Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Departamento de Psiquiatria, Escola de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. Laboratório de Psiquiatria Molecular, Centro de Pesquisa Experimental (CPE), Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil. Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil.
Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Departamento de Psiquiatria, Escola de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Trends Psychiatry Psychother. 2021 Jul-Sep;43(3):167-176. doi: 10.47626/2237-6089-2020-0099. Epub 2021 Apr 16.
Neuroprogression has been proposed as the pathological rewiring of the brain that takes place in parallel with clinical and neurocognitive deterioration in the course of psychiatric disorders. This study aims to review the biological underpinnings and clinical outcomes related to neuroprogression in post-traumatic stress disorder (PTSD).
We performed a systematic review by searching PubMed, Embase, and Web of Science for articles published between January 1, 1960, and January 6, 2020. Inclusion criteria were met when articles assessed brain changes, neurocognition, functioning, inflammation, oxidative stress, and neurotrophins in patients with PTSD. Narrative review articles, case reports, and preclinical studies were excluded.
A total of 965 abstracts were identified and 15 articles were included in our systematic review. It seems that for a subset of patients whose symptoms worsen or are maintained at a high intensity there is a progressive change in the frontal lobe, especially the prefrontal cortex, and worsening of both neurocognition (verbal memory and facial recognition) and functioning (physical, psychological, social and environmental).
Although current findings associate progressive reduction in frontal lobe size with neurocognitive impairment, further research is needed to characterize PTSD as a neuroprogressive disorder.
神经进展被认为是精神障碍过程中与临床和神经认知恶化并行发生的大脑病理性重塑。本研究旨在综述与创伤后应激障碍（PTSD）中神经进展相关的生物学基础和临床结果。
我们通过检索 PubMed、Embase 和 Web of Science，对 1960 年 1 月 1 日至 2020 年 1 月 6 日期间发表的文章进行了系统综述。当文章评估 PTSD 患者的大脑变化、神经认知、功能、炎症、氧化应激和神经营养因子时，符合纳入标准。排除叙事性综述文章、病例报告和临床前研究。
共确定了 965 篇摘要，其中有 15 篇文章被纳入我们的系统综述。似乎对于一部分症状恶化或持续高强度的患者，额叶，特别是前额叶，会发生进行性变化，并且神经认知（言语记忆和面部识别）和功能（身体、心理、社会和环境）都会恶化。
尽管目前的研究结果将额叶大小的进行性减少与神经认知障碍联系起来，但仍需要进一步研究将 PTSD 确定为神经进展性疾病。
