Posttraumatski stresni sindrom i povezane anatomske strukture

  • Neda M Ognjanovic "Univerzitet u Kragujevcu" Fakultet medicinskih nauka, Institut za anatomiju

Sažetak


 

Postraumatski stresni poremećaj (PTSP) predstavlja značajan problem društva i nedavna neuroimidžing istraživanja su bila fokusirana na utvrđivanje moždanog anatomskog kruga koji leži u osnovi  nastanka.  PTSD je svrstan u druga anksiozna stanja kao što su stanja straha (napadi panike,  fobije i slično) zbog svog dominantnog simptoma – intenzivne,   preplavljujuće anksioznosti.

Uloženi su napori da se ispita da li su određene neurobiološke promene u posttraumatskom stresnom poremećaju odraz već postojećih vulnerabilnih faktora češće nego posledica izloženosti traumi i korelata posttraumatskog stresnog poremećaja.

Korišćenjem neuroimidžing metoda  identifikovane su promene u moždanoj strukturi i funkciji pacijenata sa posttraumatskim stresnim poremećajem.  Regioni mozga koji su promenjeni u pacijenata sa PTSP obuhvataju hipokampus,  amigdalu i  prefrontalni kortikalni region,  a uključuju i orbitofrontalni korteks i cingulum.

Ovim radom načinjen je pregled regiona mozga u kojima su identifikovane promene u pacijenata sa PTSP,  prikaz mogućih terapijskih procedura,  kao i protokol praćenja njihovih efekata.

Biografija autora

Neda M Ognjanovic, "Univerzitet u Kragujevcu" Fakultet medicinskih nauka, Institut za anatomiju
saradnik u nastavi

Reference

American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: American Psychiatric Association 1994

Sherin JE, Nemeroff CB. Post-traumatic stress disorder: the neurobiological impact of psychological trauma Dial in Clin Neuroscience 2011; 13: 263-278

Yehunda R. LeDoux J. Response variation following trauma:a translation neuroscience approach to understanding PTSD. Neuron 2007;56:19-32

Rauch SL, Shin LM, Phelps EA. Neurocircuitry models of posttraumatic stress disorder and extinction:human neuroimaging research-past, present and future. Biol Psychiatry 2006;60:376-382

Heim C, Nemeroff CB. Neurobiology of posttraumatic stress disorder. CNS Spectr. 2009;14:13-24

Fuchs E, Gould E. Mini review:in vivo neurogenesis in the adult brain regulation and functional implication. Eur J Neurosci 2000;12:2211-2214

Bremner JD, Randall P, Scott TM, et. al. MRI-based measurement of hippocampal volume inpatients with combat related posttraumatic stress disorder. Am J Psychiatry 1995;152:973-981

Bremner JD, Randall P, Vermetten F, et al. Magnetic resonance imaging-based measurement of hippocampal volume in posttraumatic stress disorder related to childhood physical and sexual abuse-a preliminary report. Biol Psychiatry. 1997;41:23-32

Gurvits TV, Shenton ME, Hokama H, et al. Magnetic resonance imaging study of hippocampal volume in chronic, combat-related posttraumatic stress disorder. Biol Psychiatry. 1996;40:1091-1099

Stein MB, Koverola C, Hanna C, Torchia MG, McClarty B. Hippocampal volume in women victimized by childhood sexual abuse. Psichol Med. 1997;27:951-959

Neylan TC, Schaff N, Lenoci m, Yehuda R, Weiner MW, Marwar CR. Cortisol levels are positively correlated with hippocampal N-acetylaspartate. biol Psychiatry 2003;54;1118-1121

De Bellis MD, Keshavan MS, Claru DB, et al, A. Ebennet research Award Developmental traumatology. Part iI Brain development. Biol Psychiatry 1999;45:1271-1284.

Vythilingam M. Heim C, Newport J, et. al. childhood trauma associated with smaller hippocampal volume in women with major depression. AM J Psychiatry 2002;159:2072-2081

Pitman RK, Sanders KM, Zusman RM, et. al. Pilot study of secondary prevention of posttraumatic stress disorder with propranolol. Biol Psychiatry 2002;51:189-192

Bremner JD, Vythilingam M, Vermetten E, et al. Neural correlates of declarative memory for emotionally valenced words in women with posttraumatic stress disorder related to early childhood sexual abuse. Biol Psychiatry. 2008;53:879-889

Gilbertson MW, Shenton ME, Ciszewski A, et al. Smaller hippocampal volume predict pathologic vulnerability too psychological trauma. Nat Neurosci. 2002;5:1242-1247.

Brenner LA Neuropsychological and neuroimaging findings in traumatic brain injury and post-traumatic stress disorder. Dialogues Clin Neurosci. 2011;13:311-23.

Van Zuiden M, Geuze E, Willemen HL, et al. Pre-existing high glucocorticoid receptor number predicting development of posttraumatic stress symptoms after military deployment. Am J Psychiatry. 2011;168:89-96

Vasterling JJ, Proctor SP. Understanding the neuropsychological consequences of deployment stress:a public health framework. J. Int Neuropsychol soc. 2011;17:1-6

Gilbertson NW, Paulus LA, Williston SK, et al. Neurocognitive function in monozygotic twins discordant for combat exposure:relationship to posttraumatic stress disorder. J Abnorm Psychol. 2006;115:484-495

Vasterling JJ, Duke LM, Brailey K, et al. Attention, Learning and memory performances and intellectual resources in Vietnam veterans:PTSD and no disorder comparisons. Neuropsychologia. 2002;16:5-14

Schulkin J. Angst and the amygdale. Dialogues Clin Neurosci. 2006;8:407-416

Shin LM, Rauch SL, Pitman RK. Amygdala, medial prefrontal cortex, and hippocampal function in PTSD. Ann N Y Acad Sci 2006;1071:67-79

Hendler i, Rotshtein P, Yeshurun Y, et al. Sensing the invisible:differential sensitivity of visual cortex and amygdale to traumatic context. Neuroimage 2003;19:587-600

Rauch SL, Whalen PJ, Shin LM, et. al. Exaggerated amygdale response to masked facial stimuli in posttraumatic stress disorder:a functional MRI study Biol Psychiatry. 2000;47:769-776

Bryant RA, Kemp AH, Felmingham KL, et. al. Enhanced amygdala and medial prefrontal activation during nonconscious processing of fear in posttraumatic stress disorder:an fMRI study. Hum. Brain Mapp 2008;29:517-523

Brewner JD, Vermetten E, Sclmahl C, et al. Positron emission tomographic imaging of neural correlates of a fear acquisition and extinction paradigm in women with childhood sexual-abuse-related post-traumatic stress disorder. Psychol Med. 2005;35:791-806

Rauch SL, Shin LM, Segal E, et al. Selectively reduced regional cortical volumes in post-traumatic stress disorder. Neuroreport. 2003;14:913-916

Yamasue H, , Kasai K, Iwanami A, et al. Voxel-based analysis of MRI reveals anterior cingulated gray-matter volume reduction in posttraumatic stress disorder due to terrorism. Proc Natl Acad Sci USA. 2003;100:9039-9043

Woodward SH, Kaloupek DG, Streeter CC, Martinez C, Schaer M, Eliez S. Decreased anterior cingulated volume in combat-related PTSD. Biol Psychiatry, 2006;59:582-587

Corbo V, Clement MH, Armony JL, Pruessner JC, Brunet A. Size versus shape differences:contrasting voxel-based and volumetric analyses of the anterior cingulate cortex in individuals with acute posttraumatic stress disorder. Biol Psychiatry 2005;58:119-124

De Bellis MD, Keshavan MS, Spencer S, Hall J. N-Acetylaspartate concentration in the anterior cingulated of maltreated children and adolescents with PTSD. Am J Psychiatry. 2000;157:1175-1177.

Kasai K, Yamasue H, Gilbertson MW, Shenton ME, Rauch SL, Pitman RK. Evidence for acquired pregenual anterior cingulate gray matter loss from twin study of combat-related posttraumatic stress disorder. Biol Psychiatry. 2008;63:550-556

Shin LM, Orr SP, Carson MA, et al. Regional cerebral blood flow in the amygdale and medial prefrontal cortex during traumatic imagery in male and female Vietnam veterans with PTSD. Arch Gen Psychiatry. 2004;61:168-176

Britton JC, Phan KL, Taylor SF, Fig LM, Liberzon i, Corticolimbic blood flow in posttraumatic stress disorder during script-driven imagery. Biol Psychiatry. 2005;57:832-840

Bremner JD, narayan M, Staib LH, Southwick SM, McGlashan T, Charney DS. Neural correlates of memories of childhood sexual abuse in womenwith and without posttraumatic stress disorder. Am J Psychiatry 1999;156:1787-1795

Lanius RA, Williamson PC, Hopper J, et al. Recall of emotional states in posttraumatic stress disorder:an fMRI investigation. Biol Psychiatry. 2003;53:204-2l0

Shin LM, Wright Cl, Cannistraro PA, et al. A functional magnetic resonance imaging study of amygdale and medial prefrontal cortex responses to overtly presented fearful faces in posttraumatic stress disorder: Arch Gen Psychiatry. 2005;62:273-281

Objavljeno
2013/01/09
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