Sensory gating in chronic posttraumatic stress disorder: reduced auditory p50 suppression in combat veterans

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.

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

[2]  B Altman,et al.  Psychophysiologic responses to combat imagery of Vietnam veterans with posttraumatic stress disorder versus other anxiety disorders. , 1990, Journal of abnormal psychology.

[3]  G. Fein,et al.  P50 suppression is not affected by attentional manipulations , 1992, Biological Psychiatry.

[4]  G Zouridakis,et al.  Replication and Extension of P50 Findings in Schizophrenia , 1991, Clinical EEG.

[5]  D. Dinges,et al.  Habituation of the startle reflex in posttraumatic stress disorder. , 1989, The Journal of neuropsychiatry and clinical neurosciences.

[6]  L. Adler,et al.  Transient impairment in P50 auditory sensory gating induced by a cold-pressor test , 1993, Biological Psychiatry.

[7]  C. A. Morgan,et al.  Startle reflex abnormalities in women with sexual assault-related posttraumatic stress disorder. , 1997, The American journal of psychiatry.

[8]  S. Orr,et al.  Physiologic responses to loud tones in israeli veterans of the 1973 yom kippur war , 1997, Biological Psychiatry.

[9]  E. Ornitz,et al.  Startle modulation in children with posttraumatic stress disorder. , 1989, The American journal of psychiatry.

[10]  S. Potkin,et al.  P50 responses in normal subjects with sensory overloading , 1994, Biological Psychiatry.

[11]  G. Rose,et al.  Neurophysiological studies of sensory gating in rats: Effects of amphetamine, phencyclidine, and haloperidol , 1986, Biological Psychiatry.

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

[13]  G. Everly,et al.  Neuropsychology of Posttraumatic Stress Disorder: A Pilot Study , 1989, Perceptual and motor skills.

[14]  A Pfefferbaum,et al.  Clinical application of the P3 component of event-related potentials. I. Normal aging. , 1984, Electroencephalography and clinical neurophysiology.

[15]  D L Braff,et al.  Physiological evidence of exaggerated startle response in a subgroup of Vietnam veterans with combat-related PTSD. , 1990, The American journal of psychiatry.

[16]  Ruben C. Gur,et al.  Midlatency auditory evoked responses in schizophrenia , 1991, Biological Psychiatry.

[17]  D. Lykken,et al.  Habituation of the skin conductance response to strong stimuli: a twin study. , 1988, Psychophysiology.

[18]  A. Baum,et al.  Chronic stress and posttraumatic stress disorders. , 1986, Journal of consulting and clinical psychology.

[19]  Robert Freedman,et al.  Auditory sensory gating in hippocampal neurons: A model system in the rat , 1990, Biological Psychiatry.

[20]  S. Orr,et al.  Psychophysiologic assessment of posttraumatic stress disorder imagery in Vietnam combat veterans. , 1987, Archives of general psychiatry.

[21]  J. Lamberti,et al.  Concurrent assessment of acoustic startle and auditory P50 evoked potential measures of sensory inhibition , 1993, Biological Psychiatry.

[22]  C. Richard Clark,et al.  Abnormal stimulus processing in posttraumatic stress disorder , 1993, Biological Psychiatry.

[23]  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.

[24]  D L Braff,et al.  Sensory gating deficits in schizophrenia: new results. , 1992, The American journal of psychiatry.

[25]  Miles E. McFall,et al.  Autonomic responses to stress in Vietnam combat veterans with posttraumatic stress disorder , 1990, Biological Psychiatry.

[26]  Robert Freedman,et al.  Cholinergic gating of response to auditory stimuli in rat hippocampus , 1992, Brain Research.

[27]  Ruth Bochner,et al.  THE CLINICAL APPLICATION , 1945 .

[28]  S. Orr,et al.  Psychometric profile of posttraumatic stress disorder, anxious, and healthy Vietnam veterans: correlations with psychophysiologic responses. , 1990, Journal of consulting and clinical psychology.

[29]  G. Gerhardt,et al.  Auditory sensory gating and catecholamine metabolism in schizophrenic and normal subjects , 1992, Psychiatry Research.

[30]  M Reite,et al.  Source location of a 50 msec latency auditory evoked field component. , 1988, Electroencephalography and clinical neurophysiology.

[31]  S. Southwick,et al.  Altered platelet alpha 2-adrenergic binding sites in posttraumatic stress disorder. , 1987, The American journal of psychiatry.

[32]  Philip D. Harvey,et al.  Learning and memory in combat veterans with posttraumatic stress disorder. , 1995, The American journal of psychiatry.

[33]  D. Amaral,et al.  Evidence for a direct projection from the superior temporal gyrus to the entorhinal cortex in the monkey , 1983, Brain Research.

[34]  George Fein,et al.  The reliability of P50 suppression as measured by the conditioning/testing ratio is vastly improved by dipole modeling , 1993, Biological Psychiatry.

[35]  S. Potkin,et al.  Single-trial P50 in normal and schizophrenic subjects , 1994, Biological Psychiatry.

[36]  S. Orr,et al.  Physiologic responses to loud tones in Israeli patients with posttraumatic stress disorder. , 1992, Archives of general psychiatry.

[37]  E. Blanchard,et al.  Changes in Plasma Norepinephrine to Combat‐Related Stimuli among Vietnam Veterans with Posttraumatic Stress Disorder , 1991, The Journal of nervous and mental disease.

[38]  S. Southwick,et al.  Urinary Catecholamine Excretion and Severity of PTSD Symptoms in Vietnam Combat Veterans , 1992, The Journal of nervous and mental disease.

[39]  L Kruglyak,et al.  Linkage of a neurophysiological deficit in schizophrenia to a chromosome 15 locus. , 1997, Proceedings of the National Academy of Sciences of the United States of America.

[40]  G. Fein,et al.  A multichannel, model-free method for estimation of event-related potential amplitudes and its comparison with dipole source localization. , 1995, Journal of medical engineering & technology.

[41]  G. Fein,et al.  Human P50 suppression is not affected by variations in wakeful alertness , 1997, Biological Psychiatry.

[42]  S. Orr,et al.  Psychophysiologic assessment of traumatic imagery in Israeli civilian patients with posttraumatic stress disorder. , 1993, The American journal of psychiatry.

[43]  C. A. Morgan,et al.  Abnormal noradrenergic function in posttraumatic stress disorder. , 1993, Archives of general psychiatry.

[44]  Psychophysiological assessment of posttraumatic stress disorder imagery in World War II and Korean combat veterans. , 1993 .

[45]  S. Kugelmass,et al.  Cognitive functioning in Post-Traumatic Stress Disorder , 1990 .

[46]  F. Perrin,et al.  Spherical splines for scalp potential and current density mapping. , 1989, Electroencephalography and clinical neurophysiology.

[47]  R Freedman,et al.  Inhibitory gating of an evoked response to repeated auditory stimuli in schizophrenic and normal subjects. Human recordings, computer simulation, and an animal model. , 1996, Archives of general psychiatry.

[48]  C. A. Morgan,et al.  Exaggerated acoustic startle reflex in Gulf War veterans with posttraumatic stress disorder. , 1996, The American journal of psychiatry.

[49]  I. Churchill-Davidson,et al.  Oxygenation in radiotherapy. II. Clinical application. , 1957, The British journal of radiology.

[50]  S. Orr,et al.  Physiologic responses to loud tones in Vietnam veterans with posttraumatic stress disorder. , 1995, Journal of abnormal psychology.

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

[52]  E. Blanchard,et al.  Psychophysiological Responses in the Diagnosis of Posttraumatic Stress Disorder in Vietnam Veterans , 1991, The Journal of nervous and mental disease.

[53]  G. Fein,et al.  Cocaine abusers have reduced auditory P50 amplitude and suppression compared to both normal controls and alcoholics , 1996, Biological Psychiatry.

[54]  S. Orr,et al.  Psychophysiological assessment of posttraumatic stress disorder imagery in World War II and Korean combat veterans. , 1993, Journal of abnormal psychology.

[55]  G. Fein,et al.  Reduced Hippocampal Volume and N‐Acetyl Aspartate in Posttraumatic Stress Disorder , 1997, Annals of the New York Academy of Sciences.

[56]  Thomas R. Kosten,et al.  Sustained urinary norepinephrine and epinephrine elevation in post-traumatic stress disorder , 1987, Psychoneuroendocrinology.