Putative dopamine agonist (KB220Z) attenuates lucid nightmares in PTSD patients: role of enhanced brain reward functional connectivity and homeostasis redeeming joy.
Putative dopamine agonist (KB220Z) attenuates lucid nightmares in PTSD patients: role of enhanced brain reward functional connectivity and homeostasis redeeming joy.
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DOI：
10.1556/2006.4.2015.008
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发表时间：
2015-06
影响因子：
7.8
通讯作者：
Gold MS
中科院分区：
文献类型：
--
作者：
McLaughlin T;Blum K;Oscar-Berman M;Febo M;Agan G;Fratantonio JL;Simpatico T;Gold MS
清醒梦通常是令人愉快的，人们已经开发出训练技巧来教做梦者诱导清醒梦。此外，清醒梦的诱导也被用作改善噩梦的一种方法。另一方面，清醒梦可能与精神疾病有关，包括创伤后应激障碍（PTSD）和奖励缺乏综合征相关的诊断。在后一种情况下，清醒梦可能呈现出令人不快、常常令人恐惧的特征。我们提出了两个戏剧性的减轻与创伤后应激障碍患者可怕的清醒梦的情况。在第一个案例研究中，一名51岁的肥胖女性被诊断患有创伤后应激障碍和抑郁症，她曾试图自杀，并经历了与包括酗酒父亲在内的家庭成员在童年早期的性/身体虐待有关的可怕的清醒噩梦。尽管用辩证行为疗法（DBT）和标准药物（包括哌唑嗪、clonidie和Adderall）治疗6个月，她生动的“噩梦”仍然顽固。第二位39岁的PTSD女性患者也患有清醒噩梦。药物访问记录显示，在第一名患者的治疗方案中加入复杂的假定多巴胺激动剂KB 220 Z后，这些梦的频率，强度和性质发生了变化。病人报告说，她第一次经历了一段长时间的快乐的梦想。第二名PTSD患者曾遭受清醒噩梦，服用KB 220 Z以减轻美沙酮戒断症状，并偶然报告了充满幸福和笑声的梦想。这些情况下讨论参考已知的影响KB 220 Z，包括增强多巴胺稳态和功能连接的大脑奖励电路在啮齿动物和人类。他们的理解有待深入调查，涉及大人口，双盲研究。
Lucid dreams are frequently pleasant and training techniques have been developed to teach dreamers to induce them. In addition, the induction of lucid dreams has also been used as a way to ameliorate nightmares. On the other hand, lucid dreams may be associated with psychiatric conditions, including Post-Traumatic Stress Disorder (PTSD) and Reward Deficiency Syndrome-associated diagnoses. In the latter conditions, lucid dreams can assume an unpleasant and frequently terrifying character. We present two cases of dramatic alleviation of terrifying lucid dreams in patients with PTSD. In the first case study, a 51-year-old, obese woman, diagnosed with PTSD and depression, had attempted suicide and experienced terrifying lucid nightmares linked to sexual/physical abuse from early childhood by family members including her alcoholic father. Her vivid “bad dreams” remained refractory in spite of 6 months of treatment with Dialectical Behavioral Therapy (DBT) and standard pharmaceutical agents which included prazosin, clonidie and Adderall. The second 39-year-old PTSD woman patient had also suffered from lucid nightmares. The medication visit notes reveal changes in the frequency, intensity and nature of these dreams after the complex putative dopamine agonist KB220Z was added to the first patient’s regimen. The patient reported her first experience of an extended period of happy dreams. The second PTSD patient, who had suffered from lucid nightmares, was administered KB220Z to attenuate methadone withdrawal symptoms and incidentally reported dreams full of happiness and laughter. These cases are discussed with reference to the known effects of KB220Z including enhanced dopamine homeostasis and functional connectivity of brain reward circuitry in rodents and humans. Their understanding awaits intensive investigation involving large-population, double-blinded studies.