A New Link between Traumatic Brain Injury and Posttraumatic Stress Disorder

From a new study in Biological Psychiatry

Philadelphia, PA, February 22, 2012 – Mild traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) are cardinal injuries associated with combat stress, and TBI increases the risk of PTSD development. The reasons for this correlation have been unknown, in part because physical traumas often occur in highly emotional situations.

However, scientists at University of California at Los Angeles provide new evidence from an animal model of a mechanistic link underlying the association between TBI and PTSD-like conditions.

Using procedures to separate the physical and emotional traumas, Dr. Maxine Reger and colleagues trained rats using fear conditioning techniques two days after the rats had a concussive brain trauma. This ensured the brain injury and experience of fear occurred on different days.

Dr. Michael Fanselow explained their findings: “We found that the rats with the earlier TBI acquired more fear than control rats (those without TBI). Something about the brain injury rendered them more susceptible to acquiring an inappropriately strong fear. It was as if the injury primed the brain for learning to be afraid.”

To further understand why this happened, the researchers analyzed a small piece of brain tissue, the amygdala, which is the brain's critical hub for fear learning. They found that there were significantly more receptors for excitatory neurotransmitters that promote learning. “This suggests that brain injury leaves the amygdala in a more excitable state that readies it for acquiring potent fear,” added Fanselow.

These findings now suggest a causal link between TBI and the increased susceptibility to PTSD, and identified an important role for the amygdala in this effect. “The next challenge is to characterize the neural circuitry and neurobiology of this effect. These are critical steps in building from these findings to preventative or therapeutic advances,” commented Dr. John Krystal, editor of Biological Psychiatry.

Although this work was performed in rats, these findings also suggest that people who suffer even a mild traumatic brain injury are more likely to develop an anxiety disorder, and that proper management of stress after such an injury could be critically important to maintaining ones’ mental health.

The article is “Concussive Brain Injury Enhances Fear Learning and Excitatory Processes in the Amygdala” by Maxine L. Reger, Andrew M. Poulos, Floyd Buen, Christopher C. Giza, David A. Hovda, and Michael S. Fanselow (doi:10.1016/j.biopsych.2011.11.007). The article appears in Biological Psychiatry, Volume 71, Issue 4 (February 15, 2012), published by Elsevier.

# # #

Notes for editors
Full text of the article is available to credentialed journalists upon request; contact Rhiannon Bugno at +1 214 648 0880 or Biol.Psych@utsouthwestern.edu. Journalists wishing to interview the authors may contact Michael Fanselow at +1 310 206 0247 or fanselow@ucla.edu.

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 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 4th out of 126 Psychiatry titles and 15th out of 237 Neurosciences titles in the Journal Citations Reports® published by Thomson Reuters. The 2010 Impact Factor score for Biological Psychiatry is 8.674.

About Elsevier

Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Elsevier Research Intelligence,and ClinicalKey—and publishes over 2,200 journals, including The Lancet and Cell, and over 25,000 book titles, including a number of iconic reference works.

The company is part of Reed Elsevier Group PLC, a world leading provider of professional information solutions in the Science, Medical, Legal and Risk and Business sectors, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Media contact
Rhiannon Bugno
Biological Psychiatry Editorial Office
+1 214 648 0880
biol.psych@utsouthwestern.edu