What role does the gut microbiome play in posttraumatic stress disorder?

Dr Stefanie Malan-Muller

The bacteria in your gut could hold clues to whether or not you will develop posttraumatic stress disorder (PTSD) after experiencing a traumatic event.

PTSD is a serious psychiatric disorder that can develop after a person experiences a life-threatening trauma. However, not everyone exposed to a traumatic event will develop PTSD, and several factors influence an individual’s susceptibility, including living conditions, childhood experiences and genetic makeup. Stellenbosch University researchers are now also adding gut bacteria to this list.

In recent years, scientists have become aware of the important role of microbes existing inside the human gastrointestinal tract, called the gut microbiome. These microbes perform important functions, such as metabolising food and medicine, and fighting infections. It is now believed that the gut microbiome also influences the brain and brain function by producing neurotransmitters/hormones, immune-regulating molecules and bacterial toxins.

In turn, stress and emotions can change the composition of the gut microbiome. Stress hormones can affect bacterial growth and compromise the integrity of the intestinal lining, which can result in bacteria and toxins entering the bloodstream. This can cause inflammation, which has been shown to play a role in several psychiatric disorders.

“Our study compared the gut microbiomes of individuals with PTSD to that of people who also experienced significant trauma, but did not develop PTSD (trauma-exposed controls). We identified a combination of three bacteria (Actinobacteria, Lentisphaerae and Verrucomicrobia) that were different in people with PTSD,” explains the lead researcher, Dr Stefanie Malan-Muller. She is a postdoctoral fellow in the Department of Psychiatry at the Faculty of Medicine and Health Sciences.

Individuals with PTSD had significantly lower levels of this trio of bacteria compared to trauma-exposed control groups. Individuals who experienced trauma during their childhood also had lower levels of two of these bacteria (Actinobacteria and Verrucomicrobia). “What makes this finding interesting, is that individuals who experience childhood trauma are at higher risk of developing PTSD later in life, and these changes in the gut microbiome possibly occurred early in life in response to childhood trauma,” says Malan-Muller. She collaborated with researchers from the University of Colorado Boulder on the study.

One of the known functions of these bacteria is immune system regulation, and researchers have noted increased levels of inflammation and altered immune regulation in individuals with PTSD. “Changes in immune regulation and increased inflammation also impact the brain, brain functioning and behaviour. Levels of inflammatory markers measured in individuals shortly after a traumatic event, was shown to predict later development of PTSD.

“We therefore hypothesise that the low levels of those three bacteria may have resulted in immune dysregulation and heightened levels of inflammation in individuals with PTSD, which may have contributed to their disease symptoms,” explains Malan-Muller.

However, researchers are unable to determine whether this bacterial deficit contributed to PTSD susceptibility, or whether it occurred as a consequence of PTSD.

“It does, however, bring us one step closer to understanding the factors that might play a role in PTSD. Factors influencing susceptibility and resilience to developing PTSD are not yet fully understood, and identifying and understanding all these contributing factors could in future contribute to better treatments, especially since the microbiome can easily be altered with the use of prebiotics (non-digestible food substances), probiotics (live, beneficial microorganisms), and synbiotics (a combination of probiotics and prebiotics), or dietary interventions.”

The research group is launching a large-scale, population based initiative to unravel the intricate connections between the gut microbiome and the brain, in collaboration with the South African Microbiome Initiative in Neuroscience (www.saneurogut.org). The study will focus on people that have been diagnosed with any kind of psychiatric disorder in comparison to healthy control groups. This study will identify more links between the gut microbiome and disorders that affect the brain.

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Can light therapy help with brain injuries and PTSD?

A staffer in Dr. Margaret Naeser's lab demonstrates the equipment built especially for the research: an LED helmet (Photomedex), intranasal diodes (Vielight), and LED cluster heads placed on the ears (MedX Health). The real and sham devices look identical. Goggles are worn to block out the red light. The near-infrared light is beyond the visible spectrum and cannot be seen. (Photo courtesy of Naeser lab)

A staffer in Dr. Margaret Naeser’s lab demonstrates the equipment built especially for the research: an LED helmet (Photomedex), intranasal diodes (Vielight), and LED cluster heads placed on the ears (MedX Health). The real and sham devices look identical. Goggles are worn to block out the red light. The near-infrared light is beyond the visible spectrum and cannot be seen. (Photo courtesy of Naeser lab)

VA study with 160 Gulf War Veterans will test red, near-infrared light

Following up on promising results from pilot work, researchers at the VA Boston Healthcare System are testing the effects of light therapy on brain function in Veterans with Gulf War Illness.

Veterans in the study wear a helmet lined with light-emitting diodes that apply red and near-infrared light to the scalp. They also have diodes placed in their nostrils, to deliver photons to the deeper parts of the brain.

The light is painless and generates no heat. A treatment takes about 30 minutes.

The therapy, though still considered “investigational” and not covered by most health insurance plans, is already used by some alternative medicine practitioners to treat wounds and pain. The light from the diodes has been shown to boost the output of nitric oxide near where the LEDs are placed, which improves blood flow in that location.

“We are applying a technology that’s been around for a while,” says lead investigator Dr. Margaret Naeser, “but it’s always been used on the body, for wound healing and to treat muscle aches and pains, and joint problems. We’re starting to use it on the brain.”

Naeser is a research linguist and speech pathologist for the Boston VA, and a research professor of neurology at Boston University School of Medicine (BUSM). She is also a licensed acupuncturist and has conducted past research on laser acupuncture to treat paralysis in stroke, and pain in carpal tunnel syndrome.

How do the diodes work?

The LED therapy increases blood flow in the brain, as shown on MRI scans. It also appears to have an effect on damaged brain cells, specifically on their mitochondria. These are bean-shaped subunits within the cell that put out energy in the form of a chemical known as ATP. The red and near-infrared light photons penetrate through the skull and into brain cells and spur the mitochondria to produce more ATP. That can mean clearer, sharper thinking, says Naeser.

Naeser says brain damage caused by explosions, or exposure to pesticides or other neurotoxins—such as in the Gulf War—could impair the mitochondria in cells. She believes light therapy can be a valuable adjunct to standard cognitive rehabilitation, which typically involves “exercising” the brain in various ways to take advantage of brain plasticity and forge new neural networks.

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Common Anesthetic Procedure Dramatically Improves Well Being of Veterans with PTSD

Regions of the brain affected by PTSD and stress. (Photo credit: Wikipedia)

Regions of the brain affected by PTSD and stress. (Photo credit: Wikipedia)

A single application of a common anesthetic procedure could be the answer to alleviating anxiety, depression and psychological pain in those suffering from chronic, extreme post-traumatic stress disorder (PTSD).

In a study presented at the ANESTHESIOLOGY™ 2014 annual meeting, researchers followed 12 patients with PTSD who had undergone a simple anesthetic procedure called a stellate ganglion block (SGB). This common procedure involves injecting a small amount of local anesthesia into the base of the neck. SGB is traditionally used to treat a variety of conditions, from pain syndromes to sleep disorders.

“While it doesn’t cure the problem, we found that SGB appears to be a fast-acting and effective long-term treatment for chronic, extreme PTSD in veterans,” said Michael T. Alkire, M.D., staff anesthesiologist at the Long Beach VA Healthcare System in California. “These improvements far outlasted what we would expect from SGB, which is usually used as a temporary nerve block and typically lasts three to five hours.”

In the study, the patients each were given one SGB and followed closely with structured interviews and other psychological tests for six months after treatment. The positive effects of the SGB were evident often within minutes and resulted in significant improvement of scores for the Clinician Administered PTSD Score, or CAPS, the test used to measure the severity of PTSD.

Symptoms improved over time, and after one month, CAPS scores registered normal to mild PTSD levels for most of the patients. Positive effects were still seen at three months, but began fading and were generally gone by six months. Overall, 75 percent of the participants reported significant improvement of their PTSD symptoms after the SGB.

Data from the study further suggested that SGB might also be an effective initial treatment for depression and anxiety disorders.

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Yogic Breathing Shows Promise in Reducing Symptoms of Post-Traumatic Stress Disorder

Amazing Health Benefits and Different Types of Yoga | CureJoy

Amazing Health Benefits and Different Types of Yoga | CureJoy

One of the greatest casualties of war is its lasting effect on the minds of soldiers. This presents a daunting public health problem: More than 20 percent of veterans returning from the wars in Iraq and Afghanistan have post-traumatic stress disorder, according to a 2012 report by RAND Corp.

A new study from the Center for Investigating Healthy Minds at the Waisman Center of the University of Wisconsin-Madison offers hope for those suffering from the disorder. Researchers there have shown that a breathing-based meditation practice called Sudarshan Kriya Yoga can be an effective treatment for PTSD.

Individuals with PTSD suffer from intrusive memories, heightened anxiety, and personality changes. The hallmark of the disorder is hyperarousal, which can be defined as overreacting to innocuous stimuli, and is often described as feeling “jumpy,” or easily startled and constantly on guard.

Hyperarousal is one aspect of the autonomic nervous system, the system that controls the beating of the heart and other body functions, and governs one’s ability to respond to his or her environment. Scientists believe hyperarousal is at the core of PTSD and the driving force behind some of its symptoms.

Standard treatment interventions for PTSD offer mixed results. Some individuals are prescribed antidepressants and do well while others do not; others are treated with psychotherapy and still experience residual affects of the disorder.

Sudarshan Kriya Yoga is a practice of controlled breathing that directly affects the autonomic nervous system. While the practice has proven effective in balancing the autonomic nervous system and reducing symptoms of PTSD in tsunami survivors, it has not been well studied until now.

The CIHM team was interested in Sudarshan Yoga because of its focus on manipulating the breath, and how that in turn may have consequences for the autonomic nervous system and specifically, hyperarousal. Theirs is the first randomized, controlled, longitudinal study to show that the practice of controlled breathing can benefit people with PTSD.

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Neuroscientists reverse memories’ emotional associations

This image depicts the injection sites and the expression of the viral constructs in the two areas of the brain studied: the Dentate Gyrus of the hippocampus (middle) and the Basolateral Amygdala (bottom corners). Image courtesy of the researchers

This image depicts the injection sites and the expression of the viral constructs in the two areas of the brain studied: the Dentate Gyrus of the hippocampus (middle) and the Basolateral Amygdala (bottom corners).
Image courtesy of the researchers

MIT study also identifies the brain circuit that links feelings to memories.

Most memories have some kind of emotion associated with them: Recalling the week you just spent at the beach probably makes you feel happy, while reflecting on being bullied provokes more negative feelings.

A new study from MIT neuroscientists reveals the brain circuit that controls how memories become linked with positive or negative emotions. Furthermore, the researchers found that they could reverse the emotional association of specific memories by manipulating brain cells with optogenetics — a technique that uses light to control neuron activity.

The findings, described in the Aug. 27 issue of Nature, demonstrated that a neuronal circuit connecting the hippocampus and the amygdala plays a critical role in associating emotion with memory. This circuit could offer a target for new drugs to help treat conditions such as post-traumatic stress disorder, the researchers say.

“In the future, one may be able to develop methods that help people to remember positive memories more strongly than negative ones,” says Susumu Tonegawa, the Picower Professor of Biology and Neuroscience, director of the RIKEN-MIT Center for Neural Circuit Genetics at MIT’s Picower Institute for Learning and Memory, and senior author of the paper.

Shifting memories

Memories are made of many elements, which are stored in different parts of the brain. A memory’s context, including information about the location where the event took place, is stored in cells of the hippocampus, while emotions linked to that memory are found in the amygdala.

Previous research has shown that many aspects of memory, including emotional associations, are malleable. Psychotherapists have taken advantage of this to help patients suffering from depression and post-traumatic stress disorder, but the neural circuitry underlying such malleability is not known.

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