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创伤后应激障碍中炎症、神经生物学和认知功能的失调:综合述评。

Dysregulation of inflammation, neurobiology, and cognitive function in PTSD: an integrative review.

机构信息

Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642, USA.

Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.

出版信息

Cogn Affect Behav Neurosci. 2020 Jun;20(3):455-480. doi: 10.3758/s13415-020-00782-9.

Abstract

Compelling evidence from animal and human research suggest a strong link between inflammation and posttraumatic stress disorder (PTSD). Furthermore, recent findings support compromised neurocognitive function as a key feature of PTSD, particularly with deficits in attention and processing speed, executive function, and memory. These cognitive domains are supported by brain structures and neural pathways that are disrupted in PTSD and which are implicated in fear learning and extinction processes. The disruption of these supporting structures potentially results from their interaction with inflammation. Thus, the converging evidence supports a model of inflammatory dysregulation and cognitive dysfunction as combined mechanisms underpinning PTSD symptomatology. In this review, we summarize evidence of dysregulated inflammation in PTSD and further explore how the neurobiological underpinnings of PTSD, in the context of fear learning and extinction acquisition and recall, may interact with inflammation. We then present evidence for cognitive dysfunction in PTSD, highlighting findings from human work. Potential therapeutic approaches utilizing novel pharmacological and behavioral interventions that target inflammation and cognition also are discussed.

摘要

动物和人类研究的有力证据表明,炎症与创伤后应激障碍(PTSD)之间存在很强的关联。此外,最近的研究结果支持神经认知功能受损是 PTSD 的一个关键特征,特别是在注意力、处理速度、执行功能和记忆方面存在缺陷。这些认知领域由大脑结构和神经通路支持,而 PTSD 会破坏这些结构和通路,并与恐惧学习和遗忘过程有关。这些支持结构的破坏可能是由于它们与炎症的相互作用。因此,这些汇聚的证据支持炎症失调和认知功能障碍作为 PTSD 症状的共同机制的模型。在这篇综述中,我们总结了 PTSD 中炎症失调的证据,并进一步探讨了 PTSD 中神经生物学基础,在恐惧学习和遗忘获取和回忆的背景下,可能与炎症相互作用。然后,我们介绍了 PTSD 中的认知功能障碍,强调了人类研究的发现。还讨论了利用针对炎症和认知的新型药理学和行为干预措施的潜在治疗方法。

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