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Cited by 206Posttraumatic Stress Disorder ResearchStress Responses and CortisolChild Abuse and Trauma

Diagnostic Biomarkers for Posttraumatic Stress Disorder: Promising Horizons from Translational Neuroscience Research

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Michopoulos, Vasiliki, Norrholm, Seth Davin, Jovanovic, Tanja·2015·Biological Psychiatry
DOI 10.1016/j.biopsych.2015.01.005PMC PMC4520791
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Abstract

Posttraumatic stress disorder (PTSD) is a heterogeneous disorder that affects individuals exposed to trauma (e.g., combat, interpersonal violence, and natural disasters). Although its diagnostic features have been recently reclassified with the emergence of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition, the disorder remains characterized by hyperarousal, intrusive reminders of the trauma, avoidance of trauma-related cues, and negative cognition and mood. This heterogeneity indicates the presence of multiple neurobiological mechanisms underlying the etiology and maintenance of PTSD. Translational research spanning the past few decades has revealed several potential avenues for the identification of diagnostic biomarkers for PTSD. These include, but are not limited to, monoaminergic transmitter systems, the hypothalamic-pituitary-adrenal axis, metabolic hormonal pathways, inflammatory mechanisms, psychophysiological reactivity, and neural circuits. The current review provides an update to the literature with regard to the most promising putative PTSD biomarkers, with specific emphasis on the interaction between neurobiological influences on disease risk and symptom progression. Such biomarkers will most likely be identified by multi-dimensional models derived from comprehensive descriptions of molecular, neurobiological, behavioral, and clinical phenotypes.

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  • PTSD is a chronic disorder with dysregulated stress axis function.

    “These data in parallel with evidence indicating that PTSD is a chronic disorder with dysregulated stress axis function (Michopoulos et al, 2015b), have recently led to a burgeoning attempt to understand how”

    From Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond (2017) · cites this paper as Michopoulos et al, 2015b

    The Neuroendocrine Biomarkers of PTSD section (page unavailable) explicitly says that HPA-axis dysregulation is present in PTSD, while noting mixed findings for specific cortisol measures. The Introduction calls PTSD a severe disorder but does not establish the claim that it is chronic. (LLM, conf=0.82)

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  • Inflammation-induced amygdala response may contribute to the association between increased CRP levels and heightened psychophysiological hyperarousal in traumatized individuals with PTSD.

    “Furthermore, this inflammation-induced amygdala response may also contribute to the association between increased CRP levels and heightened psychophysiological hyperarousal in traumatized individuals with PTSD (Michopoulos et al, 2015b).”

    From Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond (2017) · cites this paper as Michopoulos et al, 2015b

    The “Biomarkers of Heightened Inflammation in PTSD” section links increased CRP to exacerbated PTSD symptoms and impaired inhibition of fear-potentiated startle, a psychophysiological measure. The “Neuroanatomical and neuroactivational biomarkers” section separately reports greater amygdala activation in PTSD. Neither section says inflammation induces that amygdala response or that it contributes to the CRP–hyperarousal association; page numbers are unavailable in our copy. (LLM, conf=0.86)

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1 retracted

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Research works printed but not linked: 4

  1. [79]Michopoulos V Rothbaum AO Jovanovic T Almli LM Bradley B Rothbaum B Gillespie CF Ressler KJ CRP levels are associated with increased PTSD symptoms and influenced by CRP genetic variation in a highly traumatized civilian population American Journal of Psychiatry Accepted 2014 PMC4440454 25827033
  2. [91]von Känel R Hepp U Kraemer B Traber R Keel M Mica L Schnyder U Evidence for low-grade systemic proinflammatory activity in patients with posttraumatic stress disorder Journal of Psychiatric Research 41 9 744 752 16901505
  3. [104]Shalev AY Peri T Brandes D Freedman S Orr SP Pitman RK Auditory startle response in trauma survivors with posttraumatic stress disorder: A prospective study American Journal of Psychiatry 2000 157 255 261 10671396
  4. [143]Schmidt U Kaltwasser SF Wotjak CT Biomarkers in Posttraumatic Stress Disorder: Overview and Implications for Future Research Disease markers 2013 35 1 43 54 24167348 PMC3774961

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Authors
Michopoulos, V., Norrholm, S. D., & Jovanovic, T.
Affiliations
Emory University (US)
ORCID
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
2015-09
Volume
78
Issue
5
Pages
344-353
ISSN
0006-3223 (ISSN-L)
DOI
10.1016/j.biopsych.2015.01.005
PMC
PMC4520791
OpenAlex
W2087060903
Cited by
206
References
153
Citations by year
2026: 8 · 2025: 17 · 2024: 17 · 2023: 14 · 2022: 22 · 2021: 24 · 2020: 13 · 2019: 21 · 2018: 20 · 2017: 24 · 2016: 17 · 2015: 9
FWCI
3.38
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (MH098212, MH100122)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords
post-traumatic stress disorder, diagnostic biomarkers, monoaminergic systems, hypothalamic-pituitary-adrenal axis, inflammatory mechanisms, psychophysiological reactivity, neural circuits, trauma exposure, neurobiological mechanisms
MeSH terms
Animals, Humans, Neurosciences, Stress Disorders, Post-Traumatic, Biomarkers, Translational Research, Biomedical

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