A report on Post-traumatic stress disorder and Locus coeruleus

Service members use art to relieve PTSD symptoms.
Rhomboid fossa. (Locus coeruleus not labeled, but is very near [just lateral to] the colliculus facialis, which is labeled at center left.)
No quieren (They do not want to) by Francisco Goya (1746–1828) depicts an elderly woman wielding a knife in defense of a girl being assaulted by a soldier.
Locus coeruleus and its influence pathways
Regions of the brain associated with stress and post-traumatic stress disorder
The diagram depicts how emotions, thoughts, and behaviors all influence each other. The triangle in the middle represents CBT's tenet that all humans' core beliefs can be summed up in three categories: self, others, future.
Vietnam Veterans Memorial, Washington, D.C.
Statue, Three Servicemen, Vietnam Veterans Memorial
Disability-adjusted life year rates for post-traumatic stress disorder per 100,000 inhabitants in 2004 no data < 43.5 43.5–45 45–46.5 46.5–48 48–49.5 49.5–51 51–52.5 52.5–54 54–55.5 55.5–57 57–58.5 > 58.5

Psychiatric research has documented that enhanced noradrenergic postsynaptic responsiveness in the neuronal pathway (brain circuit) that originates in the locus coeruleus and ends in the basolateral nucleus of the amygdala is a major factor in the pathophysiology of most stress-induced fear-circuitry disorders and especially in posttraumatic stress disorder (PTSD).

- Locus coeruleus

The maintenance of fear has been shown to include the HPA axis, the locus coeruleus-noradrenergic systems, and the connections between the limbic system and frontal cortex.

- Post-traumatic stress disorder
Service members use art to relieve PTSD symptoms.

5 related topics with Alpha

Overall
Location of the amygdalae in the human brain

Amygdala

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One of two almond-shaped clusters of nuclei located deep and medially within the temporal lobes of the brain's cerebrum in complex vertebrates, including humans.

One of two almond-shaped clusters of nuclei located deep and medially within the temporal lobes of the brain's cerebrum in complex vertebrates, including humans.

Location of the amygdalae in the human brain
Human brain in the coronal orientation. Amygdalae are shown in dark red.
MRI coronal view of the right amygdala
Coronal section of brain through intermediate mass of third ventricle. Amygdala is shown in purple.
Rorschach test blot 03
Frontal and side view of amygdala
Amygdala along with other subcortical regions, in glass brain.
Dorsal view of the amygdala in an average human brain
Frontal view of the amygdala in an average human brain
Left lateral view of the amygdala in an average human brain
thumb|Amygdala highlighted in green on coronal T1 MRI images
thumb|Amygdala highlighted in green on sagittal T1 MRI images
thumb|Amygdala highlighted in green on transversal T1 MRI images

A simple view of the information processing through the amygdala follows as: the amygdala sends projections to the hypothalamus, the dorsomedial thalamus, the thalamic reticular nucleus, the nuclei of the trigeminal nerve and the facial nerve, the ventral tegmental area, the locus coeruleus, and the laterodorsal tegmental nucleus.

The left amygdala has been linked to social anxiety, obsessive and compulsive disorders, and post traumatic stress, as well as more broadly to separation and general anxiety.

Humans have two hippocampi, one in each hemisphere of the brain. They are located in the medial temporal lobes of the cerebrum. In this lateral view of the human brain, the frontal lobe is at the left, the occipital lobe at the right, and the temporal and parietal lobes have largely been removed to reveal one of the hippocampi underneath.

Hippocampus

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Major component of the brain of humans and other vertebrates.

Major component of the brain of humans and other vertebrates.

Humans have two hippocampi, one in each hemisphere of the brain. They are located in the medial temporal lobes of the cerebrum. In this lateral view of the human brain, the frontal lobe is at the left, the occipital lobe at the right, and the temporal and parietal lobes have largely been removed to reveal one of the hippocampi underneath.
Image 1: The human hippocampus and fornix (left) compared with a seahorse (right)
Image 2: Cross-section of cerebral hemisphere showing structure and location of hippocampus
Image 3: Coronal section of the brain of a macaque monkey, showing hippocampus (circled)
Image 4: Basic circuit of the hippocampus, as drawn by Cajal DG: dentate gyrus. Sub: subiculum. EC: entorhinal cortex
Image 5: Hippocampal location and regions
Rats and cognitive maps
Image 6: Spatial firing patterns of 8 place cells recorded from the CA1 layer of a rat. The rat ran back and forth along an elevated track, stopping at each end to eat a small food reward. Dots indicate positions where action potentials were recorded, with color indicating which neuron emitted that action potential.
Image 7: Examples of rat hippocampal EEG and CA1 neural activity in the theta (awake/behaving) and LIA (slow-wave sleep) modes. Each plot shows 20 seconds of data, with a hippocampal EEG trace at the top, spike rasters from 40 simultaneously recorded CA1 pyramidal cells in the middle (each raster line represents a different cell), and a plot of running speed at the bottom. The top plot represents a time period during which the rat was actively searching for scattered food pellets. For the bottom plot the rat was asleep.
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Image 9: An EEG showing epilepsy right-hippocampal seizure onset
Image 10: An EEG showing epilepsy left-hippocampal seizure onset
Image 11: Drawing by Italian pathologist Camillo Golgi of a hippocampus stained using the silver nitrate method
thumb|Hippocampus highlighted in green on coronal T1 MRI images
thumb|Hippocampus highlighted in green on sagittal T1 MRI images
thumb|Hippocampus highlighted in green on transversal T1 MRI images

Different thalamic nuclei, (from the anterior and midline groups), the medial septal nucleus, the supramammillary nucleus of the hypothalamus, and the raphe nuclei and locus coeruleus of the brainstem all send axons to the EC, so that it serves as the interface between the neocortex and the other connections, and the hippocampus.

These effects show up in post-traumatic stress disorder, and they may contribute to the hippocampal atrophy reported in schizophrenia and severe depression.

Skeletal formula of noradrenaline

Norepinephrine

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Organic chemical in the catecholamine family that functions in the brain and body as both a hormone and neurotransmitter.

Organic chemical in the catecholamine family that functions in the brain and body as both a hormone and neurotransmitter.

Skeletal formula of noradrenaline
Norepinephrine degradation. Metabolizing enzymes are shown in boxes.
Norepinephrine (labeled "noradrénaline" in this drawing) processing in a synapse. After release norepinephrine can either be taken up again by the presynaptic terminal, or broken down by enzymes.
Schema of the sympathetic nervous system, showing the sympathetic ganglia and the parts of the body to which they connect.
Brain areas containing noradrenergic neurons.
Chemical structure of octopamine, which serves as the homologue of norepinephrine in many invertebrate species

The most important of these nuclei is the locus coeruleus, located in the pons.

Their effects on the central nervous system make them useful for treating generalized anxiety disorder, panic disorder, and posttraumatic stress disorder.

Duloxetine, an example of an SNRI.

Serotonin–norepinephrine reuptake inhibitor

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Serotonin–norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant drugs used to treat major depressive disorder (MDD), anxiety disorders, obsessive–compulsive disorder (OCD), social phobia, attention-deficit hyperactivity disorder (ADHD), chronic neuropathic pain, fibromyalgia syndrome (FMS), and menopausal symptoms.

Serotonin–norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant drugs used to treat major depressive disorder (MDD), anxiety disorders, obsessive–compulsive disorder (OCD), social phobia, attention-deficit hyperactivity disorder (ADHD), chronic neuropathic pain, fibromyalgia syndrome (FMS), and menopausal symptoms.

Duloxetine, an example of an SNRI.
Timeline of approved SNRIs.
Timeline of development of antidepressant agents.
Inhibiting the reuptake transport protein results in increased concentrations of serotonin and norepinephrine in the synaptic clefts, leading to improvement of depression symptoms.
Aryloxypropanamine scaffold and agents containing it.
Cycloalkanol ethylamine scaffold and agents containing it.
Structure of milnacipran.

These regions are locus coeruleus and lateral tegmental.

Posttraumatic stress disorder (PTSD)

Sorrowing Old Man (At Eternity's Gate) by Vincent van Gogh (1890)

Major depressive disorder

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Mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities.

Mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities.

Sorrowing Old Man (At Eternity's Gate) by Vincent van Gogh (1890)
An 1892 lithograph of a woman diagnosed with melancholia
A cup analogy demonstrating the diathesis–stress model that under the same amount of stressors, person 2 is more vulnerable than person 1, because of their predisposition.
Caricature of a man with depression
Physical exercise is one recommended way to manage mild depression.
Sertraline (Zoloft) is used primarily to treat major depression in adults.
Diagnoses of depression go back at least as far as Hippocrates.
The 16th American president, Abraham Lincoln, had "melancholy", a condition that now may be referred to as clinical depression.

Third, decreased size of the locus coeruleus, decreased activity of tyrosine hydroxylase, increased density of alpha-2 adrenergic receptor, and evidence from rat models suggest decreased adrenergic neurotransmission in depression.

Post-traumatic stress disorder and depression often co-occur.