Surís Alina, North Carol, Adinoff Bryon, Powell Craig M, Greene Robert
VA North Texas Health Care System, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75216, USA.
Ann Clin Psychiatry. 2010 Nov;22(4):274-9.
Very few systematic human studies focus on changing the underlying traumatic memory after posttraumatic stress disorder (PTSD) has been established. Evidence from animal and human studies indicates that cortisol can be used to address traumatic memories. This translational pilot study is based on our previous rodent research in which extinction of fear memories was enhanced by glucocorticoids. The current study aims to assess the effectiveness of glucocorticoids in augmenting memory extinction and reducing clinical symptoms in veterans with combat-related PTSD.
In a double-blind, placebo-controlled study, veterans with combat-related PTSD were exposed to a memory reactivation task using well established imagery and psychophysiology assessment technique followed by administration of either glucocorticoid or placebo.
One week after glucocorticoid or placebo administration, participants who received the study medication showed significant PTSD-related symptom (cluster C) improvement compared with control participants who received placebo only. However, reduction of symptoms degraded at a 1-month postadministration assessment.
These findings are consistent with a glucocorticoid-mediated enhancement of extinction to ameliorate PTSD symptoms. The use of traumatic memory reactivation temporally paired with glucocorticoid administration holds potential for developing a viable therapeutic option.
很少有系统的人体研究聚焦于创伤后应激障碍（PTSD）确立后改变潜在的创伤性记忆。动物和人体研究的证据表明，皮质醇可用于处理创伤性记忆。这项转化性初步研究基于我们之前对啮齿动物的研究，在该研究中糖皮质激素增强了恐惧记忆的消退。当前研究旨在评估糖皮质激素增强退伍军人与战斗相关的创伤后应激障碍记忆消退及减轻临床症状的有效性。
在一项双盲、安慰剂对照研究中，与战斗相关的创伤后应激障碍退伍军人通过成熟的意象和心理生理学评估技术接触记忆再激活任务，随后给予糖皮质激素或安慰剂。
在给予糖皮质激素或安慰剂一周后，接受研究药物的参与者与仅接受安慰剂的对照参与者相比，创伤后应激障碍相关症状（C类）有显著改善。然而，在给药后1个月的评估中症状减轻情况有所恶化。
这些发现与糖皮质激素介导的消退增强以改善创伤后应激障碍症状一致。将创伤性记忆再激活与糖皮质激素给药在时间上配对使用，具有开发可行治疗方案的潜力。
