Decreased Benzodiazepine Receptor Binding in Prefrontal Cortex in Combat-Related Posttraumatic Stress Disorder

• Published in: The American journal of psychiatry Vol. 157; no. 7; pp. 1120 - 1126
• Main Authors: Bremner, J. Douglas, Innis, Robert B., Southwick, Steven M., Staib, Lawrence, Zoghbi, Sami, Charney, Dennis S.
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychiatric Publishing 01.07.2000; American Psychiatric Association
• Subjects: Adult; Adult and adolescent clinical studies; Anxiety disorders. Neuroses; Biological and medical sciences; Brain; Brief Psychiatric Rating Scale - statistics & numerical data; Combat Disorders - diagnosis; Combat Disorders - metabolism; Combat Disorders - physiopathology; Drug therapy; Flumazenil - analogs & derivatives; Hippocampus - diagnostic imaging; Hippocampus - metabolism; Humans; Iodine Radioisotopes; Male; Medical sciences; Mesencephalon - diagnostic imaging; Mesencephalon - metabolism; Middle Aged; Neurotransmitters; NMR; Nuclear magnetic resonance; Pons - diagnostic imaging; Pons - metabolism; Post traumatic stress disorder; Prefrontal Cortex - diagnostic imaging; Prefrontal Cortex - metabolism; Prefrontal Cortex - physiopathology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Receptors, GABA-A - metabolism; Receptors, GABA-A - physiology; Thalamus - diagnostic imaging; Thalamus - metabolism; Tomography, Emission-Computed, Single-Photon - statistics & numerical data; Veterans; Veterans - psychology; Vietnam; Vietnam War; Radionuclide study; Human; Posttraumatic syndrome; Anxiety disorder; Central nervous system; Benzodiazepine receptor; Prefrontal cortex; Photon; Stress; Biological fixation; Distribution volume; Clinical investigation; Veteran; Computer aid; Brain (vertebrata); Emission tomography
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/appi.ajp.157.7.1120

OBJECTIVE: Animals exposed to stress exhibit a decrease in benzodiazepine receptor binding in the frontal cortex. No studies have examined central benzodiazepine receptor binding in patients with posttraumatic stress disorder (PTSD). The purpose of this study was to examine measures of benzodiazepine receptor binding in PTSD.METHOD: From 13 patients with Vietnam combat-related PTSD and 13 case-matched healthy comparison subjects, a quantitative measure related to benzodiazepine receptor binding (distribution volume) was obtained with single photon emission computed tomography (SPECT) imaging of [123I]iomazenil binding and measurement of radioligand concentration in plasma. Distribution volume image data were analyzed by means of statistical parametric mapping.RESULTS: Lower distribution volumes were found in the prefrontal cortex (Brodmann's area 9) of PTSD patients than in comparison subjects.CONCLUSIONS: These findings of lower values for the benzodiazepine receptor binding measure of distribution volume are consistent with fewer benzodiazepine receptors and or reduced affinity of receptor binding in the medial prefrontal cortex in patients with PTSD. Alterations in benzodiazepine receptor function in this area may underlie many of the symptoms of PTSD.