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Brain function in a patient with torture related post-traumatic stress disorder before and after fluoxetine treatment: a positron emission tomography provocation study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
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2001 (English)In: Neuroscience Letters, ISSN 0304-3940, E-ISSN 1872-7972, Vol. 297, no 2, 101-104 p.Article in journal (Refereed) Published
Abstract [en]

We report positron emission tomographic measurements of regional cerebral blood flow (rCBF) in a male patient with war and torture related post-traumatic stress disorder (PTSD) during symptom provocation. The subject was exposed to war related sounds before and after treatment with a selective serotonin reuptake inhibitor (SSRI; Fluoxetine; Fontex((R))). Therapy reduced PTSD symptoms, provoked anxiety and heart rate. Before treatment trauma reminders resulted in decreased rCBF in the insula, prefrontal, and inferior frontal cortices. Increased activity was evident in the cerebellum, precuneus and supplementary motor cortex. This was normalized after SSRI administration. Prefrontal and cingulate rCBF correlated with heart rate. Hence, the anxiolytic effect of SSRI for PTSD could be mediated by prefrontal and paralimbic cortices. Data suggest that SSRI treatment normalize provocation induced rCBF alterations in areas involved in memory, emotion, attention and motor-control.

Place, publisher, year, edition, pages
2001. Vol. 297, no 2, 101-104 p.
Keyword [en]
torture, anxiety, fear, positron emission tomography, neuroimaging, regional cerebral blood-flow
National Category
Medical and Health Sciences Social Sciences
Identifiers
URN: urn:nbn:se:uu:diva-90688DOI: 10.1016/S0304-3940(00)01674-8PubMedID: 11121880OAI: oai:DiVA.org:uu-90688DiVA: diva2:163134
Available from: 2003-09-05 Created: 2003-09-05 Last updated: 2013-10-30Bibliographically approved
In thesis
1. Posttraumatic Stress Disorder (PTSD) in the General Population
Open this publication in new window or tab >>Posttraumatic Stress Disorder (PTSD) in the General Population
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis explored the epidemiology of Posttraumatic Stress Disorder (PTSD) and different aspects of the disorder. Firstly, we investigated the lifetime prevalence of traumatic experiences and PTSD in the general adult population in Sweden and evaluated the impact of different trauma types, trauma frequency, and perceived distress. The results show that traumatic experiences are common and PTSD is not rare; roughly one out of ten traumatic events results in PTSD, with a 5.6% lifetime prevalence. The female/male ratio is 2:1. The risk for PTSD increases considerably with a high trauma-associated emotional impact. The distressing impact of a given trauma appears to be higher in women than in men, indicating an increased vulnerability in women. Secondly, we hypothesized that traffic road accidents (TRA’s) are one of the most prevalent types of traumatic events in Swedish society; therefore, we examined the impact of event and response characteristics associated with TRA’s on PTSD development. The data demonstrate that of those who had experienced a TRA (n=1074, 58.9%), 6.1% reported lifetime PTSD. TRA’s associated with fatal accidents and injury to oneself and related to high distress more than double the risk for PTSD. Thirdly, we compared the relative merits of the DSM-IV’s three-factor solution for PTSD symptoms to alternative models. We found that the symptomatology is equally well accounted for using all factor analytic models as yet presented in the literature; the DSM-IV, we found, provides as good a fit to data as other models. Fourthly, we examined the neurofunctional correlates of PTSD symptoms and whether a treatment-induced (serotonin reuptake inhibitor - SSRI) reduction of PTSD symptoms is associated with altered rCBF during symptom provocation. Our results indicate that PTSD symptoms correlates with areas involved in memory, emotion, attention, and motor control and that SSRI treatment normalizes provocation-induced rCBF in these areas.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2003. 66 p.
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 0282-7492 ; 129
Keyword
Psychology, posttraumatic stress disorder, trauma, epidemiology, general population, prevalence, traffic road accidents, DSM-structure, positron emission tomography, regional cerebral blood flow, symptom provocation, selective serotonin reuptake inhibitor, Psykologi
National Category
Psychology
Research subject
Clinical Psychology
Identifiers
urn:nbn:se:uu:diva-3528 (URN)91-554-5697-9 (ISBN)
Public defence
2003-10-03, Sal IX, Universitetshuset, Uppsala, 09:15
Opponent
Supervisors
Available from: 2003-09-05 Created: 2003-09-05Bibliographically approved

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Fernandez, ManuelFrans, Örjanvon Knorring, LarsFredrikson, Mats

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