Dysfunctions of cortical excitability in drug-naïve posttraumatic stress disorder patients.

Por: Estimulação Magnética Transcraniana repetitiva (EMTr)  17/10/2009
Palavras-chave: Depressão, Psiquiatria, Antidepressivo

 Dysfunctions of cortical excitability in drug-naïve posttraumatic stress disorder patients.
 Biol Psychiatry. 2009 Jul 1;66(1):54-61. Epub 2009 Apr 15Rossi S, De Capua A, Tavanti M, Calossi S, Polizzotto NR, Mantovani A, Falzarano V, Bossini L, Passero S, Bartalini S, Ulivelli M.BACKGROUND: The investigation of a wide set of transcranial magnetic stimulation (TMS)-related variables in both hemispheres might help to identify a pattern of cortical excitability changes in posttraumatic stress disorder (PTSD) patients, reflecting gamma-amino-butiric acid (GABA)/glutamate balance and dysfunction, and to determine whether some of these variables are related to clinical features. METHODS: In 20 drug-naive PTSD patients without comorbidity and 16 matched healthy control subjects we tested bilaterally with standard TMS procedures: resting motor threshold (RMT) to single-pulse TMS (reflecting ion channel function), paired-pulse short-latency intracortical inhibition (SICI; mainly reflecting GABA(A) function) and intracortical facilitation (ICF; mainly reflecting glutamatergic function), single-pulse cortical silent period (CSP; mainly reflecting GABA(B)-ergic function), and paired-pulse short-latency afferent inhibition (SAI; reflecting cholinergic mechanisms and their presynaptic GABA(A)-mediated modulation). RESULTS: The PTSD patients showed widespread impairment of GABA(A)-ergic SICI, which was reversed toward facilitation in both hemispheres in one-half of the patients, marked increase of glutamatergic ICF in the right hemisphere, and right-sided impairment of SAI. Illness duration and avoidance symptoms but not anxiety correlated with right-lateralized dysfunctions of cortical excitability.

Palavras-chave: Antidepressivo, Depressão, EMTr, Estimulação Magnética, Psiquiatria

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