Nishi Daisuke, Hashimoto Kenji, Noguchi Hiroko, Hamazaki Kei, Hamazaki Tomohito, Matsuoka Yutaka
Department of Psychiatry, National Disaster Medical Center, 3256 Midoricho, Tachikawa, Tokyo, 190-0014, Japan.
CREST, Japan Science and Technology Agency, 3256 Midoricho, Tachikawa, Tokyo, 190-0014, Japan.
Psychopharmacology (Berl). 2015 Dec;232(23):4261-8. doi: 10.1007/s00213-015-4052-5. Epub 2015 Aug 22.
Accumulating evidence suggests involvement of the glutamatergic system in the biological mechanisms of posttraumatic stress disorder (PTSD), but few studies have demonstrated an association between glutamatergic system abnormalities and PTSD diagnosis or severity.
We aimed to examine whether abnormalities in serum glutamate and in the glutamine/glutamate ratio were associated with PTSD diagnosis and severity in severely injured patients at risk for PTSD and major depressive disorder (MDD).
This is a nested case-control study in TPOP (Tachikawa project for prevention of posttraumatic stress disorder with polyunsaturated fatty acid) trial. Diagnosis and severity of PTSD were assessed 3 months after the accidents using the Clinician-Administered PTSD Scale. The associations of glutamate levels and the glutamine/glutamate ratio with diagnosis and severity of PTSD and MDD were investigated by univariate and multiple linear regression analyses.
Ninety-seven of 110 participants (88 %) completed assessments at 3 months. Serum glutamate levels were significantly higher for participants with full or partial PTSD than for participants without PTSD (p = 0.049) and for participants with MDD than for participants without MDD (p = 0.048). Multiple linear regression analyses showed serum glutamate levels were significantly positively associated with PTSD severity (p = 0.02) and MDD severity (p = 0.03). The glutamine/glutamate ratio was also significantly inversely associated with PTSD severity (p = 0.03), but not with MDD severity (p = 0.07).
These findings suggest that the glutamatergic system may play a major role in the pathogenesis of PTSD and the need for new treatments targeting the glutamatergic system to be developed for PTSD.
越来越多的证据表明谷氨酸能系统参与创伤后应激障碍（PTSD）的生物学机制，但很少有研究证明谷氨酸能系统异常与PTSD诊断或严重程度之间存在关联。
我们旨在研究血清谷氨酸和谷氨酰胺/谷氨酸比值异常是否与有患PTSD和重度抑郁症（MDD）风险的重伤患者的PTSD诊断及严重程度相关。
这是一项在TPOP（多不饱和脂肪酸预防创伤后应激障碍立川项目）试验中的巢式病例对照研究。事故发生3个月后，使用临床医生管理的PTSD量表评估PTSD的诊断和严重程度。通过单变量和多元线性回归分析研究谷氨酸水平和谷氨酰胺/谷氨酸比值与PTSD和MDD诊断及严重程度之间的关联。
110名参与者中有97名（88%）在3个月时完成了评估。患有完全或部分PTSD的参与者的血清谷氨酸水平显著高于无PTSD的参与者（p = 0.049），患有MDD的参与者的血清谷氨酸水平显著高于无MDD的参与者（p = 0.048）。多元线性回归分析显示血清谷氨酸水平与PTSD严重程度显著正相关（p = 0.02）和MDD严重程度显著正相关（p = 0.03）。谷氨酰胺/谷氨酸比值也与PTSD严重程度显著负相关（p = 0.03），但与MDD严重程度无关（p = 0.07）。
这些发现表明谷氨酸能系统可能在PTSD发病机制中起主要作用，并且需要开发针对谷氨酸能系统的新治疗方法来治疗PTSD。
