Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven.
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
JAMA Psychiatry. 2013 Nov;70(11):1199-1205. doi: 10.1001/jamapsychiatry.2013.399.
Animal data suggest that chronic stress is associated with a reduction in norepinephrine transporter (NET) availability in the locus coeruleus. However, it is unclear whether such models are relevant to posttraumatic stress disorder (PTSD), which has been linked to noradrenergic dysfunction in humans.
To use positron emission tomography and the radioligand [11C]methylreboxetine to examine in vivo NET availability in the locus coeruleus in the following 3 groups of individuals: healthy adults (HC group), adults exposed to trauma who did not develop PTSD (TC group), and adults exposed to trauma who developed PTSD (PTSD group) and to evaluate the relationship between NET availability in the locus coeruleus and a contemporary phenotypic model of PTSD symptoms.
DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional positron emission tomography study under resting conditions at academic and Veterans Affairs medical centers among 56 individuals in the following 3 study groups: HC (n = 18), TC (n = 16), and PTSD (n = 22).
The [11C]methylreboxetine-binding potential of NET availability in the locus coeruleus and the severity of PTSD symptoms assessed using the Clinician-Administered PTSD Scale.
The PTSD group had significantly lower NET availability than the HC group (41% lower, Cohen d = 1.07). NET availability did not differ significantly between the TC and HC groups (31% difference, Cohen d = 0.79) or between the TC and PTSD groups (15% difference, Cohen d = 0.28). In the PTSD group, NET availability in the locus coeruleus was independently positively associated with the severity of anxious arousal (ie, hypervigilance) symptoms (r = 0.52) but not with any of the other PTSD symptom clusters.
These results suggest that PTSD is associated with significantly reduced NET availability in the locus coeruleus and that greater NET availability in this brain region is associated with increased severity of anxious arousal symptoms in individuals with PTSD.
动物数据表明，慢性应激与蓝斑核去甲肾上腺素转运体（NET）的可用性降低有关。然而，目前尚不清楚这些模型是否与创伤后应激障碍（PTSD）相关，后者与人类的去甲肾上腺素能功能障碍有关。
使用正电子发射断层扫描和放射性配体 [11C] 甲基麦角灵来检查以下 3 组个体的蓝斑核中 NET 的体内可用性：健康成年人（HC 组）、暴露于创伤但未发展为 PTSD 的成年人（TC 组）和暴露于创伤后发展为 PTSD 的成年人（PTSD 组），并评估蓝斑核中 NET 的可用性与 PTSD 症状的当代表型模型之间的关系。
设计、地点和参与者：在学术和退伍军人事务医疗中心进行的横断面正电子发射断层扫描研究，在以下 3 个研究组中的 56 名个体中进行：HC（n=18）、TC（n=16）和 PTSD（n=22）。
使用临床医生管理的 PTSD 量表评估蓝斑核中 NET 可用性的 [11C] 甲基麦角灵结合潜能和 PTSD 症状的严重程度。
与 HC 组相比，PTSD 组的 NET 可用性明显降低（低 41%，Cohen d=1.07）。TC 组与 HC 组之间（差异低 31%，Cohen d=0.79）或 TC 组与 PTSD 组之间（差异低 15%，Cohen d=0.28）的 NET 可用性无显著差异。在 PTSD 组中，蓝斑核中的 NET 可用性与焦虑唤醒（即警觉）症状的严重程度呈独立正相关（r=0.52），但与 PTSD 的任何其他症状群均无关。
这些结果表明，PTSD 与蓝斑核中 NET 可用性显著降低有关，而该脑区的 NET 可用性增加与 PTSD 个体中焦虑唤醒症状的严重程度增加有关。
