Research links locus coeruleus activity with hyperarousal in PTSD

October 31, 2017

Philadelphia, PA, October 31, 2017 - A new study in Biological Psychiatry has linked signs of heightened arousal and reactivity -- a core symptom of posttraumatic stress disorder (PTSD) -- to overactivity of the locus coeruleus (LC), a brain region that mediates arousal and reactivity. By combining bodily responses and brain imaging data, the new paper by Dr. Christoph Mueller-Pfeiffer at the University of Zurich, Switzerland and colleagues is the first to provide direct human evidence for a theory over 30 years old. Pinpointing the origin of symptoms in the brain is a major step in efforts to improve treatment options for patients with the disorder.

"The authors are to be congratulated on imaging this part of the brain," said Dr. John Krystal, Editor of Biological Psychiatry. "Demonstrating the presence of LC hyperactivity in PTSD sets the stage for clarifying the relationship of LC activity to stress response, resilience, PTSD symptoms, and the treatment of PTSD," he added.

In the study, first author Christoph Naegeli, also of University of Zurich, and colleagues analyzed 54 participants who had been exposed to trauma, about half of whom developed PTSD. When the participants listened to random bursts of white noise, those who were diagnosed with PTSD had more frequent eye blinks, and increased heart rate, skin conductance and pupil area responses -- indicators of the body's autonomic response -- than participants without PTSD.

Using functional magnetic resonance imaging to measure brain activity, Naegeli and colleagues found that patients with PTSD had larger brain responses in the LC and other regions wired to the LC that control alertness and motor preparation. According to Mueller-Pfeiffer, the increased brain activity and autonomic responses measured in the participants provide a biologically plausible explanation for hypervigilance and exaggerated startle responses in PTSD. However, LC activation was not directly associated with arousal symptoms. Thus, direct links between LC hyperactivity and PTSD symptom severity still need to be demonstrated.

The study may also reveal new avenues for treating these common and disabling symptoms of PTSD. "Our results suggest that targeting locus coeruleus system hyperactivity with new pharmacological or psychotherapeutic interventions are approaches worthy of further investigation," said Dr. Mueller-Pfeiffer.
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Notes for editors

The article is "Locus Coeruleus Activity Mediates Hyper-Responsiveness in Posttraumatic Stress Disorder," by Christoph Naegeli, Thomas Zeffiro, Marco Piccirelli, Assia Jaillard, Anina Weilenmann, Katayun Hassanpour, Matthis Schick, Michael Rufer, Scott P Orr, and Christoph Mueller-Pfeiffer. (http://dx.doi.org/10.1016/j.biopsych.2017.08.021). It appears in Biological Psychiatry, published by Elsevier.

Copies of this paper are available to credentialed journalists upon request; please contact Rhiannon Bugno at Biol.Psych@UTSouthwestern.edu or +1 214 648 0880. Journalists wishing to interview the authors may contact Christoph Mueller-Pfeiffer, M.D., at christoph.mueller-pfeiffer@access.uzh.ch or +41 44 255 52 80.

The authors' affiliations and disclosures of financial and conflicts of interests are available in the article.

John H. Krystal, M.D., is Chairman of the Department of Psychiatry at the Yale University School of Medicine, Chief of Psychiatry at Yale-New Haven Hospital, and a research psychiatrist at the VA Connecticut Healthcare System. His disclosures of financial and conflicts of interests are available here.

About Biological Psychiatry

Biological Psychiatry is the official journal of the Society of Biological Psychiatry, whose purpose is to promote excellence in scientific research and education in fields that investigate the nature, causes, mechanisms and treatments of disorders of thought, emotion, or behavior. In accord with this mission, this peer-reviewed, rapid-publication, international journal publishes both basic and clinical contributions from all disciplines and research areas relevant to the pathophysiology and treatment of major psychiatric disorders.

The journal publishes novel results of original research which represent an important new lead or significant impact on the field, particularly those addressing genetic and environmental risk factors, neural circuitry and neurochemistry, and important new therapeutic approaches. Reviews and commentaries that focus on topics of current research and interest are also encouraged.

Biological Psychiatry is one of the most selective and highly cited journals in the field of psychiatric neuroscience. It is ranked 6th out of 142 Psychiatry titles and 10th out of 258 Neurosciences titles in the Journal Citations Reports® published by Thomson Reuters. The 2016 Impact Factor score for Biological Psychiatry is 11.412.

About Elsevier

Elsevier is a global information analytics business that helps institutions and professionals progress science, advance healthcare and improve performance for the benefit of humanity. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, Scival, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, more than 35,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX Group, a global provider of information and analytics to professionals and business customers across industries. http://www.elsevier.com

Media contact

Rhiannon Bugno
Editorial Office, Biological Psychiatry
+1 214 648 0880
Biol.Psych@UTSouthwestern.edu

Elsevier

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