Traumatic stress: Effects on the brain

Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Ga 30306, USA.
Dialogues in clinical neuroscience 02/2006; 8(4):445-61.
Source: PubMed


Brain areas implicated in the stress response include the amygdala, hippocampus, and prefrontal cortex. Traumatic stress can be associated with lasting changes in these brain areas. Traumatic stress is associated with increased cortisol and norepinephrine responses to subsequent stressors. Antidepressants have effects on the hippocampus that counteract the effects of stress. Findings from animal studies have been extended to patients with post-traumatic stress disorder (PTSD) showing smaller hippocampal and anterior cingulate volumes, increased amygdala function, and decreased medial prefrontal/anterior cingulate function. In addition, patients with PTSD show increased cortisol and norepinephrine responses to stress. Treatments that are efficacious for PTSD show a promotion of neurogenesis in animal studies, as well as promotion of memory and increased hippocampal volume in PTSD.

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    • "However, the pathophysiological mechanisms underlying the development of neurobiological consequences of childhood trauma and its relationship to development of psychiatric illness have not been fully elucidated. Disruption of the hypothalamic-pituitaryadrenal (HPA) axis with subsequent cortisol induced toxicity has been proposed as one mechanism for some of the observed neuroimaging differences in this population (Bremner, 2006, 1999; Marin et al., 2007; McCrory et al., 2010). Another proposed mechanism is a trauma-induced inflammatory response which could lead to neuronal injury (Herberth et al., 2008; Miller et al., 2009). "
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    ABSTRACT: Serum levels of the astrocytic protein S100B have been reported to indicate disruption of the blood-brain barrier. In this study, we investigated the relationship between S100B levels and childhood trauma in a child psychiatric inpatient unit. Levels of S100B were measured in a group of youth with mood disorders or psychosis with and without history of childhood trauma as well as in healthy controls. Study participants were 93 inpatient adolescents admitted with a diagnosis of psychosis (N = 67), or mood disorder (N = 26) and 22 healthy adolescents with no history of trauma or psychiatric illness. Childhood trauma was documented using the Life Events Checklist (LEC) and Adverse Child Experiences (ACE). In a multivariate regression model, suicidality scores and trauma were the only two variables which were independently related to serum S100B levels. Patients with greater levels of childhood trauma had significantly higher S100B levels even after controlling for intensity of suicidal ideation. Patients with psychotic diagnoses and mood disorders did not significantly differ in their levels of S100B. Patients exposed to childhood trauma were significantly more likely to have elevated levels of S100B (p < .001) than patients without trauma, and patients with trauma had significantly higher S100B levels (p < .001) when compared to the control group. LEC (p = 0.046), and BPRS-C suicidality scores (p = 0.001) significantly predicted S100B levels. Childhood trauma can potentially affect the integrity of the blood-brain barrier as indicated by associated increased S100B levels. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Journal of Psychiatric Research 12/2014; 62. DOI:10.1016/j.jpsychires.2014.12.002 · 3.96 Impact Factor
    • "Studies in psychiatric patients report associations between HPA axis dysregulation and reduced HV (O'Brien et al., 2004; Swaab et al., 2005; Bremner, 2006; Karl et al., 2006). Among healthy populations, studies have revealed that smaller HV is associated with higher basal cortisol levels in young (Wolf et al., 2002; Vythilingam et al., 2004) and older adults (Lupien et al., 1998; Wolf et al., 2002; O'Hara et al., 2007; Bruehl et al., 2009; Knoops et al., 2010). "
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    ABSTRACT: The hypothalamic pituitary adrenal axis production of the stress hormone cortisol interacts with the hippocampal formation and impacts memory function. A growing interest is to determine whether hippocampal volume (HV) predicts basal and/or reactive cortisol levels in young and older adults. Recent evidence shows that contextual features in testing environments might be stressful and inadvertently induce a stress response in young and/or older populations. This latter result suggests that variations in testing environments might influence associations between HV and cortisol levels in young and older adults. To this end, we investigated 28 healthy young adults (ages 18 to 35) and 32 healthy older adults (ages 60 to 75) in two different environments constructed to be more or less stressful for each age group (Favouring-Young versus Favouring-Old conditions). Cortisol levels were repeatedly assessed in each environment, and young and older participants underwent an anatomical magnetic resonance imaging scan for subsequent assessment of HV. Results in both age groups showed that HV was significantly associated with cortisol levels only in the unfavourable stressful testing conditions specific for each age group. This association was absent when testing environments were designed to decrease stress for each age group. These findings are fundamental in showing that unless the nature of the testing environment is taken into consideration, detected associations between HV and cortisol levels in both young and older populations might be confounded by environmental stress. © 2014 Wiley Periodicals, Inc.
    Hippocampus 12/2014; 24(12). DOI:10.1002/hipo.22341 · 4.16 Impact Factor
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    • "Increased levels of cortisol may affect both brain structure and function, leading to increased vulnerability to stress-related psychiatric disorders ( Phillips et al., 2006; Frodl and O'Keane, 2013). Indeed, higher cortisol levels in both humans and animals have been associated with hippocampal volume reductions over time, although not consistently (Hibberd et al., 2000; Coe et al., 2003; Brown et al., 2004; Frodl and O'Keane, 2013), and there are possible relations with post-traumatic stress disorder (Bremner, 2006) and early life maltreatment , both being associated with changes in the volume of the hippocampus and prefrontal cortex (Frodl and O'Keane, 2013). Increased cortisol levels and evidence of reduced negative feedback of the HPA axis, as indexed by the combined dexamethasone Contents lists available at ScienceDirect journal homepage: "
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    ABSTRACT: Stress and abnormal hypothalamic-pituitary-adrenal axis functioning have been implicated in the early phase of psychosis and may partly explain reported changes in brain structure. This study used magnetic resonance imaging to investigate whether biological measures of stress were related to brain structure at baseline and to structural changes over the first 12 weeks of treatment in first episode patients (n=22) compared with matched healthy controls (n=22). At baseline, no significant group differences in biological measures of stress, cortical thickness or hippocampal volume were observed, but a significantly stronger relationship between baseline levels of cortisol and smaller white matter volumes of the cuneus and anterior cingulate was found in patients compared with controls. Over the first 12 weeks of treatment, patients showed a significant reduction in thickness of the posterior cingulate compared with controls. Patients also showed a significant positive relationship between baseline cortisol and increases in hippocampal volume over time, suggestive of brain swelling in association with psychotic exacerbation, while no such relationship was observed in controls. The current findings provide some support for the involvement of stress mechanisms in the pathophysiology of early psychosis, but the changes are subtle and warrant further investigation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
    Psychiatry Research: Neuroimaging 11/2014; 231(2). DOI:10.1016/j.pscychresns.2014.11.004 · 2.42 Impact Factor
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