Bolu Abdullah, Balikci Adem, Erdem Murat, Öznur Taner, Çelik Cemil, Uzun Özcan
Department of Psychiatry, Aircrew Health Research and Training Center, Eskişehir, Turkey.
Department of Psychiatry, Gülhane Military Medical Academy, Ankara, Turkey.
Noro Psikiyatr Ars. 2015 Mar;52(1):73-77. doi: 10.5152/npa.2015.7031. Epub 2015 Mar 1.
Hyperarousal and alertness play an important role in the clinical presentation of Post-traumatic stress disorder (PTSD). Strenuous effort has been made to shed light on the mechanisms that cause these symptoms of patients. Based on the claim that there is a relationship between some subtypes of hyperarousal symptoms and aggression in patients with PTSD, we aimed to examine the relationship between electrophysiological measurements that was measured through transcranial magnetic stimulation (TMS) and aggression scale scores of PTSD patients in this study.
The study included 37 patients with a diagnosis of PTSD according to DSM-IV criteria and 25 healthy volunteers. Electrophysiological measurements of participants were made with TMS. The Buss Perry Aggression Questionnaires was administered to patients and control group.
In the patient group, a positive correlation was found between scores of aggression and arousal symptoms. Motor excitability threshold, one of TMS measurements, which is a sign of cortical excitability, was significantly lower in the patient group than the control group. There was a negative correlation between aggression scale scores and the parameters of motor excitability threshold and cortical silent period which both shows cortical excitability of the patients.
We concluded that there was an increase in cortical excitability in PTSD patients and we suggest that this increase might be associated with hyperarousal symptoms and aggressive behavior.
过度觉醒和警觉在创伤后应激障碍（PTSD）的临床表现中起着重要作用。人们已做出巨大努力来阐明导致患者出现这些症状的机制。基于PTSD患者某些过度觉醒症状亚型与攻击性之间存在关联这一观点，我们旨在本研究中探讨通过经颅磁刺激（TMS）测量的电生理指标与PTSD患者攻击性量表得分之间的关系。
该研究纳入了37例根据《精神疾病诊断与统计手册》第四版（DSM-IV）标准诊断为PTSD的患者以及25名健康志愿者。采用TMS对参与者进行电生理测量。对患者和对照组进行了巴斯-佩里攻击性问卷测试。
在患者组中，攻击性得分与觉醒症状之间存在正相关。作为皮质兴奋性指标之一的TMS测量指标——运动兴奋性阈值，在患者组中显著低于对照组。攻击性量表得分与反映患者皮质兴奋性的运动兴奋性阈值和皮质静息期参数之间存在负相关。
我们得出结论，PTSD患者存在皮质兴奋性增加的情况，并且我们认为这种增加可能与过度觉醒症状及攻击性行为有关。
