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Paul Thuras

5 papers in the library · 16 citations · publishing 2018-2024

Papers

Serotonin Transporter (SLC6A4) and FK506-Binding Protein 5 (FKBP5) Genotype and Methylation Relationships with Response to Meditation in Veterans with PTSD.

Molecular Neurobiology November 1, 2024 Adam M Lee, Paul Thuras, Joshua Baller et al. 9 citations

Meditation-based therapies such as mindfulness-based stress reduction and Transcendental Meditation can reduce PTSD symptoms in veterans. In 72 veterans with PTSD, those with the 5HTTLPR LALA high expression genotype of the serotonin transporter gene who had experienced early life trauma showed greater symptom improvement. Additionally, changes in DNA methylation at nine specific sites in the FKBP5 gene from before to after treatment were linked to greater symptom improvement, with an odds ratio of 2.8. These findings suggest that genetic and epigenetic markers in the SLC6A4 and FKBP5 genes may be important for understanding treatment mechanisms and predicting symptom improvement.

Ketamine-enhanced prolonged exposure therapy in veterans with PTSD: A randomized controlled trial protocol.

Contemporary Clinical Trials August 1, 2024 Paulo R Shiroma, Paul Thuras, Melissa A Polusny et al. 7 citations

Trauma-focused therapies like Prolonged Exposure (PE) are recommended over medication for PTSD, but 30% to 50% of military and veteran patients do not show meaningful symptom improvement. Ketamine, an anesthetic that affects glutamate signaling, has shown in preclinical studies to improve extinction learning and reduce fear renewal. A planned randomized controlled trial will compare three ketamine infusions to an active placebo (midazolam) given alongside PE therapy in veterans with PTSD. Infusions occur 24 hours before PE sessions for the first three weeks. Out of 100 veterans, 80 are expected to reach the primary outcome assessment. Secondary outcomes include depression, anxiety, safety, cognition, and dropout rates. Results may clarify which components are essential and which patients benefit most.

A Retrospective Pilot Study of Imagery Rehearsal Therapy Enhanced with Narrative Therapy Principles for the Treatment of Nightmares in US Military Veterans.

Sleep science (Sao Paulo, Brazil) December 1, 2023 Ann Marie Wagner, Anne Richards, Christine Chiros et al.

A brief intervention combining imagery rehearsal therapy with narrative therapy principles reduced nightmare frequency and intensity in eight veterans with PTSD-related nightmares. After a single 60-minute rescripting session and four weeks of homework, participants reported significant decreases in nightmare frequency and intensity, along with improvements in nightmare distress, coping, sleep quality, and overall PTSD symptoms. These pilot results suggest the approach is effective for veterans, though larger controlled trials are needed to confirm effectiveness.

Transcendental meditation for veterans with post-traumatic stress disorder.

Psychological trauma : theory, research, practice and policy November 1, 2018 Seung Suk Kang, Christopher R Erbes, Greg J Lamberty et al.

Transcendental Meditation (TM), a mantra-based technique, appears to be an acceptable and effective treatment for veterans with posttraumatic stress disorder (PTSD). In a pilot study of 29 veterans (20.7% female), eight weeks of TM instruction led to reductions in PTSD symptoms, experiential avoidance, and depressive and somatic symptoms, along with increases in mindfulness and quality of life. These gains were maintained or improved at a two-month follow-up. Electroencephalography (EEG) showed increased low-frequency (1-7 Hz) spectral power during meditation states at posttreatment and follow-up, indicating TM-specific changes in brain state. The findings warrant further study of TM's outcomes and beneficial brain changes.

Methylation of FKBP5 and SLC6A4 in Relation to Treatment Response to Mindfulness Based Stress Reduction for Posttraumatic Stress Disorder.

Frontiers in Psychiatry January 1, 2018 Jeffrey R Bishop, Adam M Lee, Lauren J Mills et al.

Veterans with PTSD who responded to Mindfulness Based Stress Reduction (MBSR) showed decreased methylation in a specific region of the FKBP5 gene after treatment, while non-responders showed increased methylation. The change occurred in a glucocorticoid response element, suggesting meditation may affect stress-related molecular pathways. No baseline methylation differences were found between responders and non-responders. These preliminary results from 22 veterans indicate FKBP5 DNA methylation could be a biomarker for MBSR treatment response in PTSD, but validation in larger studies is needed.