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创伤后应激障碍(PTSD)的临床治疗策略及神经机制。

Clinical Therapeutic Strategy and Neuronal Mechanism Underlying Post-Traumatic Stress Disorder (PTSD).

机构信息

Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai 980-8578, Japan.

出版信息

Int J Mol Sci. 2019 Jul 24;20(15):3614. doi: 10.3390/ijms20153614.

Abstract

Post-traumatic stress disorder (PTSD) is characterized by an exaggerated response to contextual memory and impaired fear extinction, with or without mild cognitive impairment, learning deficits, and nightmares. PTSD is often developed by traumatic events, such as war, terrorist attack, natural calamities, etc. Clinical and animal studies suggest that aberrant susceptibility of emotion- and fear-related neurocircuits, including the amygdala, prefrontal cortex (PFC), and hippocampus may contribute to the development and retention of PTSD symptoms. Psychological and pharmacological therapy, such as cognitive behavioral therapy (CBT), and treatment with anti-depressive agents and/or antipsychotics significantly attenuate PTSD symptoms. However, more effective therapeutics are required for improvement of quality of life in PTSD patients. Previous studies have reported that ω3 long-chain polyunsaturated fatty acid (LCPUFA) supplements can suppress the development of PTSD symptoms. Fatty acid binding proteins (FABPs) are essential for LCPUFA intracellular trafficking. In this review, we have introduced null mice as an animal model of PTSD with impaired fear extinction. Moreover, we have addressed the neuronal circuits and novel therapeutic strategies for PTSD symptoms.

摘要

创伤后应激障碍(PTSD)的特征是对情境记忆的反应过度,恐惧消退受损,伴有或不伴有轻度认知障碍、学习缺陷和噩梦。PTSD 通常由创伤事件引起,如战争、恐怖袭击、自然灾害等。临床和动物研究表明,情绪和恐惧相关神经回路的异常易感性,包括杏仁核、前额叶皮层(PFC)和海马体,可能导致 PTSD 症状的发展和持续。心理和药理学治疗,如认知行为疗法(CBT)以及抗抑郁药和/或抗精神病药的治疗,显著减轻 PTSD 症状。然而,需要更有效的治疗方法来提高 PTSD 患者的生活质量。先前的研究报告称,ω3 长链多不饱和脂肪酸(LCPUFA)补充剂可以抑制 PTSD 症状的发展。脂肪酸结合蛋白(FABPs)是 LCPUFA 细胞内转运所必需的。在这篇综述中,我们介绍了作为恐惧消退受损的 PTSD 动物模型的 null 小鼠。此外,我们还讨论了 PTSD 症状的神经元回路和新的治疗策略。

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