New PTSD study identifies potential path to treatment

July 18, 2017 by Bill Hathaway, Yale University
New PTSD study identifies potential path to treatment
PET images indicating higher mGluR5 receptor availability in an individual with PTSD vs. a healthy comparison participant. Credit: Yale University

A study of post-traumatic stress disorder (PTSD)—conducted by the VA National Center for PTSD (NCPTSD), National PTSD Brain Bank, and Yale University—has identified a new potential mechanism contributing to the biology of the disorder that may be targeted by future treatments.

Among combat veterans, PTSD is a common and disabling condition that is associated with high suicide risk, and in some cases it is difficult to treat effectively. Patients—civilians with significant trauma history and veterans with combat-related or civilian trauma history—are commonly treated with a combination of psychological therapy and medications aimed at alleviating diverse symptoms, such as hyper-arousal and depression.

At present, there are two medications approved by the FDA for the treatment of PTSD symptoms, but the limited effectiveness of these medications results in patients being treated frequently with multiple medications that are not specifically approved for PTSD, note the researchers.

"We really need to examine what is happening at a molecular level so we can start developing novel efficacious therapies," said Sophie Holmes, postdoctoral research associate in the Yale Department of Psychiatry and lead author of the study published in the Proceedings of the U.S. National Academy of Sciences.

The study, led by NCPTSD and Yale psychiatrist Irina Esterlis, is the first to implicate a specific alteration in brain glutamate signaling in PTSD. Glutamate is a chemical messenger of brain signals, and alterations in glutamate levels in PTSD were described previously. The new study reports that positron emission tomography (PET) scans show increased levels of a subtype of glutamate receptor in the brain, metabotropic glutamate receptor-5 (mGluR5), in patients with PTSD. In animals, overstimulation of mGluR5 is associated with fear and stress-related behaviors; drugs that reduce mGluR5 function may reduce these symptoms. Thus, the current study may have implications for the treatment of PTSD, said the researchers.

This study also provided potential insights into how the increases in mGluR5 might arise. A novel and important feature of this study, according to the researchers, is that it is the first to link brain chemistry findings in patients with PTSD, as measured through PET scans, to detailed molecular analyses of brain changes in PTSD that can only be conducted in tissue that has been donated by veterans or their families for research purposes. The analyses, conducted in the laboratory of Yale psychiatrist Ronald Duman, found a clue at the level of gene expression, or the conversion of DNA to RNA. Messenger RNA (mRNA) levels of mGluR5 were not increased, but mRNA levels that code for the Shank1 protein were increased. Shank1 "activates" mGluR5 by linking them to the cell surface. The PET scans may have detected higher mGluR5 availability at the cell surface in PTSD.

"This study is one of the first examples to highlight the importance of the new National PTSD Brain Bank in enabling us to study the biology of PTSD at a deeper level. We have a long way to go to understand the complex neurobiology of PTSD, but these new research approaches should have a significant impact on the field," said Esterlis.

Explore further: PTSD may be physical and not only psychological

More information: Sophie E. Holmes et al. Altered metabotropic glutamate receptor 5 markers in PTSD: In vivo and postmortem evidence, Proceedings of the National Academy of Sciences (2017). DOI: 10.1073/pnas.1701749114

Individuals or families seeking information about the National PTSD Brain Bank may visit its website or call 800-762-6609.

Related Stories

PTSD may be physical and not only psychological

July 11, 2017
The part of the brain that helps control emotion may be larger in people who develop post-traumatic stress disorder (PTSD) after brain injury compared to those with a brain injury without PTSD, according to a study released ...

Some patients with dementia may experience delayed-onset PTSD

July 7, 2017
Delayed-onset post-traumatic symptoms in the elderly may be misdiagnosed as falling under the umbrella of behavioural and psychological symptoms of dementia (BPSD), according to a recent review.

Veterans with PTSD have an increased 'fight or flight' response

May 15, 2017
Young veterans with combat-related post-traumatic stress disorder (PTSD) have an increased 'fight or flight' response during mental stress, according to new findings published this week in the Journal of Physiology.

Study reveals areas of the brain impacted by PTSD

January 23, 2017
Researchers at Boston University School of Medicine (BUSM) and the VA Boston Healthcare System are one step closer to understanding the specific nature of brain changes associated with Posttraumatic Stress Disorder (PTSD).

Sexual problems may be affected by evidence-based psychotherapy for PTSD

April 6, 2017
The National Center for Post-Traumatic Stress Disorder (PTSD) has published the research findings of a University of Kentucky researcher in its latest issue of the Clinician's Trauma Update. Assistant Professor of Psychology ...

PTSD, certain prescriptions for PTSD may raise risk for dementia

May 8, 2017
Researchers are discovering that post-traumatic stress disorder (PTSD) is a significant risk factor in developing dementia. Dementia is a memory problem that affects a person's ability to carry out usual tasks. Dementia is ...

Recommended for you

Neuroimaging study reveals 'hot spot' for cue-reactivity in substance-dependent population

November 20, 2018
When patients with dependence on alcohol, cocaine or nicotine are shown drug cues, or images related to the substance, an area of their brain known as the medial prefrontal cortex (mPFC) shows increased activity, report investigators ...

Being fair: The benefits of early child education

November 20, 2018
Children from low-income families who got intensive education early in life treat others with high levels of fairness in midlife, more than 40 years later, even when being fair comes at a high personal cost, according to ...

Does Netflix's '13 Reasons Why' influence teen suicide? Survey asks at-risk youths

November 20, 2018
A significant proportion of suicidal teens treated in a psychiatric emergency department said that watching the Netflix series "13 Reasons Why" had increased their suicide risk, a University of Michigan study finds.

MDMA makes people cooperative, but not gullible

November 19, 2018
New research from King's College London has found that MDMA, the main ingredient in ecstasy, causes people to cooperate better—but only with trustworthy people. In the first study to look in detail at how MDMA impacts cooperative ...

Exploring the genetic contribution to suicide risk

November 19, 2018
Researchers at University of Utah Health identified four gene changes that occur more frequently in people who died by suicide that may point to increased risk in vulnerable individuals.

Response to daily stressors could affect brain health in older adults

November 19, 2018
Taking typical daily annoyances such as a long wait at the doctor's office or a traffic jam on the freeway in stride may help preserve brain health in older adults, while emotional reactions could contribute to declines in ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.