Brain Posttraumatic stress disorder

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Nutt, D.J. and Malizia, A.L. 2004. Structural and functional brain changes in posttraumatic stress disorder. J. Clin. Psychiatry, 65 Suppl 1 11-17. 

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Bremner, J.D. 2006. The relationship between cognitive and brain changes in posttraumatic stress disorder. Ann N YAcad Sci 1071 80-6. 

Semple WE, Goyer P, McCormick R. Preliminary report brain blood flow using PET in patients with posttraumatic stress disorder and substance abuse histories. Biol Psychiatry 1993 34 115-118. 

Damage to the blood-brain barrier (BBB) as a result of trauma or disease permits hormones (molecules), such as epinephrine, or toxic substances to reach the brain. Normally, the BBB keeps the contents within blood vessels from reaching the brain. Closely packed endothelial cells line blood vessels. The endothelial cell membrane has transport systems that facilitate the movement of desired molecules and nutrients into the brain, while keeping undesirable molecules out. Damage to the BBB from trauma may be involved in posttraumatic stress disorder. 

An increasing cause of mental dysfunction among soldiers is posttraumatic stress disorder (PTSD), which is becoming more common as a result of the war in Iraq. Of 1.4 million soldiers, 13% have developed PTSD, compared with 20-30% who developed PTSD after the Vietnam War. It is clear that the brain retains images of violent events that can emerge as flashbacks years after the traumatic experiences. 

Positron emission tomography (PET) is another imaging technique that employs radioactive tracers to image brain activity. PET can detect and map the presence of glucose, neurotransmitters, and a dozen other chemicals critical to brain function. Subtle changes in brain structure or function that correlate to diseases have been used to distinguish brain chemistry changes associated with Alzheimer s disease, schizophrenia, alcoholism, anxiety disorders, and posttraumatic stress disorder. PET can also be used to detect emotional responses and perceptions of emotion. 

Psychiatrists prescribe antipsychotics to treat mental illnesses that cause patients to experience marked breaks with reality (psychosis). The most common of such disorders is schizophrenia, which is a chronic, disabling, persistent, and severe brain disease that sigpiificantly impairs brain functioning and affects 1 percent of the world s population, including 3 million people in the United States alone. Antipsychotic medications are referred to as typical or atypical. Psychiatrists prescribe anxiolytics (antianxiety medications) to treat anxiety disorders, which include panic disorder, generalized anxiety disorder, specific phobias, obsessive-compulsive disorder, social anxiety disorder, and posttraumatic stress disorder. Psychiatrists prescribe antidepressants and mood stabilizers to treat the symptoms of mood disorders, the most common and severe of which are major depression and bipolar disorder. 

Bremner, J.D., Elzinga, B., Schmahl, C., et al., 2008. Structural and functional plasticity of the human brain in posttraumatic stress disorder. Prog. Brain Res. 167,171-186. 

Bryant, R.A., Kemp, A.H., Felmingham, K.L., et al., 2008. Enhanced amygdala and medial prefrontal activation during nonconsdous processing of fear in posttraumatic stress disorder an fMRI study. Hum. Brain Mapp. 29,517-523. 

Koenen, K.C., Driver, K.L., Oscar-Berman, M., et al., 2001. Measures of prefrontal system dysfunction in posttraumatic stress disorder. Brain Cogn. 45, 64-78. 

Kroes, M.C., Rugg, M.D., Whalley, M.G., et al., 2011. Structural brain abnormalities common to posttraumatic stress disorder and depression. J. Psychiatry... 

Su, Y.A., Wu, J., Zhang, L., et al, 2008. Dysregulated mitochondrial genes and networks with drug targets in postmortem brain of patients with posttraumatic stress disorder (PTSD) revealed by human mitochondria-focused cDNA microarrays. Int. J. Biol. Sci. 4, 223-235. 

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