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Review
. 2011;13(3):263-78.
doi: 10.31887/DCNS.2011.13.2/jsherin.

Post-traumatic stress disorder: the neurobiological impact of psychological trauma

Jonathan E Sherin  1 , Charles B Nemeroff
Affiliations
Review

Post-traumatic stress disorder: the neurobiological impact of psychological trauma

Jonathan E Sherin et al. Dialogues Clin Neurosci. 2011.

Abstract
in English, Spanish, French

The classic fight-or-flight response to perceived threat is a reflexive nervous phenomenon thai has obvious survival advantages in evolutionary terms. However, the systems that organize the constellation of reflexive survival behaviors following exposure to perceived threat can under some circumstances become dysregulated in the process. Chronic dysregulation of these systems can lead to functional impairment in certain individuals who become "psychologically traumatized" and suffer from post-traumatic stress disorder (PTSD), A body of data accumulated over several decades has demonstrated neurobiological abnormalities in PTSD patients. Some of these findings offer insight into the pathophysiology of PTSD as well as the biological vulnerability of certain populations to develop PTSD, Several pathological features found in PTSD patients overlap with features found in patients with traumatic brain injury paralleling the shared signs and symptoms of these clinical syndromes.

La clâsica respuesta de ataque o huida ante la perceptión de una amenaza es un fenómeno nervioso reflejo que, obviamente en términos evolutivos, tiene ventajas para la supervivencia. Sin embargo, los sistemas que organizan la constelación de conductas reflejas de supervivencia que siguen a la exposición a la amenaza percibida en algunas circunstancias pueden constituirse en procesos mal regulados. La mala regulatión crónica de estos sistemas puede llevar a un deterioro funcional en ciertos individuos quienes pueden convertirse en “traumatizados psicológicamente” y presentar un trastorno por estrés postraumático (TEPT), Una gran cantidad de informatión acumulada en varias décadas ha demostrado alteraciones neurobiológicas en los patientes con TEPT, Algunos de estos hallazgos permiten adentrarse en la fisiopatologia asi como en la vulnerabilidad biológica de ciertas poblaciones que van a desarrollar un TEPT Algunas caracteristicas patológicas encontradas en patientes con TEPT se sobreponen con caracteristicas de patientes con daño cerebral traumático, estableciendo un paralelo de signos y sintomas compartidos entre estos sindromes clinicos.

La réponse classique de lutte ou de fuite à une menace perçue est un phénomène nerveux réflexe dont les avantages pour la survie sont évidents en termes d'évolution. Cependant, les systèmes organisés en constellation de comportements réflexes de survie après exposition à une menace perçue peuvent se déréguler dans certaines circonstances. Une dysregulation chronique de ces systèmes peut entraîner un déficit fonctionnel chez certains sujets qui deviennent « psychologiquement traumatisés » ef souffrent de l'état de stress posi-traumatique (ESPT), Des données recueillies pendant des dizaines d'années montrent des anomalies neurobiologiques chez les patients souffrant d'ESPT, ce qui permet de mieux comprendre la physiopathologie de l'ESPT ainsi que la vulnérabilité biologique de certaines populations à développer un ESPT, Certaines caractéristiques pathologiques de l'ESPT se superposent à celles trouvées chez des patients atteints de lésion cérébrale traumatique, en parallèle avec les signes et les symptômes partagés par ces deux syndromes.

Keywords: PTSD; biological markers; pathophysiology; psychological trauma; psychopathology; stress; traumatic brain injury.

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Figures

Figure 1.
Figure 1.. The hypothalamic-pituitary-adrenal axis is the body's major response system for stress. The hypothalamus secretes CRH, which binds to receptors on pituitary cells, which produce/release ACTH, which is transported to the adrenal gland where adrenal hormones such as Cortisol are produced/released. The release of Cortisol activates sympathetic nervous pathways and generates negative feedback to both the hypothalamus and the anterior pituitary. This negative feedback system appears to be compromised in patients with post-traumatic stress disorder. CRH, corticotropin-releasing hormone; ACTH, adrenocorticotropin
See this image and copyright information in PMC

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