased defensive responding.
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Affiliation(s)
- Margaret A Carson
- Department of Nursing, Saint Anselm College, Manchester, NH 03102-1310, USA.
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26
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Geerse GJ, van Gurp LCA, Wiegant VM, Stam R. Individual reactivity to the open-field predicts the expression of cardiovascular and behavioural sensitisation to novel stress. Behav Brain Res 2006; 175:9-17. [PMID: 16926056 DOI: 10.1016/j.bbr.2006.07.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2006] [Revised: 07/10/2006] [Accepted: 07/11/2006] [Indexed: 11/18/2022]
Abstract
Posttraumatic stress disorder (PTSD) is the fourth most common psychiatric disorder. It is associated with cardiovascular disorders and irritable bowel syndrome (IBS). Besides stressful life-events, a prior history of gastrointestinal infection is a predisposing factor for the development of IBS. Only a proportion of persons exposed to traumatic events develop PTSD. Several factors, like genetic predisposition, stressor intensity, cognitive appraisal mechanisms and coping processes influence the likelihood of developing PTSD after exposure to a trauma. We used a single session of footshocks in rats, an animal model with a high degree of validity for PTSD, to study whether transient colonic inflammation alters local and distal visceral sensitivity, and whether reactivity to the open-field (low (LA) or high (HA) active) predicts long-term stress-induced behavioural and cardiovascular sensitisation and altered visceral pain sensitivity. A distention series and noise challenge were given 2 weeks after foot-shocks, followed by a transient colonic inflammation period and a second distention series and noise challenge 4 weeks after foot-shocks. During exposure to noise, both before and after inflammation, footshocked rats showed increased immobility compared to controls, which was significantly greater in LA rats than in HA rats. LA preshocked rats also showed a greater blood pressure response to the noise test, but this only became evident in the second noise-test. Neither footshocks nor colonic inflammation affected duodenal pain sensitivity. The results provide additional evidence for long-lasting cardiovascular hyperresponsivity after a stressful event and indicate that its degree is predicted by personality traits or coping style.
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Affiliation(s)
- Gert-Jan Geerse
- Department of Pharmacology and Anatomy, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands
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Mineur YS, Belzung C, Crusio WE. Effects of unpredictable chronic mild stress on anxiety and depression-like behavior in mice. Behav Brain Res 2006; 175:43-50. [PMID: 17023061 DOI: 10.1016/j.bbr.2006.07.029] [Citation(s) in RCA: 322] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2006] [Revised: 07/27/2006] [Accepted: 07/31/2006] [Indexed: 10/24/2022]
Abstract
The widely accepted stress-diathesis hypothesis of depression postulates that genetic factors contribute to biological vulnerability. Based on this concept, the unpredictable chronic mild stress (UCMS) animal model was developed. Most effects of UCMS can be reversed by antidepressant agents, illustrating a strong predictive validity. In rodents, UCMS also has good face validity as it can elicit depression-like symptoms. While abundant for rats, the UCMS literature on mice is relatively limited. Reports sometimes are contradictory, making it difficult to establish a clear profile of stress-induced depression-like behaviors in mice. As different groups often use different strains for their experiments, differential strain susceptibility to UCMS may provide at least a partial explanation of these discrepancies. Moreover, differences in testing methodology add another level of complexity. Very little is known about the role of genetic factors and their interactions with the environment in the development of stress-induced behavioral changes relevant to depression, though recent studies unequivocally demonstrated the effects of specific gene polymorphisms on stress-induced depressive symptoms, as well as the effects of stress on gene expression. In the present study, we investigated the effects of UCMS on a battery of different tests measuring anxiety and depression-like behaviors in three behaviorally and genetically distinct inbred strains. The goals of these experiments are to obtain a clearer behavioral profile of genetically/phenotypically distant mouse strains after UCMS treatment and to evaluate the limitations and strengths of the UCMS model in mice.
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Affiliation(s)
- Yann S Mineur
- Brudnick Neuropsychiatric Research Institute, University of Massachusetts Medical School, 303 Belmont Street, Worcester, MA 01604, USA.
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28
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Bernier R, Dawson G, Panagiotides H, Webb S. Individuals with autism spectrum disorder show normal responses to a fear potential startle paradigm. J Autism Dev Disord 2006; 35:575-83. [PMID: 16167091 DOI: 10.1007/s10803-005-0002-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The present study utilized a fear potentiated startle paradigm to examine amygdala function in individuals with autism spectrum disorder. Two competing hypotheses regarding amygdala dysfunction in autism have been proposed: (1) The amygdala is under-responsive, in which case it would be predicted that, in a fear potentiated startle experiment, individuals with autism would exhibit decreased fear conditioning and/or potentiation, and (2) The amygdala is over responsive, in which case an exaggerated potentiation of the startle response would be predicted. Fourteen adolescents and adults diagnosed with autism spectrum disorder and 14 age, gender, IQ, and anxiety level-matched typical adolescents and adults participated. Both participants with autism and typical participants potentiated the startle response following fear conditioning and no group differences in the latency or amplitude of the potentiated startle response were found. These results suggest that this aspect of amygdala function, namely fear conditioning and potentiation of the startle response, is intact in individuals with autism.
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Affiliation(s)
- Raphael Bernier
- Center on Human Development and Disability, University of Washington, Seattle 98195, USA.
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Abstract
Sexual abuse is considered to be a pandemic contemporary public health issue, with significant physical and psychosocial consequences for its victims. However, the incidence of elder sexual assault is difficult to estimate with any degree of confidence. A convenience sample of 284 case records were reviewed for Post-Traumatic Stress Disorder (PTSD) symptoms. The purpose of this paper is to present the limited data noted on record review on four PTSD symptoms of startle, physiological upset, anger, and numbness. A treatment model for information processing of intrapsychic trauma is presented to describe domain disruption within a nursing diagnosis of rape trauma syndrome and provide guidance for sensitive assessment and intervention.
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Affiliation(s)
- Ann W Burgess
- William E Connell School of Nursing, Boston College, Chestnut Hill, MA, USA
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Lipschitz DS, Mayes LM, Rasmusson AM, Anyan W, Billingslea E, Gueorguieva R, Southwick SM. Baseline and modulated acoustic startle responses in adolescent girls with posttraumatic stress disorder. J Am Acad Child Adolesc Psychiatry 2005; 44:807-14. [PMID: 16034283 DOI: 10.1097/01.chi.0000166379.60769.b6] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess baseline and modulated acoustic startle responses in adolescent girls with posttraumatic stress disorder (PTSD). METHOD Twenty-eight adolescent girls with PTSD and 23 healthy control girls were recruited for participation in the study. Acoustic stimuli were bursts of white noise of 104 dB presented biaurally through headphones. Baseline startle responses as well as prepulse inhibition, a 1,000-Hz prestimulation tone presented 120 milliseconds before the startle stimulus for 30 milliseconds, and prepulse facilitation, a 1000-Hz prestimulation tone presented continuously for 2, 000 milliseconds before the startle stimulus, were compared in these two groups of girls. RESULTS At baseline and under neutral testing conditions, the magnitude of the startle response (eye blink) did not differ significantly between girls with PTSD and healthy control girls. There were no significant differences in the degree of prepulse inhibition or facilitation between the two groups of girls. CONCLUSIONS Unlike combat veterans with PTSD, adolescent girls with PTSD who report exaggerated startle may not have exaggerated baseline acoustic startle responses in the laboratory. Further research should explore whether girls with PTSD demonstrate altered startle responses under stress and/or evidence of other types of psychophysiological abnormalities.
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Affiliation(s)
- Deborah S Lipschitz
- Neuroscience Division, National Center for PTSD, and the Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06824, USA.
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Milde AM, Enger Ø, Murison R. The effects of postnatal maternal separation on stress responsivity and experimentally induced colitis in adult rats. Physiol Behav 2004; 81:71-84. [PMID: 15059686 DOI: 10.1016/j.physbeh.2004.01.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2003] [Revised: 12/23/2003] [Accepted: 01/12/2004] [Indexed: 02/04/2023]
Abstract
In this study, we investigated the effects of three neonatal conditions on adult corticosterone (CORT) levels, acoustic startle responses (ASRs), and vulnerability to colitis induced by dextran sulfate sodium (DSS) and how these early manipulations might interact with a brief stress exposure in adulthood on the same measures. Infant animals were subjected daily to either 180-min maternal separation [prolonged maternal separation (LMS)], 10-min maternal separation [brief maternal separation (BMS)], or nonhandling (NH) conditions during postnatal days 1-14. As adults, half of the animals were exposed to a series of 10 uncontrollable foot shocks. Animals were tested for CORT levels prior to and 10 days following shock/nonshock procedures before being tested for ASRs. Finally, all animals were exposed to 4% DSS in their drinking water for 6 days. LMS animals showed enhanced vulnerability to DSS-induced colitis when previously exposed to shock and enhanced stress reactivity responses as shown by elevated startle and CORT levels. Among the nonshocked animals, NH animals showed most colonic damage. Taken together, the results support previous findings suggesting that BMS has a protective effect on adult stress exposure. Additionally, BMS protects the animals from chemically induced colitis. The NH condition has clearly an effect on sensitizing mucosal response to DSS exposure.
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Affiliation(s)
- Anne Marita Milde
- Department of Biological and Medical Psychology, University of Bergen, Jonas Liesvei 91, 5009 Bergen, Norway.
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Osuch E, Ursano R, Li H, Webster M, Hough C, Fullerton C, Leskin G. Brain environment interactions: stress, posttraumatic stress disorder, and the need for a postmortem brain collection. Psychiatry 2004; 67:353-83. [PMID: 15801377 DOI: 10.1521/psyc.67.4.353.56565] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Stress, especially the extreme stress of traumatic events, can alter both neurobiology and behavior. Such extreme environmental situations provide a useful model for understanding environmental influences on human biology and behavior. This paper will review some of the evidence of brain alterations that occur with exposure to environmental stress. This will include recent studies using neuroimaging and will address the need for histological confirmation of imaging study results. We will review the current scientific approaches to understanding brain environment interactions, and then make the case for the collection and study of postmortem brain tissue for the advancement of our understanding of the effects of environment on the brain. Creating a brain tissue collection specifically for the investigation of the effects of extreme environmental stressors fills a gap in the current research; it will provide another of the important pieces to the puzzle that constitutes the scientific investigation of negative effects of environmental exposures. Such a resource will facilitate new discoveries related to the psychiatric illnesses of acute stress disorder and posttraumatic stress disorder, and can enable scientists to correlate structural and functional imaging findings with tissue abnormalities, which is essential to validate the results of recent imaging studies.
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MESH Headings
- Acoustic Stimulation/adverse effects
- Axons/physiology
- Brain/metabolism
- Brain/pathology
- Brain/physiopathology
- Environment
- Epinephrine/blood
- Epinephrine/urine
- Humans
- Limbic System/anatomy & histology
- Limbic System/metabolism
- Limbic System/pathology
- Limbic System/physiopathology
- Norepinephrine/blood
- Norepinephrine/urine
- Reflex, Startle
- Stress Disorders, Post-Traumatic/metabolism
- Stress Disorders, Post-Traumatic/physiopathology
- Stress Disorders, Post-Traumatic/psychology
- Stress Disorders, Traumatic, Acute/metabolism
- Stress Disorders, Traumatic, Acute/physiopathology
- Stress Disorders, Traumatic, Acute/psychology
- Tissue Banks
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Affiliation(s)
- Elizabeth Osuch
- Department of Psychiatry, Uniformed Services Universityof the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
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Grillon C, Baas J. A review of the modulation of the startle reflex by affective states and its application in psychiatry. Clin Neurophysiol 2003; 114:1557-79. [PMID: 12948786 DOI: 10.1016/s1388-2457(03)00202-5] [Citation(s) in RCA: 432] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To provide an overview of startle reflex methodologies applied to the examination of emotional and motivational states in humans and to review the findings in different forms of psychopathology. METHODS Pertinent articles were searched mostly via MEDLINE and PsycINFO. RESULTS The startle reflex is a non-invasive translational tool of research that bridges the gap between animal and human investigations. Startle is used to study fear and anxiety, affective disturbances, sensitization, motivational states, and homeostasis. CONCLUSIONS The startle reflex is highly sensitive to various factors that are of interest in the studies of emotional disorders and has promoted new areas of investigations in psychiatry. However, research in psychiatry is still in its infancy and most findings await replication. Future progress will benefit from the development of innovative and powerful designs tailored to investigate specific disorders. SIGNIFICANCE The startle reflex has utility as a research tool to examine trauma-related disorders, fear learning, drug addiction, and to contrast affective states and emotional processing across diagnostic groups, but its usefulness as a diagnostic tool is limited.
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Affiliation(s)
- Christian Grillon
- National Institute of Mental Health, DHHS, Mood and Anxiety Disorders Program, 15K North Drive, Bldg 15K, MSC 2670, Bethesda, MD 20895, USA.
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Klorman R, Cicchetti D, Thatcher JE, Ison JR. Acoustic startle in maltreated children. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2003; 31:359-70. [PMID: 12831226 DOI: 10.1023/a:1023835417070] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We investigated the eyeblink component of acoustic startle reactions in maltreated children. Previous research indicates that acoustic startle is enhanced in adult males with posttraumatic stress disorders (PTSD) whereas findings on women with PTSD have been inconsistent. In accord with the only previous report for children with PTSD, we found that maltreated boys, particularly those who had been physically abused, responded to increases in startle probe loudness with smaller increments in amplitude of startle eyeblink and smaller reductions in blink latency than did comparison boys. Results for girls were inconsistent: younger maltreated girls had smaller startle amplitude and slower onset latency than controls, whereas older maltreated girls exhibited the opposite pattern.
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Affiliation(s)
- Rafael Klorman
- Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, New York 14620-0266, USA.
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35
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Wells JE, Williams TH, Macleod AD, Carroll GJ. Posttraumatic stress disorder: do electrical startle responses and thyroid function usefully supplement self-report? A study of Vietnam War veterans. Aust N Z J Psychiatry 2003; 37:334-9. [PMID: 12780473 DOI: 10.1046/j.1440-1614.2003.01185.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the usefulness of electrical startle responses and thyroid function as supplements to self-report measures of posttraumatic stress disorder (PTSD). METHOD Invitations were sent to all New Zealand Vietnam War veterans known to be living in North Canterbury; 50 responded and the 35 living in or near Christchurch were included. Self-report measures of PTSD (the Davidson Trauma Scale (DTS) and the Symptom Check List (SCL-90-R) ), an eye blink electrical startle response and thyroid function were measured. The DTS was re-administered one to two weeks later to assess short-term test-retest reliability. Six months later the DTS and the electrical startle response were measured again. RESULTS The veterans reported a wide range of PTSD severity, with 15/35 reporting prior diagnosis of PTSD. The DTS showed high short-term test-retest reliability (r = 0.93) and a moderate correlation after 6 months (r = 0.73). It also showed sensitivity to change; in one to two weeks the scores increased by nearly half a standard deviation, possibly because of an imminent "homecoming" march. The DTS and a PTSD scale from the SCL-90-R were highly correlated (r = 0.89). The total triiodothyronine (T3) to free thyroxine (T4) ratio measure of thyroid function correlated poorly with self-report (r < or = 0.27). The electrical startle response also correlated poorly with self-report (r < or = 0.26), showed low internal consistency between left and right sides (r = 0.43), and correlated 0.39 over six months. It was disliked by the veterans and had increased slightly at 6 month follow-up, perhaps because of sensitization. CONCLUSIONS The DTS was reliable and correlated highly with the SCL-90-R PTSD scale. Neither thyroid function nor eye blink electrical startle correlated with each other or with self-report, and reliability was not good for electrical startle. These two measures do not appear to add anything useful to the assessment of PTSD.
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Affiliation(s)
- J Elisabeth Wells
- Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, PO Box 4345, Christchurch, New Zealand.
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36
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Winkel FW, Wohlfarth T, Blaauw E. Police-based early detection of persistent Type A trauma symptomatology in crime victims: the validity of rapid, objective risk assessment. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2003; 26:191-205. [PMID: 12581755 DOI: 10.1016/s0160-2527(02)00207-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- Frans Willem Winkel
- Forensic Psychology and Victimology Program, Department of Clinical Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, Amsterdam 1081 BT, The Netherlands.
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37
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Guitar B. Acoustic startle responses and temperament in individuals who stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2003; 46:233-240. [PMID: 12647901 DOI: 10.1044/1092-4388(2003/018)] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Fourteen individuals who stutter and 14 individuals who do not stutter were presented with 10 bursts of white noise to assess the magnitude of their eyeblink responses as a measure of temperament. Both the magnitude of the eyeblink response to the initial noise burst and the mean of the 10 responses were significantly greater for the stuttering group. The Taylor-Johnson Temperament Analysis (R. M. Taylor & L P. Morrison, 1996) did not distinguish between the two groups, but informal follow-up statistics indicated that the Nervous subscale showed a significant group difference. Scores on this subscale were also significantly positively correlated with the magnitude of the startle response. A discriminant analysis demonstrated that although both the startle response and the nervous trait differentiated the two groups, the startle response measures were more powerful in making this differentiation.
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Affiliation(s)
- Barry Guitar
- Department of Commuication Sciences, University of Vermont, Burlington 05405-0010, USA.
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38
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Abstract
In general, the results of psychophysiologic research on PTSD support the presence of a variety of autonomic, sensory, and cognitive processing differences between individuals with and without the disorder. The findings are diverse and include heightened responsiveness to trauma reminders; exaggerated startle; increased conditionability and autonomic responsiveness to aversive, high-intensity stimuli; and elevated tonic or baseline physiologic activity. Increased sensitivity of the central nervous system is suggested by electrophysiologic evidence for a failure to habituate to redundant information, over-responsiveness to novel information, and reduced cortical responsiveness to overstimulation. Cognitive processing abnormalities are suggested by electrophysiologic evidence for a reduced ability to attend to task-relevant information and increased attention to task-irrelevant, trauma-related information in individuals with PTSD. Some findings, such as the heightened physiologic and P300 response amplitude responses to trauma-related stimuli and increased HR response to loud tones, have been highly replicable and appear to be as reliable as any biologic finding in the psychiatric literature. Other findings, such as increased eye-blink startle responses and tonic or baseline physiologic activity, have been less consistently replicated and have led investigators to explore how stressful or threatening experimental contexts might produce phasic alterations in the psychophysiology of individuals with PTSD. We hope that the broad range of psychophysiologic investigations and findings in PTSD will inspire others to consider possible applications of these methodologies to their own clinical and research endeavors.
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Affiliation(s)
- Scott P Orr
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA 02129, USA.
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39
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Welch KL, Beere DB. Eye movement desensitization and reprocessing: a treatment efficacy model. Clin Psychol Psychother 2002. [DOI: 10.1002/cpp.323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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40
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Bruijnzeel AW, Stam R, Compaan JC, Wiegant VM. Stress-induced sensitization of CRH-ir but not P-CREB-ir responsivity in the rat central nervous system. Brain Res 2001; 908:187-96. [PMID: 11454329 DOI: 10.1016/s0006-8993(01)02646-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There is some evidence that a traumatic life event can induce long-term alterations in corticotropin-releasing hormone (CRH) producing neurons in humans, which may play a role in the pathophysiology of anxiety disorders, including post-traumatic stress disorder (PTSD). To study the long-term effects of a traumatic event on brain CRH-immunoreactivity (CRH-ir) and phospho-cAMP response element binding protein-immunoreactivity (P-CREB-ir), rats were exposed to a single session of foot shocks (preshocked) or no shocks (control). Two weeks later half of the control rats and half of the preshocked rats received an electrified prod in the home cage for 15 min and behavior was recorded. Fifteen minutes after the removal of the prod rats were perfused and brain sections were stained for CRH-ir and P-CREB-ir. There was no basal difference between preshocked and control rats in brain CRH-ir and P-CREB-ir. Exposure to the electrified prod induced a significant increase in CRH-ir in the paraventricular nucleus of the hypothalamus, the median eminence and the central amygdala in preshocked rats, but not in control rats. The electrified prod increased the number of P-CREB-ir neurons in the paraventricular nucleus of the hypothalamus and the locus coeruleus, but the preshock experience did not affect this response. In an additional experiment with a similar design plasma hormone levels were measured 14 days after the foot shocks. The preshock experience sensitized the shock prod-induced ACTH and corticosterone response. No behavioral differences between preshocked and control rats were found during the shock prod tests. We suggest that long-term stress-induced changes in neuropeptide dynamics of CRH-ir neurons may play a role in long-term stress-induced neuroendocrine sensitization.
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Affiliation(s)
- A W Bruijnzeel
- Division of Pharmacology and Anatomy, Rudolf Magnus Institute for Neurosciences, University Medical Center Utrecht, P.O. Box 85060, 3508 AB Utrecht, The Netherlands.
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41
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Medina AM, Mejia VY, Schell AM, Dawson ME, Margolin G. Startle reactivity and PTSD symptoms in a community sample of women. Psychiatry Res 2001; 101:157-69. [PMID: 11286819 DOI: 10.1016/s0165-1781(01)00221-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Exaggerated startle and PTSD symptoms have been investigated primarily in relation to acute or Type I stressors. The present study examined PTSD symptoms and startle eyeblink response in relation to chronic or Type II stressors. Type II stressors were operationally defined as high levels of childhood corporal punishment and high levels of current partner aggression. This study recruited a sample of 52 women from a metropolitan community and administered several questionnaires assessing experience of corporal punishment in childhood, current intimate partner aggression and level of PTSD symptoms. Following questionnaires, women were presented with eight auditory startle probes (white noise). Results showed that both childhood corporal punishment and intimate partner aggression were associated with women's PTSD symptom scores. However, only PTSD symptom scores were associated with reduced startle. Results are discussed in light of Type I and Type II stressors, and recent suggestions in the PTSD literature that a subgroup of individuals may experience physiological suppression rather than heightened physiological reactivity.
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Affiliation(s)
- A M Medina
- Department of Psychology, University of Southern California, Los Angeles 90089-1061, USA.
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42
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Schore AN. The effects of early relational trauma on right brain development, affect regulation, and infant mental health. Infant Ment Health J 2001. [DOI: 10.1002/1097-0355(200101/04)22:1%3c201::aid-imhj8%3e3.0.co;2-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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43
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Schore AN. The effects of early relational trauma on right brain development, affect regulation, and infant mental health. Infant Ment Health J 2001. [DOI: 10.1002/1097-0355(200101/04)22:1<201::aid-imhj8>3.0.co;2-9] [Citation(s) in RCA: 530] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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44
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Abstract
Stressful experiences in humans can result in a spectrum of long-term changes in behavioural, autonomic and hormonal responsivity. An extreme form of such alterations is found in patients with post-traumatic stress disorder (PTSD). A number of animal models has been developed in which intense stressful experiences (shocks, social confrontations) result in longterm altered responsivity of behavioural, autonomic and hormonal responses to aversive challenges which mimic many of the changes seen in PTSD. These models of stress-induced sensitisation are beginning to generate a better understanding of the vulnerability factors, time-course and underlying neuronal substrates of the long-term disturbances experienced by humans as a result of stressful life events.
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Affiliation(s)
- R Stam
- Medical Pharmacology Group, Rudolf Magnus Institute for Neurosciences, University Medical Center Utrecht, P.O. Box 80040, 3508 TA, Utrecht, The Netherlands
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45
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Chung KK, Martinez M, Herbert J. c-fos expression, behavioural, endocrine and autonomic responses to acute social stress in male rats after chronic restraint: modulation by serotonin. Neuroscience 2000; 95:453-63. [PMID: 10658625 DOI: 10.1016/s0306-4522(99)00459-5] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The effects in male rats of serotonin depletion (using the neurotoxin 5,7-dihydroxytryptamine) on the cross-sensitization of an acute social stress (defeat by a larger resident male) by previous repeated restraint stress (10 days, 60 min per day) was studied. Previous restraint increased freezing responses during social defeat in sham-operated rats, but this was not observed in those with depleted serotonin (83% or more in different regions of the brain). In contrast, neither heart rate (tachycardia) nor core temperature responses (hyperthermia) were accentuated in previously restrained rats (i.e. neither showed heterotypical sensitization), and neither adapted to repeated restraint (there is a hypothermic core temperature response during restraint). Corticosterone levels, which did adapt, nevertheless did not show accentuated responses to social defeat in previously restrained rats, though samples could only be taken 60 min after defeat. c-fos expression in the central nucleus of the amygdala 60 min after social defeat was increased by previous restraint. No other areas examined in the hypothalamus (e.g., paraventricular nucleus) or brainstem (e.g., solitary nucleus) showed differences related to previous restraint. Serotonin depletion reduced the expression of c-fos in the frontal cortex, lateral preoptic area, medial amygdala, central gray, medial and dorsal raphe, and locus coeruleus after social stress, but this was not altered by previous restraint. These results show that serotonin depletion has selective effects on the cross-sensitization of responses in previously stressed rats to a heterotypical stressor.
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Affiliation(s)
- K K Chung
- Department of Anatomy, and MRC Cambridge Centre for Brain Repair, University of Cambridge, UK
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46
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Stam R, Croiset G, Bruijnzeel AW, Visser TJ, Akkermans LM, Wiegant VM. Sex differences in long-term stress-induced colonic, behavioural and hormonal disturbances. Life Sci 2000; 65:2837-49. [PMID: 10622273 DOI: 10.1016/s0024-3205(99)00553-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Functional bowel disorders are more prevalent in women than in men, but the reason for this is unclear. Stressful experiences can increase the risk for or precipitate intestinal dysfunction. Using a model for long-term stress-induced sensitisation in rats, it was investigated whether male and female rats differ in susceptibility for long-term colonic, behavioural and hormonal disturbances following brief but intense stress. Male and female Wistar rats were fitted with chronic electrodes on proximal colon and given either a 15-minute session of foot shocks or no shocks. Two weeks later, rats were exposed to two different novel stressful challenges in the home cage: an electrified prod (day 14) and an 85 dB noise stressor (day 15). Digitalised colonic myoelectric spike burst activity was quantified automatically. Behaviour during prod and noise exposure was scored blindly from videotape. Resting plasma hormone concentrations at the end of the study were determined by radio-immuno assay. Following prod stress on day 14, both male and female preshocked rats showed a greater increase in colonic spike burst frequency than controls, but similar behaviour, and the dynamics of colonic motility differed between sexes. Following noise stress on day 15, only a small change in burst frequency was seen in all rats, but preshocked rats showed less self-grooming behaviour and there was a tendency for preshocked females to show increased noise-induced immobility. Preshocked rats also had lower levels of plasma free thyroxine. While both male and female rats show long-term stress-induced colonic sensitisation and hormonal changes, females show a different activation pattern of colonic motility, and may be more vulnerable for altered behavioural reactivity, following stress.
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Affiliation(s)
- R Stam
- Rudolf Magnus Institute for Neurosciences, University Medical Center, Utrecht University, The Netherlands
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47
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Neylan TC, Fletcher DJ, Lenoci M, McCallin K, Weiss DS, Schoenfeld FB, Marmar CR, Fein G. Sensory gating in chronic posttraumatic stress disorder: reduced auditory P50 suppression in combat veterans. Biol Psychiatry 1999; 46:1656-64. [PMID: 10624547 DOI: 10.1016/s0006-3223(99)00047-5] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) may be associated with a general impairment of cognitive function that extends beyond the processing of trauma-specific stimuli. Suppression of the auditory P50 response to repeated stimuli occurs in normal subjects and reflects the central nervous system's ability to screen out repetitive stimuli, a phenomenon referred to as sensory gating. This study examines P50 sensory gating to nonstartle auditory stimuli in PTSD subjects and normal controls. METHODS P50 generation and gating were studied using a conditioning/testing paradigm in 15 male subjects with PTSD and 12 male controls. P50 test/conditioning (T/C) ratios were estimated using the Singular Value Decomposition method. RESULTS The amplitude of the P50 response to the conditioning stimulus did not differ in subjects with PTSD compared to normal controls. The P50 T/C ratio is increased in PTSD subjects (mean = .408, SD = .275) as compared to the controls (mean = .213, SD = .126, two tailed t, p = .024). CONCLUSIONS This study provides evidence that PTSD is associated with impaired gating to nonstartle trauma-neutral auditory stimuli.
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Affiliation(s)
- T C Neylan
- Department of Psychiatry, University of California, San Francisco, USA
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Shlik J, Zhou Y, Koszycki D, Vaccarino FJ, Bradwejn J. Effects of CCK-4 infusion on the acoustic eye-blink startle and psychophysiological measures in healthy volunteers. J Psychopharmacol 1999; 13:385-90. [PMID: 10667615 DOI: 10.1177/026988119901300409] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The acoustic startle response (ASR) and a range of psychophysiological parameters were evaluated during a continuous intravenous administration of cholecystokinin-tetrapeptide (CCK-4) in healthy volunteers. Subjects (n=28) were randomly assigned to double-blind infusion of either CCK-4 (0.5 mg/60 min) or placebo. The ASR sessions were performed prior to infusion and at 20 min and 50 min after the onset of infusion by recording eye-blink response to a series of acoustic stimuli (110 dB, 40 ms). An effect of CCK-4 on the eye-blink startle was observed in the first half of infusion. CCK-4 produced an increase of eye-blink startle amplitude from baseline values in contrast to the decrease observed at this time point with placebo. A mild increase in anxiety and heart rate followed by fatigue was reported with CCK-4. Administration of CCK-4 produced increases in plasma concentrations of adrenocorticotropic hormone, cortisol, prolactin and growth hormone. The results of this study show that a prolonged intravenous administration of CCK-4 may be a useful challenge method for further studies on the role of CCK system in the modulation of human anxiety and stress response.
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Affiliation(s)
- J Shlik
- Royal Ottawa Hospital, University of Ottawa, Ontario, Canada.
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49
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Bruijnzeel AW, Stam R, Compaan JC, Croiset G, Akkermans LM, Olivier B, Wiegant VM. Long-term sensitization of Fos-responsivity in the rat central nervous system after a single stressful experience. Brain Res 1999; 819:15-22. [PMID: 10082856 DOI: 10.1016/s0006-8993(98)01350-x] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
There is considerable evidence for a role of stressful experiences in psychosomatic disorders in humans, but the mechanisms leading to altered responsivity and the relative contributions of central and peripheral neuronal changes, however, are still under debate. To investigate the contribution of specific brain areas to sensitized responsivity, rats were exposed to a single brief session of inescapable footshocks (preshocked) or no shocks (control) in a gridcage. Two weeks later, an electrified prod was inserted in the home cage for 15 min and the behaviour recorded. One hour later rats were perfused and brain sections were stained for Fos protein immunoreactivity. The number of Fos positive neurons was quantified in 27 brain areas. No significant difference in behaviour was found between the groups during the shock prod challenge. A significantly higher number of Fos positive neurons was found in preshocked rats compared to controls in the following brain areas: agranular insular cortex, frontal cortex, nucleus accumbens, bed nucleus of the stria terminalis, basolateral amygdala, CA1 area of the hippocampus, paraventricular hypothalamic nucleus, dorsolateral central grey, locus coeruleus, nucleus of the solitary tract and lateral paragigantocellular nucleus. We conclude that altered reactivity to stressful challenges in brain areas involved in neuroendocrine and autonomic control may play a role in long-term sensitization of neuroendocrine and autonomic responses in preshocked rats under conditions where behavioural sensitization is not expressed.
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Affiliation(s)
- A W Bruijnzeel
- Department of Medical Pharmacology, Rudolf Magnus Institute for Neurosciences, Utrecht University, P.O. Box 80030, 3508 TA, Utrecht,
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50
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Grillon C, Morgan CA, Davis M, Southwick SM. Effects of experimental context and explicit threat cues on acoustic startle in Vietnam veterans with posttraumatic stress disorder. Biol Psychiatry 1998; 44:1027-36. [PMID: 9821567 DOI: 10.1016/s0006-3223(98)00034-1] [Citation(s) in RCA: 190] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The hypothesis that exaggerated startle in Vietnam veterans with posttraumatic stress disorder (PTSD) reflects an anxiogenic response to stressful contexts was tested. METHODS Thirty-four nonmedicated Vietnam veterans with PTSD, and 17 combat and 14 civilian non-PTSD controls participated in two testing sessions over separate days. Acoustic startle stimuli were delivered alone or in a test of prepulse inhibition. In the first session, startle was assessed without experimental stress. In the second session, startle was investigated during a stressful "threat of shock" experiment, when subjects anticipated the administration of shocks during threat periods and during safe periods when no shocks were anticipated. RESULTS The magnitude of startle did not differ significantly among the three groups in the first session, but was increased throughout the threat of shock experiment in the PTSD veterans in the second session. The actual increase in startle in the threat compared to the safe condition did not significantly differ among the three groups. Prepulse inhibition was reduced in the PTSD veterans, compared to the non-PTSD civilians, but not compared to the non-PTSD veterans. CONCLUSION Exaggerated startle in Vietnam veterans with PTSD reflects an anxiogenic response to an environment that is experienced as stressful.
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Affiliation(s)
- C Grillon
- National Center for Post Traumatic Stress Disorder, West Haven VA Medical Center, Connecticut, USA
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