17 In addition to demonstrating enhanced recall for traumatic memories, distressing recollections for those with PTSD are often “vivid” and “long-lasting.” 18 It is in part these “reliving” experiences that take the form of nightmares, intrusive thoughts, and/or flashbacks, coupled with observed
cognitive disturbances that have fostered interest regarding the neurobiological and neuropsychological underpinning of this condition. Despite knowledge that genetic variability, gender, and developmental signaling pathway history appear to impact neurobiological systems and responses to Inhibitors,research,lifescience,medical traumatic stimuli,19 PTSD symptoms are believed to be related to an individual’s dysregulated biological response to stress.20 Table II shows brain regions and neurochemical dysfunction often discussed in association with PTSD symptoms. During traumatically stressful Inhibitors,research,lifescience,medical situations, neurotransmitter systems and neuroendocrine axes are activated.20 According to Langcland and Olff20 research has primarily focused the hypothalamus-pituitary-adrenal (HPA) axis. The sympathetic-adrenomedullary (SAM) system has also been implicated in that it releases epinephrine which facilitates the flight/fight response.21 On the contrary, the contribution of the HPA axis, glucocorticiods, take time to produce. As such
their Inhibitors,research,lifescience,medical impact, which is primarily on the brain, develops and continues over a longer period.21 The SAM and HPA systems are regulated by “limbic brain circuits that involve the amygdala, hippocampus and orbital/medial prefrontal cortex” (p 150).21 Neurobiological activation is thought to impact brain functioning and hypothesized to alter Inhibitors,research,lifescience,medical the structure of brain regions including the amygdala, hippocampus, locus coeruleus, dorsal raphe nucleaus, and prefrontal cortex.22,23 Although activation of these systems supports functioning, chronic activation seems to be problematic in terms of psychological and physical health. Table II. Brain regions and neurochemical dysfunction often discussed in
Inhibitors,research,lifescience,medical association with post-traumatic stress disorder (PTSD) symptoms. Adapted from information presented in ref 66: Hopper JW, Frewen Oxymatrine PA, van der Kolk BA, et al. Neural correlates of reexperiencing, … At the same time, it has been suggested that neurobiological findings (eg, reduced hippocampal volumes) are instead premorbid characteristics that contribute to the development, of PTSD.24 For example, van Zuidcn25 and colleagues found that predeployment glucocorticoid receptor numbers were elevated in soldiers reporting higher PTSD symptoms postdeployment; thereby, highlighting the question of whether such biological differences are pre-existing characteristics, the result of the PTSD, or a combination of the two. Much the same discussion has been had in terms of cognitive dysfunction often noted in those with PTSD.
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