Purpose of Review
Posttraumatic stress disorder (PTSD) is characterized by hyperarousal and recurrent stressful memories after an emotionally traumatic event. Extensive research has been conducted to identify the neurobiological determinants that underlie the pathophysiology of PTSD. In this review, we examine evidence regarding the molecular and cellular pathophysiology of PTSD focusing on two primary brain regions: the vmPFC and the amygdala.
This discussion includes a review of the molecular alterations related to PTSD, focusing mainly on changes to glucocorticoid receptor signaling. We also examine postmortem gene expression studies that have been conducted to date and the molecular changes that have been observed in peripheral blood studies of PTSD patients. Causal, mechanistic evidence is difficult to obtain in human studies, so we also review preclinical models of PTSD.
Integration of peripheral blood and postmortem studies with preclinical models of PTSD has begun to reveal the molecular changes occurring in patients with PTSD. These findings indicate that the pathophysiology of PTSD includes disruption of glucocorticoid signaling and inflammatory systems and occurs at the level of altered gene expression. We will assess the impact of these findings on the future of PTSD molecular research.
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Dr. Duman receives grant support from the National Institute of Mental Health, the VA National Center for PTSD, the VA National PTSD Brain Bank, and the Connecticut Mental Health Center. Dr. Girgenti receives grant support from the National Institute on Drug Abuse through the Yale Neuroproteomics Center.
Conflict of Interest
Matthew J. Girgenti, Brendan D. Hare, and Sriparna Ghosal declare that they have no conflict of interest.
Ronald S. Duman has consulted and/or received research support from Naurex, Lilly, Forest, Johnson & Johnson, Taisho, and Sunovion.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
This article is part of the Topical Collection on Disaster Psychiatry: Trauma, PTSD, and Related Disorders
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Girgenti, M.J., Hare, B.D., Ghosal, S. et al. Molecular and Cellular Effects of Traumatic Stress: Implications for PTSD. Curr Psychiatry Rep 19, 85 (2017). https://doi.org/10.1007/s11920-017-0841-3
- Glucocorticoid signaling
- Prefrontal cortex
- Animal models of PTSD