Clinical correlates of plasma brain-derived neurotrophic factor in post-traumatic stress disorder spectrum after a natural disaster
Introduction
Stress-related alterations of Brain-Derived Neurotrophic Factor (BDNF) expression and functioning have been reported both in animal and human studies (Duman and Monteggia, 2006, Machado-Vieira et al., 2007, Savitz et al., 2007, Andero and Ressler, 2012, Rakofsky et al., 2012). Post-Traumatic Stress Disorder (PTSD) represents the prototypical form of stress-induced mental disorder, but only recently BDNF studies in patients with such a diagnosis have been performed with inconsistent observations of lower BDNF plasma (Dell’Osso et al., 2009b) and serum levels (Angelucci et al., 2014), negative results in cerebrospinal fluid (Bonne et al., 2011) and higher levels in serum (Hauck et al., 2010, Matsuoka et al., 2013) and plasma (Zhang et al., 2012).
In previous report on L′Aquila (Italy) earthquake survivors, using a sample categorization based on a dimensional approach of the disorder symptomatology, we found reduced BDNF level in subjects with full blown PTSD but not in those with partial PTSD (Stratta et al., 2013).
Recent efforts have been oriented to explore the prevalence rates and impact of not only full blown PTSD in individuals exposed to a traumatic event but also of partial or subthreshold forms. The concept of partial PTSD was introduced for those subjects who fulfill only a subset of the DSM-IV criteria (B, C or D) for PTSD (Weiss et al., 1992, Stein et al., 1997, Marshall et al., 2001, Breslau et al., 2004, Mylle and Maes, 2004, Hepp et al., 2005). More recently, dimensional approaches to PTSD have also been developed conceptualizing post-traumatic stress reactions as three main dimensions: the nature of the stressor, the possible responses to trauma, including atypical, subthreshold symptoms, and the symptom severity (Dell’Osso et al., 2008, Dell’Osso et al., 2009a).
The spectrum approach represents an important challenge to the PTSD construct, allowing to identify relevant subclinical comorbidities that may contribute either to the “complex” presentation of PTSD or to the frequent behavioral outcomes and complications, such as self-harm behavior and suicidality. Studies on partial PTSD agree in reporting significantly less symptoms severity and functional impairment than in patients with full-blown disorder, but significantly more than in no-PTSD subjects, with an associated need for treatment (Stein et al., 1997, Dell’Osso et al., 2011).
The aim of this controlled study is to investigate the clinical correlates of plasma BDNF levels in a clinical population showing PTSD symptomatology, along with the post-traumatic spectrum that considers not only full expression of PTSD but also subthreshold manifestations, such as partial PTSD, by means of a dimensional assessment.
Section snippets
Subjects
A consecutive sample of 26 outpatients (19 women and 7 men; mean age±SD: 47.15+12.12 years), L′Aquila (Italy) 2009 earthquake survivors, referring for post-traumatic stress symptoms, were recruited at the National Mental Health Care Service (NMHCS) facilities in L′Aquila. Fourteen healthy subjects recruited from among those accompanying the outpatients, also survived to the same earthquake, and who were matched for age and gender (F/M 12/2; mean age 44.5+10.47 years) were enrolled. The
Results
By means of SCID interview, 13 patients were diagnosed as showing Full PTSD and 13 patients as showing Partial PTSD (age 44.9+10.2, 10 women and 3 men and age 44.4+13.6; 9 women and 4 men respectively). No differences in sex distribution (X2=1.05, df=2, NS) or age (F=.89, df=2,32, NS) among the three samples were observed. No differences in distribution of benzodiazepines / antidepressants assumption were seen.
Non parametric comparisons (Kruskal Wallis Test) showed significant differences among
Discussion
The results of the present study corroborate previous findings on BDNF reduced levels in patients with PTSD with respect to controls without PTSD despite being exposed to the a traumatic event (Stratta et al., 2013, Angelucci et al., 2014). Having included a control group who did not develop PTSD symptoms despite being exposed to the same trauma, support a BDNF involvement in PTSD. Our results also show similar BDNF levels between survivors with partial with respect to those without PTSD.
Acknowledgments
The authors report no financial relationships with commercial interests.
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