Tagged: PTSD

BUSM Study Reveals Potential Target to Better Treat, Cure Anxiety Disorders

March 6th, 2013 in 2013, News Releases, School of Medicine 0 comments

EMBARGOED FOR RELEASE through 5 p.m. ET, March 5, 2013
Jenny Eriksen Leary, 617-638-6841, jenny.eriksen@bmc.org

(Boston) – Researchers at Boston University School of Medicine (BUSM) have, for the first time, identified a specific group of cells in the brainstem whose activation during rapid eye movement (REM) sleep is critical for the regulation of emotional memory processing. The findings, published in the Journal of Neuroscience, could help lead to the development of effective behavioral and pharmacological therapies to treat anxiety disorders, such as post-traumatic stress disorder, phobias and panic attacks.

There are two main stages of sleep – REM and non-REM – and both are necessary to maintain health and to regulate multiple memory systems, including emotional memory. During non-REM sleep, the body repairs tissue, regenerates cells and improves the function of the body’s immune system. During REM sleep, the brain becomes more active and the muscles of the body become paralyzed. Additionally, dreaming generally occurs during REM sleep, as well as physiological events including saccadic eye movements and rapid fluctuations of respiration, heart rate and body temperature. One particular physiological event, which is a hallmark sign of REM sleep, is the appearance of phasic pontine waves (P-waves). The P-wave is a unique brain wave generated by the activation of a group of glutamatergic cells in a specific region within the brainstem called the pons.

Memories of fearful experiences can lead to enduring alterations in emotion and behavior and sleep plays a natural emotional regulatory role after stressful and traumatic events. Persistence of sleep disturbances, particularly of REM sleep, is predictive of developing symptoms of anxiety disorders. A core symptom of these disorders frequently reported by patients is the persistence of fear-provoking memories that they are unable to extinguish. Presently, exposure therapy, which involves controlled re-exposure to the original fearful experience, is considered one of the most effective evidence-based treatments for anxiety disorders. Exposure therapy produces a new memory, called an extinction memory, to coexist and compete with the fearful memory when the fearful cue/context is re-encountered.

The strength of the extinction memory determines the efficacy of exposure therapy. A demonstrated prerequisite for the successful development of an extinction memory is adequate sleep, particularly REM sleep, after exposure therapy. However, adequate or increased sleep alone does not universally guarantee its therapeutic efficacy.

“Given the inconsistency and unpredictability of exposure therapy, we are working to identify which process(es) during REM sleep dictate the success or failure of exposure therapy,” said Subimal Datta, PhD, director and principle investigator at the Laboratory of Sleep and Cognitive Neuroscience at BUSM who served as the study’s lead author.

The researchers used contextual fear extinction training, which works to turn off the conditioned fear, to study which brain mechanisms play a role in the success of exposure therapy. The study results showed that fear extinction training increased REM sleep. Surprisingly, however, only 57 percent of subjects retained fear extinction memory, meaning that they did not experience the fear, after 24 hours. There was a tremendous increase of phasic P-wave activity among those subjects. In 43 percent of subjects, however, the wave activity was absent and they failed to retain fear extinction memory, meaning that they re-experienced fear.

“The study results provide direct evidence that the activation of phasic P-wave activity within the brainstem, in conjunction with exposure therapy, is critical for the development of long-term retention of fear extinction memory,” said Datta, who also is a professor of psychiatry and neurology at BUSM. In addition, the study indicates the important role that the brainstem plays in regulating emotional memory.

Future research will explore how to activate this mechanism in order to help facilitate the development of new potential pharmacological treatments that will complement exposure therapy to better treat anxiety and other psychological disorders.

According to the National Institute of Mental Health, anxiety disorders affect approximately 40 million American adults each year. While anxiety can sometimes be a normal and beneficial reaction to stress, some people experience excessive anxiety that they are unable to control, which can negatively impact their day to day life.

Research included in this study was supported in part by the National Institutes of Health’s National Institute of Mental Health under grant award number MH 59839 (PI: Datta) and the National Institute of Neurological Disorders and Stroke under grant award number NS 34004 (PI: Datta).

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New approach to help military families with young children

November 20th, 2008 in Military 0 comments

For the first time, the Department of Defense has chosen a School of Social Work to develop a four-year program to help returning soldiers from Iraq and Afghanistan who suffer from post traumatic stress disorder (PTSD) and their young families, particularly those with children under five years old who are in the critical stage of development. Led by Ellen DeVoe, assistant professor at the School of Social Work, the goal is to both examine the impact of deployment stress and combat trauma on military families with young children and then develop long-lasting approaches to deal with issues such as separation and reassimilation.

“We are really focusing on the reintegration piece and what that means for children and parents, and how soldiers can come back into a familiy after they’ve been gone from 6 to 18 months.

“If you think about what that length of separation means for a child from infancy to five years old, they don’t really have a way to understand where this person went, even though we tell them and show them pictures.”

Support for Troops, After Combat

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PTSD and women in combat

October 20th, 2008 in Military 0 comments

Of the 190,000 military women who have served in Iraq and Afghanistan since 2001, 20 percent of them will likely develop post-traumatic stress disorder, (PTSD) a debilitating, life-threatening anxiety disorder. With women returning from combat deployments in greater numbers than ever before in U.S. history, the Department of Veteran Affairs is scrambling to meet a need whose scope is still unknown.

Boston University professors are among the lead investigators of current research being conducted at the VA’s National Center for Post-Traumatic Stress Disorder:

  • Dr. Terence Keane, professor of psychiatry and director of the Behavioral Sciences Division of the National Center for PTSD, developed many of today’s most widely used PTSD assessment tools.
  • Dr. Patricia Resick, a professor of psychiatry and psychology and director of the Women’s Health Services Division of the National Center for PTSD, is researching why women develop PTSD at more than twice the rate of men. She also developed cognitive processing therapy (CPT), a dramatically successful treatment for rape victims and battered women.
  • Amy Street, an assistant professor in psychiatry, leads a VA support team devoted to military sexual trauma (MST). 20% of women report experiencing MST, compared with 1% of men.
  • Suzanne Pineles, an assistant professor or psychiatry and clinical coordinator of the VA’s Women’s Stress Disorder Treatment Team, is exploring the possibility that women may have a biological susceptibility to PTSD.

Read the full article in the Fall 2008 issue of Bostonia.

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