Neurological status of Vietnam veterans with chronic posttraumatic stress disorder

Veterans Affairs Medical Center, Manchester, New Hampshire 03103.
Journal of Neuropsychiatry (Impact Factor: 2.77). 02/1993; 5(2):183-8.
Source: PubMed

ABSTRACT This study investigated neurological status in 27 medication-free outpatient Vietnam veterans meeting DSM-III-R criteria for posttraumatic stress disorder (PTSD) and 15 non-PTSD combat control subjects, all without alcohol or drug dependence or abuse during the past year. Subjects underwent neurological examination, neuropsychological testing, and sleep-deprived EEG. PTSD subjects showed significantly more neurological soft signs than non-PTSD subjects. Neither substance dependence/abuse nor the more frequent history of developmental problems in PTSD subjects accounted for this difference. There were no significant EEG or neuropsychological testing group differences; however, there were significant correlations between several neuropsychological test scores and total neurological soft signs.

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    • "DOI: 10.1002/jts.21887 Findings in the literature indicate a robust impairment in memory for episodic, emotionally neutral, nonautobiographical information in PTSD (see a meta-analysis by Brewin, Kleiner, Vasterling, & Field, 2007), with studies reporting learning (initial and single-trial list learning) and memory deficits (immediate and delayed for verbal and visuospatial information, working memory and executive memory; Bremner et al., 1993, 1995; Gurvits et al., 1993, 1996; Jenkins, Langlais, Delis, & Cohen, 1998; Kanagaratnam & Asbjornsen, 2007; Stein, Kennedy, & Twamley, 2002; Vasterling et al., 2002; Yehuda, Golier, Halligan, & Harvey, 2004; Yehuda et al., 1995). Cognitive impairment in memory of stories, executive function (Beckham, Crawford, & Feldman, 1998), attention (sustained attention, focus of attention and attention shifting), language-and information-processing speed, are more controversial (Isaac, Cushway, & Jones, 2006; Scott, Lesselyong, & Yaffe, 2012). "
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    ABSTRACT: Memory deficits are a common complaint of patients with posttraumatic stress disorder (PTSD). Despite vivid trauma-related memory, previous studies report memory impairment for nontrauma-related stimuli when compared to controls, specifically in associative memory (Guez et al., 2011). Healthy individuals show hemispheric memory asymmetry with left-prefrontal lateralization of encoding and right-prefrontal lateralization of episodic retrieval, suggesting a role for interhemispheric communication in memory-related tasks (Gazzaniga, ; Ringo, Doty, Demeter, & Simard, ). Because brain magnetic resonance imaging (bMRI) studies in PTSD patients report volume changes in various regions, including white matter and corpus callosum (CC), we aimed to test the relationship between memory deficits and CC volume in PTSD patients. We probed for specific alterations in associative memory in PTSD and measured the volume of subportions within the CC employing bMRI. Our main finding was a reduction in CC white-matter volume in PTSD patients, as compared to controls, t(35) = -2.7, p = .010, that was correlated with lower associative performance (r = .76, p = .003). We propose that CC volume reduction is a substrate for the associative memory deficits found in PTSD.
    Journal of Traumatic Stress 02/2014; 27(1). DOI:10.1002/jts.21887 · 2.72 Impact Factor
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    • "Classical measures of flexibility and switching include the Trail-Making Test (TMT, Partington and Leiter, 1949; Reynolds, 2002; Delis, et al 2001; Reitan, 1958), involving connection of " dots " while switching between letter and number (i.e., 1-A- 2-B-3-C), and verbal fluency switching (as in the Delis-Kaplan Executive Function Scale [D-KEFS]) (Delis et al., 2001), involving the production of words while switching between two categories. Some studies with PTSD have reported impairment (e.g., increased time on TMT; decreased total words on fluency) on such tasks (Stein et al., 2002; Beckham et al., 1998; Jenkins et al., 2000), while others have not (Zalewski et al., 1994; Twamley et al., 2004, 2009; Lagarde et al., 2010; Barrett et al., 1996; Crowell et al., 2002; Gurvits et al., 1993; Leskin and White, 2007). Executive function measures involving the added dimensions of planning and strategy use include, among others, the Wisconsin Card-Sorting Test (WCST) (Heaton, 1981) and Tower of London Task (Simon, 1975; Shallice, 1982). "
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    ABSTRACT: Neuropsychological approaches represent an important avenue for identifying susceptibility and resiliency factors relating to the development and maintenance of posttraumatic stress disorder (PTSD) symptoms post-trauma. This review will summarize results from prospective longitudinal and retrospective cross-sectional studies investigating executive function associated with PTSD. This research points specifically towards subtle impairments in response inhibition and attention regulation that may predate trauma exposure, serve as risk factors for the development of PTSD, and relate to the severity of symptoms. These impairments may be exacerbated within emotional or trauma-related contexts, and may relate to dysfunction within dorsal prefrontal networks. A model is presented concerning how such impairments may contribute to the clinical profile of PTSD and lead to the use of alternative coping styles such as avoidance. Further neuropsychological research is needed to identify the effects of treatment on cognitive function and to potentially characterize mechanisms of current PTSD treatments. Knowledge gained from cognitive and neuroscientific research may prove valuable for informing the future development of novel, more effective, treatments for PTSD. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.
    Neuropharmacology 02/2011; 62(2):686-94. DOI:10.1016/j.neuropharm.2011.02.008 · 4.82 Impact Factor
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    • "In experimental settings, the terms ''explicit memory " and ''implicit memory " refer to the recall or recognition of data that are expressed with and without awareness of encoding. Many studies of individuals with PTSD have reported decreased performances on verbal memory and learning (Gurvits et al., 1993; Jenkins et al., 1998; Uddo et al., 1993; Vasterling et al., 1998, 2002). Although the deficits are commonly mild, delayed free recall has been found to be more frequently impaired than cued recall and recognition, which require less data manipulation. "
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    ABSTRACT: In this paper, we look back at some of the earliest psychoanalytic approaches to trauma. The theoretical feasibility of reconciling psychoanalytic and neurobiological accounts of the effects of severe stress is examined. First, several epistemic considerations about the concepts of falsifiability and complexity in science are discussed with regard to neuroscience and psychoanalysis. We report the decisive discussions and descriptions of shell shock and hysteria that laid the foundation for the modern notions of dissociation and posttraumatic stress disorder (PTSD). We particularly underline the differences between "traumatic memory", which merely and unconsciously repeats the past, and "narrative memory", which narrates the past as past. Then, the construction of the modern concept of PTSD is described and the classification of conversion and dissociative disorders is questioned. In the next section, several recent neurobiological findings in patients with PTSD are reviewed. We place particular emphasis on cognitive impairment and cognitive bias relative to threatening stimuli, and on a general pattern of facilitated and heightened activation of the amygdala for threat-related stimuli, which are both recognized symptoms of PTSD. A possible meeting point between Cannon's and Freud's theoretical concepts is discussed in the frame of a deregulation of the stress system which helps not only to regulate homeostasis but also to adjust behaviour to external threats. We conclude that, although psychoanalysis and neuroscience may reciprocally complement and enlighten each other, their objects and methods, and thence their concepts, are fundamentally different.
    Journal of Physiology-Paris 09/2010; 104(6):296-302. DOI:10.1016/j.jphysparis.2010.09.003 · 2.35 Impact Factor
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