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Cited by 144Stress Responses and CortisolPosttraumatic Stress Disorder ResearchAdrenal Hormones and Disorders

The Neuroendocrinology of Posttraumatic Stress Disorder: New Directions

Rasmusson, Ann M., Vythilingam, Meena, Morgan, Charles A.·2003·CNS Spectrums
DOI 10.1017/s1092852900008841
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Abstract

Studies of the hypothalamic-pituitary-adrenal (HPA ) axis in persons with posttraumatic stress disorder (PTSD) have produced variable findings. This review focuses on the factors likely to have affected the outcome of these studies, including population characteristics and experimental design. Also discussed is a possible role for the adrenal neurosteroid dehydroepiandrosterone (DHEA) as a mediator of HPA axis adaptation to extreme stress and the psychiatric symptoms associated with PTSD. The antiglucocorticoid properties of DHEA may contribute to an upregulation of HPA axis responses as well as mitigate possible deleterious effects of high cortisol levels on the brain in some PTSD subpopulations. The neuromodulatory effects of DHEA and its metabolite DHEAS at γ-arninobutyric acid and N-methyl-D-aspartate receptors in the brain may contribute to psychiatric symptoms associated with PTSD. The possible importance of other neurohormone systems in modulating HPA axis and symptom responses to traumatic stress is also discussed. Understanding the complex interactions of these stress-responsive neurosteroid and peptide systems may help explain the variability in patterns of HPA axis adaptation, brain changes, and psychiatric symptoms observed in PTSD and lead to better targeting of preventive and therapeutic interventions.

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Crossref · 10.1017/s1092852900008841

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  • Blood DHEA increases under acute stress, and higher DHEA or DHEA-to-cortisol ratio is associated with less dissociative symptoms and superior performance in military survival training.

    “Reports have shown that blood DHEA levels increase under acute stress and that a higher level of DHEA, or a higher DHEA to cortisol ratio, is associated with less dissociative symptoms and superior performance in healthy subjects undergoing military survival training9.”

    From Neurobiology of resilience (2012) · cites this paper as [9]

  • DHEA responses to ACTH are elevated in PTSD and negatively correlated with symptom severity, suggesting DHEA release during stress may buffer PTSD severity.

    “It has been reported that DHEA responses to adrenocorticotropic hormone (ACTH) were elevated in PTSD and negatively correlated with the severity of symptoms, suggesting that DHEA release during stress may buffer the severity of PTSD 9.”

    From Neurobiology of resilience (2012) · cites this paper as [9]

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Authors
Rasmusson, A. M., Vythilingam, M., & Morgan, C. A.
Affiliations
Yale University (US)
ORCID
Venue
CNS Spectrums
Publisher
Cambridge University Press (CUP)
Published
2003-09
Volume
8
Issue
9
Pages
651-667
ISSN
  • 1092-8529 (ISSN-L)
  • 2165-6509
DOI
10.1017/s1092852900008841
OpenAlex
W1628939789
Cited by
144
References
88
Citations by year
2025: 2 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 5 · 2020: 2 · 2019: 5 · 2018: 7 · 2017: 6 · 2016: 8 · 2015: 3 · 2014: 9 · 2013: 5 · 2012: 8
FWCI
0.91
Type
journal article
Language
en
Open access
closed
Licence
www.cambridge.org/core/terms (unspecified, 4085 d)
Locations
  • CNS Spectrums (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute on Drug Abuse (1K12DA14038-01, K12DA014038)
Topics
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
post-traumatic stress disorder, hypothalamic-pituitary-adrenal axis, dehydroepiandrosterone, neurosteroids, dehydroepiandrosterone sulfate, cortisol, glucocorticoid receptor, GABA receptors, NMDA receptor, neuroendocrinology, stress adaptation, psychiatric symptoms
MeSH terms
Adaptation, Psychological, Arousal, Brain, Combat Disorders, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Pituitary-Adrenal System, Stress Disorders, Post-Traumatic, Stress, Psychological, Neurotransmitter Agents

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