Posttraumatic Stress Disorder (PTSD): Mechanisms and Possible Treatments
Posttraumatic stress disorder (PTSD) is a debilitating mental condition occurring after a tragedy or a traumatic experience, such as rape, assault, natural disasters, war, car or plane accidents, etc. PSTD can cause a number of symptoms, such as fear, high anxiety, hyperarousal, bad dreams, night...
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| Date: | 2015 |
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Інститут фізіології ім. О.О. Богомольця НАН України
2015
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| Cite this: | Posttraumatic Stress Disorder (PTSD): Mechanisms and Possible Treatments / S. Asalgoo, G.P. Jahromi, G.H. Meftahi, H. Sahraei // Нейрофизиология. — 2015. — Т. 47, № 6. — С. 563-570. — Бібліогр.: 51 назв. — англ. |
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Digital Library of Periodicals of National Academy of Sciences of Ukraine| _version_ | 1859971219845021696 |
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| author | Asalgoo, S. Jahromi, G.P. Meftahi, G.H. Sahraei, H. |
| author_facet | Asalgoo, S. Jahromi, G.P. Meftahi, G.H. Sahraei, H. |
| citation_txt | Posttraumatic Stress Disorder (PTSD): Mechanisms and Possible Treatments / S. Asalgoo, G.P. Jahromi, G.H. Meftahi, H. Sahraei // Нейрофизиология. — 2015. — Т. 47, № 6. — С. 563-570. — Бібліогр.: 51 назв. — англ. |
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| description | Posttraumatic stress disorder (PTSD) is a debilitating mental condition occurring after
a tragedy or a traumatic experience, such as rape, assault, natural disasters, war, car or
plane accidents, etc. PSTD can cause a number of symptoms, such as fear, high anxiety,
hyperarousal, bad dreams, night mares, etc., existing for a long time after the traumatic event.
Within recent years, the spread of PTSD has been increased in the whole world, especially
in Asia (Middle East), particularly among soldiers who have taken part in military conflicts.
This situation confirms the importance of understanding the way of PTSD development
and of the improvement of its treatment. This paper is a review of the literature related
to the respective topics. Like other anxiety disorders, PTSD is related to disruption of the
endocrine system, particularly disintegration of the hypothalamus-pituitary-adrenal axis
(HPAA). People suffering from PTSD are characterized by elevated levels of corticotropinreleasing hormone, low basal cortisol levels, and enhanced negative feedback suppression
of the HPAA. At present, certain plant-derived compounds are considered a new important
source to treat PTSD. For example, remedies obtained from saffron are such possible means.
According to our findings, saffron components may considerably affect some parts of the
HPAA for reduction of stress-induced corticosterone release.
Посттравматичний стрес-розлад (ПТСР) є психіатричною
патологією, що розвивається після трагічної або травматизуючої події – смерті/убивства, згвалтування, природних катастроф, воєнних дій, автомобільних або авіаційних аварій.
ПТСР може бути пов’язаний з багатьма симптомами – жахом, сильною тривогою, надмірним збудженням, негативними думками, нічними кошмарами, прояви котрих тривають
протягом значного часу після травматизуючої події. Впродовж останніх років розповсюдження випадків ПТСР у світі, особливо на Середньому Сході та в Азії, збільшилося, зокрема серед солдатів, що брали участь у воєнних діях. Така
ситуація підкреслює важливість розуміння того, як розвивається ПТСР, та розробки підходів до його лікування. Наша
стаття є оглядом даних літератури щодо відповідного кола
питань. Як і інші розлади, пов’язані з тривожністю, ПТСР
значною мірою базується на дисфункції ендокринної системи, зокрема на дезінтеграції гіпоталамо-гіпофізарно-адреналової осі (ГГАО). Для людей із ПТСР є характерними високі рівні кортикотропін-рілізінг-гормону, низькі базальні
рівні кортизолу та посилена супресія функції ГГАО на основі негативного зворотного зв’язку. В наш час певні препарати рослинного походження розглядаються як важливі засоби
для лікування ПТСР. Зокрема, такими ліками можуть бути
препарати, отримані із шапрану. Згідно з нашими даними,
речовини, що містяться в шапрані, взаємодіють із деякими ГГАО та забезпечують зменшення вивільнення кортикостерону, індукованого стресом.
|
| first_indexed | 2025-12-07T16:21:51Z |
| format | Article |
| fulltext |
NEUROPHYSIOLOGY / НЕЙРОФИЗИОЛОГИЯ.—2015.—T. 47, № 6 563
UDC616.895:635.716
S. ASALGOO,1 G. P. JAHROMI,2 G. H. MEFTAHI,2 and H. SAHRAEI2
POSTTRAUMATIC STRESS DISORDER (PTSD): MECHANISMS
AND POSSIBLE TREATMENTS
Received June 18, 2014
Posttraumatic stress disorder (PTSD) is a debilitating mental condition occurring after
a tragedy or a traumatic experience, such as rape, assault, natural disasters, war, car or
plane accidents, etc. PSTD can cause a number of symptoms, such as fear, high anxiety,
hyperarousal, bad dreams, night mares, etc., existing for a long time after the traumatic event.
Within recent years, the spread of PTSD has been increased in the whole world, especially
in Asia (Middle East), particularly among soldiers who have taken part in military conflicts.
This situation confirms the importance of understanding the way of PTSD development
and of the improvement of its treatment. This paper is a review of the literature related
to the respective topics. Like other anxiety disorders, PTSD is related to disruption of the
endocrine system, particularly disintegration of the hypothalamus-pituitary-adrenal axis
(HPAA). People suffering from PTSD are characterized by elevated levels of corticotropin-
releasing hormone, low basal cortisol levels, and enhanced negative feedback suppression
of the HPAA. At present, certain plant-derived compounds are considered a new important
source to treat PTSD. For example, remedies obtained from saffron are such possible means.
According to our findings, saffron components may considerably affect some parts of the
HPAA for reduction of stress-induced corticosterone release.
Keywords: posttraumatic stress disorder (PTSD), hypothalamo-pituitary (hypophyseal)-
adrenal axis (HPAA), corticosteroids, corticotropin-releasing hormone.
1Behavioral Sciences Research Center, Baqiyatallah University of Medical
Sciences, Tehran, Iran
2Neuroscience Research Center, Baqiyatallah University of Medical Sciences,
Tehran, Iran
Correspondence should be addressed to G. P. Jahromi (g_pirzad_jahromi@
yahoo.com)
INTRODUCTION
Posttraumatic stress disorder (PTSD) is manifested
as an aggregation of symptoms following exposure to
extreme psychologically stressful or severe physically
damaging events. This exposure can be visual or aural,
and it can affect people who have been subjected to
panic and desperation but avoided physical damage.
Different events may lead to PTSD, such as car or
plane accidents, criminal events, exposure to physical
or sexual assaults [1], surviving from a disaster (e.g.,
flood or explosion) [2], or being the witness of the death
of someone. In fact, all hard and horrifying events that
can threaten life and safety, or events causing panic of
not being secured, or repeated incidents are capable of
inducing this disorder. In some people, the respective
emotional reactions continue for a long time, and this
is the line by which healthy individuals and individuals
having the risk of PTSD are separated.
In these individuals having bad memories related
to a painful incident, unpleasant feeling of returning
to the event can be brought to the mind by an
occasional flux. Due to this reason, individuals with
PTSD try to avoid all places or people who can
remind the accidents; even talking about it would
be avoided. These people have a sense of separation
from the real world and do not show any interests
towards the important activities within the social
environment; they are nervous and irritable. A number
of psychological and medical treatments have been
proposed for patients with PTSD. In this review, we
focused on the history of PTSD, on diagnosis of this
disorder, and on its treatment. Special attention is paid
to plant-derived remedies for the treatment of PTSD.
ОБЗОРЫ
NEUROPHYSIOLOGY / НЕЙРОФИЗИОЛОГИЯ.—2015.—T. 47, № 6564
S. ASALGOO, G. P. JAHROMI, G. H. MEFTAHI, and H. SAHRAEI
HISTORY
In 1980, a term “PTSD” for the first time appeared
in the system of classification of mental disorders.
This does not mean that the above medical term was
related to discovery of a new disease. As early as in
2000 BC, ancient Egyptians were aware of psychologi-
cal symptoms of post-war mental shifts. Also, ancient
Greeks observed and described a disturbance similar
to PTSD among soldiers after the battle of Marathon in
year 450 BC [3]. In 1975, with the end of the Vietnam
War, the symptoms of fear, panic, and constant high
anxiety among American soldiers, who survived the
battle and returned to their homes, were frequently
observed. Recently, more than 30 years after the
Vietnam War, a study conducted on the veterans of
this war showed that long-term posttraumatic stress
causes not only a mental suffering; it creates a serious
risk of physical illnesses and quick death. Statistical
examinations showed that 7-8% of the general
population suffered from PTSD symptoms during
their period of life [4–6]. In Iran medical records, it
has been demonstrated that more than 80% of war
veterans are more or less prone to PTSD symptoms [7].
Common mental health problems have been reported
among people who were often at the frontline of the
battle [8].
RECOGNITION
Clinical features of PTSD are the most painful
feelings that the incidents may happen again, and
the problems may exist for months and even years
although the event will not occur again. On physical
examinations, the patients often feel guilty, rejected,
and humiliated; sometimes perceptual errors and
illusions are observed. In cognitive testing, the patients
may demonstrate impaired memory and attention, and
these phenomena could mostly be attributed to the
increase in the adrenalin level. As is generally known,
this hormone is produced be adrenals under stress
conditions, and its release provides physical fitness
for a rapid response in the case of danger; when stress
is removed, this index should fall. In PTSD, memory
recalls of the incident raise the adrenalin level, which
can cause secondary stress, restlessness, and insomnia
[9].
The hippocampus is a part of the CNS mostly
responsible for processing memories. High levels
of the hormones (adrenalin in particular) released
during stress may disturb normal functioning of the
hippocampus. This means that memories of traumatic
events and nightmares will be continued and cannot
be processed correctly. If the stress is removed, and
the adrenalin level returns to the norm, the brain will
be able to repair the damage; bad memories will be
processed and adequately recognized, and nightmares
and other symptoms will be lost. Posttraumatic
disorders typically associated with changes induced by
intense acute or chronic stress are frequently placed in
the group of anxiety disorders as a mental illness [10].
PTSD, like other anxiety disorders, occurs, to a
significant extent, as a result of dysfunction of the
neuroendocrine mechanisms and endocrine system.
That mostly “followed the disintegration of the
hypothalamo-pituitary axis and adrenals per se” [1,
11, 12]. According to endocrinological studies, three
common features have been reported in patients
suffering from PTSD. These are: (i) reduction in
the plasma cortisol level, (ii) increase in the level
of corticotropin-releasing hormone (CRH) in the
cerebrospinal fluid (CSF) and plasma, and (iii)
increased inhibition of the hypophyseal (pituitary)-
adrenal system (HAS) through a negative feedback.
Therefore, the clinical pattern of PTSD is a paradox
from the endocrinilogical point of view because
increased activity of the hypothalamo-pituitary-
adrenal axis (HPAA) is a central component associated
with stress. At the same time, an insufficient level of
pituitary-adrenal (HAS) activity should be considered
a crucial shift in the regulatory endocrinological
influences observed in PTSD patients.
The mechanism of the emergence of this disease
has not been studied adequately. It is known, however,
that patients with anxiety disorders demonstrate
either low or normal cortisol levels in the blood [13,
14], high CRH levels in the CSF and plasma [15,
16], as well as enhanced inhibition of the pituitary-
adrenocortical system realized via negative feedback
[12, 17]. High CRH combined with high vasopressin
in neurosecretory cells and nerve terminals in the
hypothalamus is created under stress condition, and
this intensifies the synthesis and secretion of ACTH
from the pituitary, as well as those of a releasing
hormone, corticoliberin [18, 19].
In terms of the prognosis, it is noteworthy that
the PTSD symptoms may significantly fluctuate
over time. The severity of symptoms is the greatest
during periods of high stress; about 30% of patients
completely recover, while about 10% demonstrate
no improvement of worsening of the symptoms.
NEUROPHYSIOLOGY / НЕЙРОФИЗИОЛОГИЯ.—2015.—T. 47, № 6 565
POSTTRAUMATIC STRESS DISORDER (PTSD)
Generally, according to DSM4, when the disease is
diagnosed until 4 weeks after the event and continues
from 2 days to 4 weeks, it is called a reparable
disorder. However, when acute psychiatric and
remaining symptoms are observed during more than
4 weeks, PTSD is diagnosed with certainty. Generally,
when a person has been exposed to a stressful event
and regularly recalls this incident in mind during
more than one month, he/she may show the following
symptoms: (i) restlessness and agitation, aggressive
behavior, feelings of alienation from others; (ii)
isolation and difficulties in interpersonal relationship;
(iii) guilt and shame, careless and emotional poverty
that makes them stay away from the others; (iv) a
developmental regression procedure, return to basic
behaviors of a child (e.g., thumb sucking, etc.); (v)
excessive emotional and behavioral arousal (constant
state of alert); (vi) sleep disturbances, nightmares, and
scary dreams (frightening dreams without a specific
content); (vii) avoidance of thoughts and feelings,
avoidance of places that remind unpleasant events;
(viii) repeated memories on the traumatizing events;
(ix) repeated games related to the traumatic experience
(in children), and (x) interference with daily work,
difficulties in concentration and learning [20, 21].
PATHOGENESIS OF PTSD
Neuroanatomy. At present, three areas in the brain
have been identified, which may change during
PTSD; these are the prefrontal cortex, amygdalar
complex, and hippocampus. Many respective studies
have been carried out on patients of the Vietnam War.
For example, observations of soldiers with injured
heads revealed that the prefrontal cortex plays an
important role in the prevention or development of
PTSD symptoms. In human studies, the amygdale
has shown to be strongly involved in the formation
of emotional memories, especially fear-related ones.
Neuroimaging studies in humans revealed both
morphological and functional aspects of changes in
the above cerebral structures related to PTSD [22].
It was found that the hippocampus, i.e., the structure
specifically associated with the ability to place
memories within the correct spatial/temporal context
and with the ability to recall memories, is suppressed
during intense stress [23]. Koenen et al. [9] showed
that the state of the hippocampus exerts a strong
influence on PTSD. Veterans of the Vietnam War with
PTSD showed a 20% reduction in the volume of their
hippocampus compared with the veterans who did not
suffer from such symptoms. Therefore, it is thought
that inhibition of the hippocampal functions related to
partial degeneration of hippocampal neuronal circuits
during severe stress determines obsessive reminding
of the incident occurred in patients with PTSD [12,
24]. As was mentioned, persistent fear in patients
with PTSD could be due to impairments of the HPAA,
noradrenergic system of the locus coeruleus, and
connections between the limbic system and frontal
cortex. The HPAA is a coordinator of the hormonal
response under stress conditions. If the event is
traumatic, the HPAA is stimulated, and activation of
the noradrenergic locus coeruleus system consequently
leads to a physiologically excessive increase in the
strength of memory consolidation on the event. Thus,
PTSD patients regularly remind the time and place of
the event bleak picture.
It seems that the noradrenergic locus coeruleus
system plays an important role in increasing the
power of memory consolidation due to stress. Studies
on animal models have shown that neuropeptide Y
reduces the secretion of norepinephrine (noradrenalin),
and this plays an important role in reducing the anxiety
level in patients with PTSD. Human studies showed
that concentrations on neuropeptide Y are reduced in
patients suffering from this disorder [25].
Roles of Hormones in Creating PTSD. PTSD
symptoms appear when stress causes a severe
increase in the secretion of adrenalin (epinephrine)
in circulation. High concentration of adrenalin causes
significant neurochemical and neurophysiological
changes in the brain. These shifts may remain for a
long time and maintain a sense of fear in the person.
High levels of stress hormones suppress the functions
of the hypothalamus, and this is an important factor in
the occurrence of PTSD symptoms. This disorder can
cause a series of considerable biochemical changes
in the brain and in the entire body, which differ
from those in other psychological disorders, such as
different types of depression. The responses of patients
with PTSD to the dexamethasone test are much more
intense than those in patients with a depression
disorder. In addition, patients with such dexamethasone
test pattern often demonstrate lower concentrations of
cortisol and higher concentrations of catecholamines
in their urine than other depressed patients. Also,
the norepinephrine/cortisol ratio in patients with
PTSD is much higher than that in “usual” depressed
patients. These changes occurring in subjects with
PTSD significantly differ from those observed under
NEUROPHYSIOLOGY / НЕЙРОФИЗИОЛОГИЯ.—2015.—T. 47, № 6566
S. ASALGOO, G. P. JAHROMI, G. H. MEFTAHI, and H. SAHRAEI
conditions of the fight-or-flight response in people
faced the stress, where concentrations of both cortisol
and catecholamines increase in a parallel manner.
Patients with PTSD demonstrate increased levels of
CRH and cerebral catecholamines, which is indicative
of a considerable disorder of the HPAA function. This
axis is responsible for coordination of the hormonal
responses to stress. It seems that, due to the increased
sensitivity of glucocorticoid receptors in patients with
PTSD, impairment of the HPAA and negative feedback
inhibition results in a reduced cortisol concentration.
Thus, because of increased sensitivity of the HPAA
in patients with PTSD. Non-adaptive learning paths
can be formed due to the increase of fear. Thus, it is
likely that the levels of cortisol should be precisely
considered to be a significant factor leading to
symptoms of PTSD. It was found that war veterans
having lower concentrations of cortisol in their saliva
than other soldiers with normal cortisol levels were
more susceptible to PTSD. Because cortisol plays
an important role in the general maintenance of
homeostasis, disorders in the latter during stress in
patients with PTSD may lead to persistent feelings of
fear in them. Other studies have shown that serotonin
levels are relatively low (frequently abnormally) in
PTSD patients. As is known, the serotonergic system is
involved in the formation of mood, anxiety, aggression,
and irritability; it also provides stabilization of the
secretion of glucocorticoids [26, 27].
Similarly to CRH, vasopressin plays a role in
the stress responses and acts synergistically with
the above releasing hormone [28, 29]. Both above
hormones are produced in neurosecretory cells of
the hypothalamus and exert strengthening effects
on the synthesis and secretion of ACTH from the
pituitary and release of the latter hormone in stressful
situations [18, 19]. CRH produced by neurons in the
paraventricular nucleus (PVN) of the hypothalamus is
involved in neuroendocrine control of ACTH secretion
from the pituitary anterior lobe. Also, CRH enhances
the activity of the sympathetic nervous system.
Increases in the release of vasopressin and CRF start
an endocrine response to the stressful situation and
ultimately stimulate the release of proopiomelano-
cortin (POMC), ACTH, and beta-endorphin. ACTH is
a key moderator of glucocorticoid secretion from the
adrenal cortex. Glucocorticoids, particularly cortisol
in humans and corticosterone in rats, act as the main
effect of HPAA activation in the control of body
homeostasis in response to stress. As it was reported,
patients with PTSD, due to high baseline levels of CRH
in the CSF and plasma, react to intravenous injections
of CRH by slow secretory ACTH responses from the
pituitary. Because of the continued presence of high
concentrations of anterior pituitary CRH, receptors
of the latter undergo desensitization, and the above-
mentioned responses are reduced [30-32]. According
to the results of the dexamethasone suppression test,
another treatment has been proposed within recent
years. This test is used to measure dexamethasone-
induced inhibition of the HPAA [30].
It should be noted that there are conflicting opin-
ions in neurobiology of PTSD. For example, some
studies have shown that there is no clear relationship
between the blood cortisol levels and PTSD symptoms.
At the same time, most studies of the major causes
of PTSD symptoms demonstrated that increased
concentrations of CRH, decreases blood cortisol
levels, and increased negative feedback suppres-
sion of the HPAA are the main correlates of this
mental disorder.
APPROACHES TO PTSD TREATMENT
Psychological Techniques. Based on the above-
mentioned data and considering the aim of improving
mental and physical health of the patients, researchers
focused their attention on both physical and
psychological aspects of the disease and proposed
psychological and physical therapy for PTSD
treatment. In particular, the National Institute for
Health and Care Excellence (NICE) suggested trauma-
focused psychological therapy (Cognitive Behavioral
Therapy, CBT) or an Eye Movement Desensitization
Reprocessing (EDMR) technique before specific
medication can be used.
Two psychotherapeutic approaches for treating
PTSD patients have been proposed; these approaches
are based on different general concepts, cognitive
psychology and behaviorism. Behavioral interventions
may include learning of how effectively confront fears
and avoid places or people that could remind stress-
inducing events. The use of sedation techniques and
accepting the feelings of the patient are effective in
reducing the symptoms of posttraumatic stress.
A crisis intervention technique is based on attempts
to restore normal mental functions of the patients.
Psychiatrists are focused on the methods allowing
patients to solve problems related to coping skills and
to create a supportive environment for the patient.
It was also found expedient to form a support group
NEUROPHYSIOLOGY / НЕЙРОФИЗИОЛОГИЯ.—2015.—T. 47, № 6 567
POSTTRAUMATIC STRESS DISORDER (PTSD)
for people who are experiencing stress symptoms.
Members of these groups of patients receive the
emotional support from others who have experienced
similar symptoms and conditions; they also learn
coping skills and how to manage the conditions.
All these treatments must be led and performed by
a specialist having the sufficient experience in the
treatment of PTSD. These meetings should be carried
out by an expert during at least 8 to 12 weeks; each
session takes 60 to 90 min [33].
Cognitive behavioral therapy (CBT) is another
treatment method that helps patients to think
differently about bad memories. Therefore, the
subjects become less stress-affected and more
manageable. Usually, this treatment includes
multiple sessions (with relaxation) that help pati-
ents “to feel pleasant to think about unpleasant events.”
An eye movement desensitization and reprocessing
(EMDR) technique uses recording of eye movements
to help the brain to process unpleasant incidents. This
technique seems somewhat strange, but the respective
treatment was found to be rather effective.
Psychological therapies are usually ineffective if
PTSD symptoms continue for more than a month. In
other cases, impaired functions, such as inadequate
performance of the patient’s job, etc, need transition
toward drug treatments. Although PTSD should
be considered an independent risk form for health,
combined bad habits can threaten the patient’s health.
For example, 45% of people with PTSD are smokers;
some of these patients, when trying to escape from
emotional problems, tend to use alcohol and drugs
[34].
Treatment of PTSD with Natural Herbal
Products. Effects of medical plants and their
derivatives in the treatment of various diseases are
studied more and more extensively within recent years.
These studies have shown that a number of medicinal
herbs demonstrate comparable (or even greater)
efficiency in the respective cases than “traditional,”
“standard” pharmacological agents. At the same time,
there are very few studies of applications of medicinal
plants for the treatment of PTSD. We concentrated our
attention to such a plant as saffron and shall try to
describe the respective results in more detail.
Saffron, Crocus sativus L. (Iridaceae) is a plant
known from ancient times, which has been used during
centuries as a food ingredient (spice). It is also known
in folk medicine as an antispasmodic, expectorant, and
even as aphrodisiac. Saffron has a bitter taste mostly
due to the presence of a component called picrocrocin.
This compound can be converted by thermal
decomposition or fermentation to aromatic aldehydes,
saffronil, in particular. Saffron components, such as
crocin, are glycosides consisting of a carotenoid called
crocitin (which is responsible for the color of saffron)
and sugar. The main physiologically active ingredients
of saffron are safronal, crocin, and crocetin [35, 36].
Saffron has been demonstrated to be rather highly
efficient with respect to neurological abnormalities.
For example, saffron was effective in reducing
symptoms of depression and anxiety. These effects in
humans were comparable with those of imipramine
and fluoxetine. The effects of the saffron extract were
checked out on experiments on mice and demonstrated
a high efficiency in reducing the anxiety level [37].
An inhibitory effect of this herb in reducing symptoms
of anxiety and dependence of morphine in the
conditioned place preference test were shown [38].
Previous studies demonstrated that the saffron extract
and its active components (safronal) improve brain
functions (through inhibition of serotonin reuptake and
stimulation of GABA receptors) in some pathologies,
such as Alzheimer disease, epilepsy, and other seizure
disorders in humans [39]. Sahraei et al. [40] described
positive effects of the aqueous saffron extract and
safronal, which improved mental and physical
symptoms of stress and those related to PTSD. The
effects were clearly dose-dependent. In this study, the
animals, 21 days after termination of a stress-induced
disorder, were exposed to environmental stress for the
second time. Groups that received the saffron extract
or safronal did not show significant disorders, while
the control groups demonstrated strong hormonal
effects and also strong anorexia. It could be supposed
that saffron derivatives influence the inner core of
the amygdale (basolateral nuclei). At the same time,
the saffron extract and safronal exerted no effects on
behaviors associated with the dopaminergic system,
such as exploratory movements. Finally, it was
concluded that, on the one hand, a positive effect of
the extract (moderation of stress-related symptoms)
was clearly present. On the other hand, the efficacy of
the saffron extract with respect to the basal ganglia of
the amygdale was lacking. It should be supposed that
the respective compounds of the aqueous extract of
saffron probably reduced corticosteron secretion and
inhibited anorexia. Thus, the effects on the adrenal
cortex and hypothalamus should be considered [40,
41]. The saffron extract may realize some of its effects
by blocking glutamate receptors and by increasing
concentrations of glutamate and dopamine in the
NEUROPHYSIOLOGY / НЕЙРОФИЗИОЛОГИЯ.—2015.—T. 47, № 6568
S. ASALGOO, G. P. JAHROMI, G. H. MEFTAHI, and H. SAHRAEI
rat brain. These neurotransmitters are involved in
facilitation of memory-related cerebral phenomena
and facilitation of release of the hormones from the
hypothalamus. It seems that the release of these two
neurotransmitters is altered under stress conditions
in line with the release of corticosterone and memory
reinforcement [42, 43]. In another study, Halataei et
al. [44] showed that the saffron aqueous extract much
stronger affected metabolic responses in electric
shock-induced stress (release of corticosteroids,
anorexia, and weight loss in animals) than the ethanol
extract of saffron did. This effect is mediated by the
amygdalar complex [45] and hypothalamus [46].
It was shown that there is a close overlap between
the effects of stress and addictive drugs [47-49]; this
was demonstrated on animal models. Moffet et al. in
2006 [50] highlighted stress phenomena induced by
maternal separation in young rats; it was shown that
this situation intensifies self-administration of cocaine.
On the other hand, it was shown in human studies
that prenatal stress tends to cause high probabilities
of smoking, using of marihuana, consumption of
alcohol, and using amphetamines in adulthood [51].
In another study, Sahraei et al. [40] showed the
ability of saffron to provide inhibitory effects on
the mesocorticolimbic system. So, saffron helps to
improve the state of people suffering from defective
functioning of this system. At the same time, this mean
(or a group of means) does not have side effects of
addictive drugs. Thus, consumption of saffron-based
means is prospective with respect to the reduction of
physiological symptoms of stress in people involved
in a stressful job and other stress-inducing situations
[40].
CONCLUSIONS
The above-described data demonstrate the importance
of adequate functioning of the HPAA and the state
of the respective neuroendocrine and hormonal
systems under stress and post-stress conditions. Thus,
compounds capable of normalizing the control of
production of the hormones secreted by the above
axis, such as corticosterone and cortisol, are likely
to have the ability to reduce PTSD symptoms. Today,
great attention is paid to the use of “non-chemical”
treatments, such as herb-based means, to cure the
above-described pathologies. It is obvious that further
studies are urgently necessary to understand the
mechanisms of plant-derived agents and their possible
role in modifying the control in multiple-organ
systems. Saffron is an example of the plants that could
be effectively applied in the treatment of PTSD and
disorders close to the latter. The compounds contained
in this plant can help to normalize regulation of
corticosterone release and the state of the respective
central neuronal mechanisms, which allow one to
reduce PTSD symptoms in the respective patient
contingent with minimum induction of side effects.
This paper is a review of the published data, and
confirmation of its correspondence to the ethical norms
for experiments on animals and/or studies of humans is no
necessary.
The authors, S. Asalgoo, G. P. Jahromi, G. H. Meftahi, and
H. Sahraei, confirm that they have no conflict of interest with
any organization or person that may be related to this study;
there were also no conflict of interest in interrelations between
the authors.
А. Асалгоо1, Г. П. Яхромі1, Г. Х. Мефтахі1, Х. Сахрей1
ПОСТТРАВМАТИЧНИЙ СТРЕС-РОЗЛАД (ПТСР):
МЕХАНІЗМИ ТА МОЖЛИВІ МЕТОДИ ЛІКУВАННЯ
1 Центр досліджень у сфері нейронаук Медичного
університету Бакійаталлах, Тегеран (Іран).
Р е з ю м е
Посттравматичний стрес-розлад (ПТСР) є психіатричною
патологією, що розвивається після трагічної або травмати-
зуючої події – смерті/убивства, згвалтування, природних ка-
тастроф, воєнних дій, автомобільних або авіаційних аварій.
ПТСР може бути пов’язаний з багатьма симптомами – жа-
хом, сильною тривогою, надмірним збудженням, негативни-
ми думками, нічними кошмарами, прояви котрих тривають
протягом значного часу після травматизуючої події. Впро-
довж останніх років розповсюдження випадків ПТСР у сві-
ті, особливо на Середньому Сході та в Азії, збільшилося, зо-
крема серед солдатів, що брали участь у воєнних діях. Така
ситуація підкреслює важливість розуміння того, як розвива-
ється ПТСР, та розробки підходів до його лікування. Наша
стаття є оглядом даних літератури щодо відповідного кола
питань. Як і інші розлади, пов’язані з тривожністю, ПТСР
значною мірою базується на дисфункції ендокринної систе-
ми, зокрема на дезінтеграції гіпоталамо-гіпофізарно-адре-
налової осі (ГГАО). Для людей із ПТСР є характерними ви-
сокі рівні кортикотропін-рілізінг-гормону, низькі базальні
рівні кортизолу та посилена супресія функції ГГАО на осно-
ві негативного зворотного зв’язку. В наш час певні препара-
ти рослинного походження розглядаються як важливі засоби
для лікування ПТСР. Зокрема, такими ліками можуть бути
препарати, отримані із шапрану. Згідно з нашими даними,
речовини, що містяться в шапрані, взаємодіють із деякими
NEUROPHYSIOLOGY / НЕЙРОФИЗИОЛОГИЯ.—2015.—T. 47, № 6 569
POSTTRAUMATIC STRESS DISORDER (PTSD)
ГГАО та забезпечують зменшення вивільнення кортикосте-
рону, індукованого стресом.
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|
| id | nasplib_isofts_kiev_ua-123456789-148228 |
| institution | Digital Library of Periodicals of National Academy of Sciences of Ukraine |
| issn | 0028-2561 |
| language | English |
| last_indexed | 2025-12-07T16:21:51Z |
| publishDate | 2015 |
| publisher | Інститут фізіології ім. О.О. Богомольця НАН України |
| record_format | dspace |
| spelling | Asalgoo, S. Jahromi, G.P. Meftahi, G.H. Sahraei, H. 2019-02-17T18:12:18Z 2019-02-17T18:12:18Z 2015 Posttraumatic Stress Disorder (PTSD): Mechanisms and Possible Treatments / S. Asalgoo, G.P. Jahromi, G.H. Meftahi, H. Sahraei // Нейрофизиология. — 2015. — Т. 47, № 6. — С. 563-570. — Бібліогр.: 51 назв. — англ. 0028-2561 https://nasplib.isofts.kiev.ua/handle/123456789/148228 616.895:635.716 Posttraumatic stress disorder (PTSD) is a debilitating mental condition occurring after a tragedy or a traumatic experience, such as rape, assault, natural disasters, war, car or plane accidents, etc. PSTD can cause a number of symptoms, such as fear, high anxiety, hyperarousal, bad dreams, night mares, etc., existing for a long time after the traumatic event. Within recent years, the spread of PTSD has been increased in the whole world, especially in Asia (Middle East), particularly among soldiers who have taken part in military conflicts. This situation confirms the importance of understanding the way of PTSD development and of the improvement of its treatment. This paper is a review of the literature related to the respective topics. Like other anxiety disorders, PTSD is related to disruption of the endocrine system, particularly disintegration of the hypothalamus-pituitary-adrenal axis (HPAA). People suffering from PTSD are characterized by elevated levels of corticotropinreleasing hormone, low basal cortisol levels, and enhanced negative feedback suppression of the HPAA. At present, certain plant-derived compounds are considered a new important source to treat PTSD. For example, remedies obtained from saffron are such possible means. According to our findings, saffron components may considerably affect some parts of the HPAA for reduction of stress-induced corticosterone release. Посттравматичний стрес-розлад (ПТСР) є психіатричною патологією, що розвивається після трагічної або травматизуючої події – смерті/убивства, згвалтування, природних катастроф, воєнних дій, автомобільних або авіаційних аварій. ПТСР може бути пов’язаний з багатьма симптомами – жахом, сильною тривогою, надмірним збудженням, негативними думками, нічними кошмарами, прояви котрих тривають протягом значного часу після травматизуючої події. Впродовж останніх років розповсюдження випадків ПТСР у світі, особливо на Середньому Сході та в Азії, збільшилося, зокрема серед солдатів, що брали участь у воєнних діях. Така ситуація підкреслює важливість розуміння того, як розвивається ПТСР, та розробки підходів до його лікування. Наша стаття є оглядом даних літератури щодо відповідного кола питань. Як і інші розлади, пов’язані з тривожністю, ПТСР значною мірою базується на дисфункції ендокринної системи, зокрема на дезінтеграції гіпоталамо-гіпофізарно-адреналової осі (ГГАО). Для людей із ПТСР є характерними високі рівні кортикотропін-рілізінг-гормону, низькі базальні рівні кортизолу та посилена супресія функції ГГАО на основі негативного зворотного зв’язку. В наш час певні препарати рослинного походження розглядаються як важливі засоби для лікування ПТСР. Зокрема, такими ліками можуть бути препарати, отримані із шапрану. Згідно з нашими даними, речовини, що містяться в шапрані, взаємодіють із деякими ГГАО та забезпечують зменшення вивільнення кортикостерону, індукованого стресом. en Інститут фізіології ім. О.О. Богомольця НАН України Нейрофизиология Posttraumatic Stress Disorder (PTSD): Mechanisms and Possible Treatments Посттравматичний стрес-розлад (ПТСР): механізми та можливі методи лікування Article published earlier |
| spellingShingle | Posttraumatic Stress Disorder (PTSD): Mechanisms and Possible Treatments Asalgoo, S. Jahromi, G.P. Meftahi, G.H. Sahraei, H. |
| title | Posttraumatic Stress Disorder (PTSD): Mechanisms and Possible Treatments |
| title_alt | Посттравматичний стрес-розлад (ПТСР): механізми та можливі методи лікування |
| title_full | Posttraumatic Stress Disorder (PTSD): Mechanisms and Possible Treatments |
| title_fullStr | Posttraumatic Stress Disorder (PTSD): Mechanisms and Possible Treatments |
| title_full_unstemmed | Posttraumatic Stress Disorder (PTSD): Mechanisms and Possible Treatments |
| title_short | Posttraumatic Stress Disorder (PTSD): Mechanisms and Possible Treatments |
| title_sort | posttraumatic stress disorder (ptsd): mechanisms and possible treatments |
| url | https://nasplib.isofts.kiev.ua/handle/123456789/148228 |
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