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创伤后应激障碍女性的炎症标志物及其对认知功能的可能影响。

Inflammatory markers and their possible effects on cognitive function in women with posttraumatic stress disorder.

机构信息

Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.

出版信息

J Psychiatr Res. 2018 Jul;102:192-200. doi: 10.1016/j.jpsychires.2018.04.009. Epub 2018 Apr 13.

DOI:10.1016/j.jpsychires.2018.04.009
PMID:29684628
Abstract

Posttraumatic stress disorder (PTSD) has been associated with increased inflammation, albeit with some controversy. Another key feature of PTSD is compromised function in wide-ranging cognitive domains. Increased peripheral inflammation can contribute to cognitive dysfunction, although this relationship has not been studied in patients with PTSD. Here, we examined blood inflammatory markers in adult patients with PTSD compared to healthy controls taking account of potentially confounding effects of childhood maltreatment and comorbid major depressive disorder (MDD), and explored the association between inflammation and cognition. We enrolled 40 women with PTSD, most of whom developed the disorder after interpersonal violence during adulthood, and 65 healthy control women. Diagnoses were made based on DSM-IV. History of childhood maltreatment was assessed using the Childhood Trauma Questionnaire (CTQ). Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Blood samples were collected for the measurement of 5 inflammatory markers including interleukin-6 (IL-6), soluble IL-6 receptor, interleukin-1β, high-sensitivity tumor necrosis factor-α, and high-sensitivity C-reactive protein. Compared to controls, patients with PTSD showed significantly higher IL-6 levels (p = 0.009) and lower scores on all RBANS domains (all p < 0.01). IL-6 levels in patients were not significantly associated with the presence/absence of comorbid MDD or CTQ scores. IL-6 levels in patients were significantly negatively correlated with RBANS visuospatial construction (p = 0.046), language (p = 0.008), attention (p = 0.036) and total score (p = 0.008). These results suggest that elevated IL-6 is associated with PTSD and that the lower cognitive function in PTSD may be due at least partly to increased inflammation.

摘要

创伤后应激障碍(PTSD)与炎症增加有关,但存在一些争议。PTSD 的另一个关键特征是广泛认知领域的功能受损。外周炎症增加会导致认知功能障碍,尽管这一关系尚未在 PTSD 患者中研究过。在这里,我们比较了 PTSD 成年患者与健康对照组的血液炎症标志物,同时考虑了儿童期虐待和共病重度抑郁症(MDD)的潜在混杂影响,并探讨了炎症与认知之间的关系。我们招募了 40 名 PTSD 女性患者,其中大多数在成年后因人际暴力而患上该疾病,以及 65 名健康对照组女性。根据 DSM-IV 进行诊断。使用童年创伤问卷(CTQ)评估儿童期虐待史。使用重复性神经心理状态评估测试(RBANS)评估认知功能。采集血液样本以测量 5 种炎症标志物,包括白细胞介素-6(IL-6)、可溶性 IL-6 受体、白细胞介素-1β、高敏肿瘤坏死因子-α和高敏 C 反应蛋白。与对照组相比,PTSD 患者的 IL-6 水平明显更高(p=0.009),所有 RBANS 领域的得分均较低(均 p<0.01)。患者的 IL-6 水平与共病 MDD 的存在/不存在或 CTQ 评分无显著相关性。患者的 IL-6 水平与 RBANS 视觉空间构建(p=0.046)、语言(p=0.008)、注意力(p=0.036)和总分(p=0.008)呈显著负相关。这些结果表明,升高的 IL-6 与 PTSD 相关,而 PTSD 中较低的认知功能至少部分可能是由于炎症增加所致。

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