Neuroprogression in post-traumatic stress disorder: a systematic review

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Psychology

Background:

• Neuroprogression describes pathological brain rewiring concurrent with clinical decline in psychiatric disorders.
• Post-traumatic stress disorder (PTSD) is examined for its potential neuroprogressive characteristics.

Purpose of the Study:

• To systematically review the biological underpinnings of neuroprogression in PTSD.
• To investigate the clinical outcomes associated with neuroprogression in PTSD patients.

Main Methods:

• A systematic review of literature from PubMed, Embase, and Web of Science (1960-2020).
• Inclusion criteria focused on studies assessing brain changes, neurocognition, functioning, inflammation, oxidative stress, and neurotrophins in PTSD.
• Exclusion of narrative reviews, case reports, and preclinical studies.

Main Results:

• 15 articles were included from 965 identified abstracts.
• Progressive frontal lobe changes, particularly in the prefrontal cortex, were observed in a subset of patients with worsening or persistent high-intensity PTSD symptoms.
• Associated declines in neurocognition (verbal memory, facial recognition) and overall functioning (physical, psychological, social, environmental) were noted.

Conclusions:

• Findings suggest a link between progressive frontal lobe reduction and neurocognitive impairment in PTSD.
• Further research is required to definitively classify PTSD as a neuroprogressive disorder.