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.
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.
Mindfulness
October 1, 2022
Itamar Shapira, Joshua Richman, Thaddeus W W Pace et al.
In veterans with PTSD, mindfulness-based stress reduction (MBSR) and present-centered group therapy both increased morning cortisol levels from baseline to 9 weeks, but the increase was significantly smaller with MBSR (mean difference 1.69 ± 0.8 SE). Changes in interleukin-6 and C-reactive protein did not differ between groups. Greater self-reported mindfulness was linked to higher cortisol and to reduced PTSD and depression severity. Higher IL-6 and CRP were associated with less severe PTSD but not depression. Pooled results confirmed MBSR outperformed the active control for clinical improvement. Increased mindfulness may recalibrate cortisol levels, suggesting a therapeutic response.
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.
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.