Effects of Traumatic Stress on Brain Structure and Function: Relevance to Early Responses to Trauma

SUMMARY The events of 9/11 and the widening impact of psychological trauma today have raised a higher level of awareness about the potentially deleterious effects of psychological trauma on the individual. One area of interest after 9/11 was the early trauma response and the most effective way to deal with the window of time immediately after traumatization in order to prevent long term psychopathology. Understanding the neurobiology of the acute trauma response may be useful in designing prevention and treatment strategies. Studies in animals and humans have shown that biological stress response systems, including norepinephrine and cortisol, are affected in both the acute and chronic stages of the trauma response. Brain areas involved in memory, including the hippocampus, amygdala, and prefrontal cortex, may be areas of intervention to ameliorate the early trauma response. Due to the difficulty of performing research in this time period, most research to date has been in patients with chronic disorders such as chronic posttraumatic stress disorder (PTSD). Only a few treatment studies have been performed in the early trauma period, and more research in this area is needed.

[1]  R. Kikinis,et al.  Magnetic resonance imaging study of hippocampal volume in chronic, combat-related posttraumatic stress disorder , 1996, Biological Psychiatry.

[2]  Israel Liberzon,et al.  Brain activation in PTSD in response to trauma-related stimuli , 1999, Biological Psychiatry.

[3]  C. Nemeroff,et al.  The role of corticotropin-releasing factor in depression and anxiety disorders. , 1999, The Journal of endocrinology.

[4]  B. McEwen,et al.  Stress and the individual. Mechanisms leading to disease. , 1993, Archives of internal medicine.

[5]  R. Sapolsky Why Stress Is Bad for Your Brain , 1996, Science.

[6]  B. Singer,et al.  Price of adaptation--allostatic load and its health consequences. MacArthur studies of successful aging. , 1997, Archives of internal medicine.

[7]  S. Southwick,et al.  Neural correlates of declarative memory for emotionally valenced words in women with posttraumatic stress disorder related to early childhood sexual abuse , 2003, Biological Psychiatry.

[8]  Allen Frances,et al.  The expert consensus guideline series. Treatment of Posttraumatic Stress Disorder. The Expert Consensus Panels for PTSD. , 1999, The Journal of clinical psychiatry.

[9]  S. Kosslyn,et al.  Regional cerebral blood flow during script-driven imagery in childhood sexual abuse-related PTSD: A PET investigation. , 1999, The American journal of psychiatry.

[10]  P. Blakeney,et al.  Imipramine treatment in pediatric burn patients with symptoms of acute stress disorder: a pilot study. , 1999, Journal of the American Academy of Child and Adolescent Psychiatry.

[11]  G. Chrousos,et al.  Oral administration of a corticotropin-releasing hormone receptor antagonist significantly attenuates behavioral, neuroendocrine, and autonomic responses to stress in primates. , 2000, Proceedings of the National Academy of Sciences of the United States of America.

[12]  N. Alpert,et al.  A symptom provocation study of posttraumatic stress disorder using positron emission tomography and script-driven imagery. , 1996, Archives of general psychiatry.

[13]  M. Stein,et al.  Hippocampal volume in women victimized by childhood sexual abuse , 1997, Psychological Medicine.

[14]  B. Mcewen,et al.  Proliferation of granule cell precursors in the dentate gyrus of adult monkeys is diminished by stress. , 1998, Proceedings of the National Academy of Sciences of the United States of America.

[15]  O. D. Leon Neurobiological and clinical consequences of stress , 1997 .

[16]  L H Staib,et al.  Positron emission tomography measurement of cerebral metabolic correlates of yohimbine administration in combat-related posttraumatic stress disorder. , 1997, Archives of general psychiatry.

[17]  Lisa M Shin,et al.  Exaggerated amygdala response to masked facial stimuli in posttraumatic stress disorder: a functional MRI study , 2000, Biological Psychiatry.

[18]  L. Cahill,et al.  Pilot study of secondary prevention of posttraumatic stress disorder with propranolol , 2002, Biological Psychiatry.

[19]  J. Augenstein,et al.  Pilot Evaluation of Hypnotic Medication During Acute Traumatic Stress Response , 1998, Journal of traumatic stress.

[20]  K. Fletcher Posttraumatic Stress Disorder: A Comprehensive Text , 2000 .

[21]  Michael Davis,et al.  The role of the amygdala in fear and anxiety. , 1992, Annual review of neuroscience.

[22]  M. Keshavan,et al.  N-Acetylaspartate concentration in the anterior cingulate of maltreated children and adolescents with PTSD. , 2000, The American journal of psychiatry.

[23]  S. Southwick,et al.  MRI-based measurement of hippocampal volume in patients with combat-related posttraumatic stress disorder. , 1995, The American journal of psychiatry.

[24]  E. Nestler,et al.  A molecular and cellular theory of depression. , 1997, Archives of general psychiatry.

[25]  S. Penfold Does Stress Damage the Brain? Understanding Trauma-Related Disorders from a Mind-Body Perspective. , 2004 .

[26]  L. Rowland,et al.  Reduced hippocampal volume and total white matter volume in posttraumatic stress disorder , 2002, Biological Psychiatry.

[27]  R. Duman,et al.  Regulation of BDNF and trkB mRNA in rat brain by chronic electroconvulsive seizure and antidepressant drug treatments , 1995, The Journal of neuroscience : the official journal of the Society for Neuroscience.

[28]  S. Southwick,et al.  Neural correlates of memories of childhood sexual abuse in women with and without posttraumatic stress disorder. , 1999, The American journal of psychiatry.

[29]  Lawrence H Staib,et al.  Neural correlates of exposure to traumatic pictures and sound in Vietnam combat veterans with and without posttraumatic stress disorder: a positron emission tomography study , 1999, Biological Psychiatry.

[30]  J. Davidson,et al.  A preliminary study of lamotrigine for the treatment of posttraumatic stress disorder , 1999, Biological Psychiatry.

[31]  H. Cameron,et al.  Phenytoin prevents stress‐ and corticosterone‐induced atrophy of CA3 pyramidal neurons , 1992, Hippocampus.

[32]  T. Pigott,et al.  Gender differences in the epidemiology and treatment of anxiety disorders. , 1999, The Journal of clinical psychiatry.

[33]  Stephan Eliez,et al.  Attenuation of frontal asymmetry in pediatric posttraumatic stress disorder , 2001, Biological Psychiatry.

[34]  L H Staib,et al.  Gender differences in cognitive and neural correlates of remembrance of emotional words. , 2001, Psychopharmacology bulletin.

[35]  S M Kosslyn,et al.  Visual imagery and perception in posttraumatic stress disorder. A positron emission tomographic investigation. , 1997, Archives of general psychiatry.

[36]  K. Frustaci,et al.  A pilot longitudinal study of hippocampal volumes in pediatric maltreatment-related posttraumatic stress disorder , 2001, Biological Psychiatry.

[37]  Maxim J. Schlossberg,et al.  Trauma and the Vietnam War Generation: Report of Findings from the National Vietnam Veterans Readjustment Study. , 1991 .

[38]  M. Shenton,et al.  Smaller hippocampal volume predicts pathologic vulnerability to psychological trauma , 2002, Nature Neuroscience.

[39]  S. Southwick,et al.  MRI and PET study of deficits in hippocampal structure and function in women with childhood sexual abuse and posttraumatic stress disorder. , 2003, The American journal of psychiatry.

[40]  J. Bremner,et al.  The history of posttraumatic stress disorder. , 1999 .

[41]  R. Bronen,et al.  Magnetic resonance imaging-based measurement of hippocampal volume in posttraumatic stress disorder related to childhood physical and sexual abuse—a preliminary report , 1997, Biological Psychiatry.

[42]  B. J. Casey,et al.  Developmental traumatology part II: brain development∗ ∗ See accompanying Editorial, in this issue. , 1999, Biological Psychiatry.

[43]  N. Schuff,et al.  Decreased hippocampal N-acetylaspartate in the absence of atrophy in posttraumatic stress disorder , 2001, Biological Psychiatry.

[44]  C. Glod,et al.  The Neurobiology of Posttraumatic Stress Disorder , 1995 .

[45]  M E Shenton,et al.  Longitudinal MRI study of hippocampal volume in trauma survivors with PTSD. , 2001, The American journal of psychiatry.

[46]  S. Southwick,et al.  Deficits in short-term memory in posttraumatic stress disorder. , 1993, The American journal of psychiatry.

[47]  C. Nemeroff,et al.  The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment. , 1998, Archives of general psychiatry.

[48]  J. Blumenthal,et al.  Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. , 1999, Circulation.

[49]  O. Bonne,et al.  Treatment of recent trauma survivors with benzodiazepines: a prospective study. , 1996, The Journal of clinical psychiatry.