[Neuronal mechanisms underlying main clinical syndromes of post-traumatic stress disorder]

This review is designed to consider neurophysiological aspects of post-traumatic stress disorder (PTSD). Current concepts of enhanced activity of the sympathetic nervous system and the role of hypothalamo-pituitary-adrenal axis in the development of major clinical manifestations of PTSD are presented. Mechanisms of memory impairment, phobic reactions, hyperactivity, obsession, and sleep disturbances associated with PTSD are discussed. Special attention is given to the mechanism of pain syndrome under stress conditions and the role of impaired activity of stress-limiting (opioidergic and GABA-ergic) systems. Further studies of PTSD are needed with reference to individual differences of adaptive mechanisms depending on age, gender, and injury type. Of equal interest are co-morbid conditions and their relation to pathological changes in the brain. Studies of the involved mediator systems in different diseases, e.g. neurologic pathology concomitant with PTSD, are virtually absent. Better understanding of neurobiological mechanisms underlying these conditions may lead to the development of new therapeutic modalities.