Inflammatory markers and their possible effects on cognitive function in women with posttraumatic stress disorder
Inflammatory markers and their possible effects on cognitive function in women with posttraumatic stress disorder
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DOI：
10.1016/j.jpsychires.2018.04.009
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发表时间：
2018-07-01
影响因子：
4.8
通讯作者：
Kim, Yoshiharu
中科院分区：
文献类型：
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作者：
Imai, Risa;Hori, Hiroaki;Kim, Yoshiharu
创伤后应激障碍（PTSD）与炎症增加有关，尽管存在一些争议。PTSD的另一个关键特征是广泛认知领域的功能受损。外周炎症增加可导致认知功能障碍，尽管这种关系尚未在PTSD患者中研究。在这里，我们检查了与健康对照组相比，成年PTSD患者的血液炎症标志物，考虑到儿童期虐待和共病重度抑郁症（MDD）的潜在混杂效应，并探讨了炎症和认知之间的关联。我们招募了40名患有创伤后应激障碍的女性，其中大多数人在成年期的人际暴力后患上了这种疾病，还有65名健康的对照女性。诊断依据DSM-IV。使用儿童期创伤问卷（CTQ）评估儿童期虐待史。使用神经心理状态评估可重复成套测验（RBANS）评估认知功能。采集血液样本用于测量5种炎症标志物，包括白细胞介素-6（IL-6）、可溶性IL-6受体、白细胞介素-1 β、高敏肿瘤坏死因子-α和高敏C反应蛋白。与对照组相比，PTSD患者显示出显著更高的IL-6水平（p = 0.009）和所有RBANS领域的更低得分（所有p <0.01）。患者的IL-6水平与是否存在合并症MDD或CTQ评分无显着相关性。IL 6水平与RBANS的视觉空间结构（p = 0.0 46）、语言（p = 0.0 0 8）、注意力（p = 0.0 36）和总分（p = 0.0 0 8）呈显著负相关。这些结果表明，IL-6升高与PTSD有关，PTSD中较低的认知功能可能至少部分是由于炎症增加。
Posttraumatic stress disorder (PTSD) has been associated with increased inflammation, albeit with some controversy. Another key feature of PTSD is compromised function in wide-ranging cognitive domains. Increased peripheral inflammation can contribute to cognitive dysfunction, although this relationship has not been studied in patients with PTSD. Here, we examined blood inflammatory markers in adult patients with PTSD compared to healthy controls taking account of potentially confounding effects of childhood maltreatment and comorbid major depressive disorder (MDD), and explored the association between inflammation and cognition. We enrolled 40 women with PTSD, most of whom developed the disorder after interpersonal violence during adulthood, and 65 healthy control women. Diagnoses were made based on DSM-IV. History of childhood maltreatment was assessed using the Childhood Trauma Questionnaire (CTQ). Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Blood samples were collected for the measurement of 5 inflammatory markers including interleukin-6 (IL-6), soluble IL-6 receptor, interleukin-1 beta, high-sensitivity tumor necrosis factor-alpha, and high-sensitivity C-reactive protein. Compared to controls, patients with PTSD showed significantly higher IL-6 levels (p = 0.009) and lower scores on all RBANS domains (all p < 0.01). IL-6 levels in patients were not significantly associated with the presence/absence of comorbid MDD or CTQ scores. IL 6 levels in patients were significantly negatively correlated with RBANS visuospatial construction (p = 0.046), language (p = 0.008), attention (p = 0.036) and total score (p = 0.008). These results suggest that elevated IL-6 is associated with PTSD and that the lower cognitive function in PTSD may be due at least partly to increased inflammation.