Neurobiology of comorbid post-traumatic stress disorder and alcohol-use disorder - PubMed (original) (raw)

Review

Neurobiology of comorbid post-traumatic stress disorder and alcohol-use disorder

N W Gilpin et al. Genes Brain Behav. 2017 Jan.

Abstract

Post-traumatic stress disorder (PTSD) and alcohol-use disorder (AUD) are highly comorbid in humans. Although we have some understanding of the structural and functional brain changes that define each of these disorders, and how those changes contribute to the behavioral symptoms that define them, little is known about the neurobiology of comorbid PTSD and AUD, which may be due in part to a scarcity of adequate animal models for examining this research question. The goal of this review is to summarize the current state-of-the-science on comorbid PTSD and AUD. We summarize epidemiological data documenting the prevalence of this comorbidity, review what is known about the potential neurobiological basis for the frequent co-occurrence of PTSD and AUD and discuss successes and failures of past and current treatment strategies. We also review animal models that aim to examine comorbid PTSD and AUD, highlighting where the models parallel the human condition, and we discuss the strengths and weaknesses of each model. We conclude by discussing key gaps in our knowledge and strategies for addressing them: in particular, we (1) highlight the need for better animal models of the comorbid condition and better clinical trial design, (2) emphasize the need for examination of subpopulation effects and individual differences and (3) urge cross-talk between basic and clinical researchers that is reflected in collaborative work with forward and reverse translational impact.

Keywords: Alcohol dependence; alcohol use disorder (AUD); alcoholism; amygdala; comorbid PTSD and AUD; hippocampus; mesolimbic reward circuit; norepinephrine; post-traumatic stress disorder (PTSD); prefrontal cortex.

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Figures

Figure 1. Neurobiology of comorbid PTSD and AUD

Illustration of hallmark central and peripheral nervous system changes associated with PTSD (left), AUD (right), PTSD + AUD (bottom) and relative to healthy controls (top). All denoted biological changes reflect the human literature on PTSD, AUD or comorbid PTSD + AUD, although it should be noted that very few human studies have focused specifically on the neurobiology and neurophysiology of comorbid PTSD + AUD. Smaller size of a structure reflects literature showing volumetric reductions in that brain structure. Yellow glow of structures and connections reflects normal function in healthy controls (top). Absence or exaggeration of yellow glow in other panels indicates functional deficits or hyperactivity in those structures and/or pathways. Upward and downward arrows indicate evidence in support of effects in both directions in a particular brain region. Question marks indicate ambiguity of findings or lack of information, as summarized in the text.

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Neurobiology of comorbid post-traumatic stress disorder and alcohol-use disorder - PubMed (original) (raw)