A prospective examination of sex differences in posttraumatic autonomic functioning.

Autor:	Seligowski AV; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA.; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA., Steuber ER; Department of Psychiatry, Johns Hopkins Hospital, Baltimore, MD, 21287, USA., Hinrichs R; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA., Reda MH; Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA., Wiltshire CN; Wayne State University, Detroit, MA, 48202, USA., Wanna CP; Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA., Winters SJ; Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA., Phillips KA; McLean Hospital, Belmont, MA, 02478, USA.; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA., House SL; Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA., Beaudoin FL; Department of Emergency Medicine & Department of Health Services, Policy, and Practice, The Alpert Medical School of Brown University, Rhode Island Hospital and the Miriam Hospital, Providence, RI, 02930, USA., An X; Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA., Stevens JS; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA., Zeng D; Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27559, USA., Neylan TC; Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, 94143, USA., Clifford GD; Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, 30332, USA.; Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA., Linnstaedt SD; Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA., Germine LT; Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA.; The Many Brains Project, Belmont, MA, 02478, USA.; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA., Bollen KA; Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA., Guffanti G; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA.; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA., Rauch SL; Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA.; Department of Psychiatry, McLean Hospital, Belmont, MA, 02478, USA.; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA., Haran JP; Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, 01655, USA., Storrow AB; Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA., Lewandowski C; Department of Emergency Medicine, Henry Ford Health System, Detroit, MI, 48202, USA., Musey PI Jr; Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA., Hendry PL; Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA., Sheikh S; Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA., Jones CW; Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, 08103, USA., Punches BE; Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA.; College of Nursing, University of Cincinnati, Cincinnati, OH, 45221, USA., Kurz MC; Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, AL, 35294, USA.; Department of Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham, AL, 35294, USA.; Center for Injury Science, University of Alabama at Birmingham, Birmingham, AL, 35294, USA., Murty VP; Department of Psychology, Temple University, Philadelphia, PA, 19121, USA., McGrath ME; Department of Emergency Medicine, Boston Medical Center, Boston, MA, 02118, USA., Hudak LA; Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, 30329, USA., Pascual JL; Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Pennsylvania, PA, 19104, USA.; Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, 19104, USA., Seamon MJ; Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Pennsylvania, PA, 19104, USA.; Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, 19104, USA., Datner EM; Department of Emergency Medicine, Einstein Healthcare Network, Pennsylvania, PA, 19141, USA.; Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Pennsylvania, PA, 19107, USA., Chang AM; Department of Emergency Medicine, Jefferson University Hospitals, Pennsylvania, PA, 19107, USA., Pearson C; Department of Emergency Medicine, Wayne State University, Detroit, MA, 48202, USA., Peak DA; Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA., Merchant RC; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA., Domeier RM; Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI, 48197, USA., Rathlev NK; Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, 01107, USA., O'Neil BJ; Department of Emergency Medicine, Wayne State University, Detroit, MA, 48202, USA., Sanchez LD; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.; Department of Emergency Medicine, Harvard Medical School, Boston, MA, 02115, USA., Bruce SE; Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, 63121, USA., Miller MW; National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, 02130, USA.; Department of Psychiatry, Boston University School of Medicine, Boston, MA, 02118, USA., Pietrzak RH; National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA.; Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA., Joormann J; Department of Psychology, Yale School of Medicine, New Haven, CT, 06510, USA., Barch DM; Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, 63130, USA., Pizzagalli DA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA.; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA., Sheridan JF; Department of Biosciences, OSU Wexner Medical Center, Columbus, OH, 43210, USA.; Institute for Behavioral Medicine Research, OSU Wexner Medical Center, Columbus, OH, 43211, USA., Luna B; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15213, USA., Harte SE; Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.; Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA., Elliott JM; Kolling Institute of Medical Research, University of Sydney, St Leonards, New South Wales, 2065, Australia.; Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, New South Wales, 2006, Australia.; Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60208, USA., Koenen KC; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 02115, USA., Kessler RC; Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA., McLean SA; Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA.; Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA., Ressler KJ; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA.; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA., Jovanovic T; Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA.
Jazyk:	angličtina
Zdroj:	Neurobiology of stress [Neurobiol Stress] 2021 Aug 21; Vol. 15, pp. 100384. Date of Electronic Publication: 2021 Aug 21 (Print Publication: 2021).
DOI:	10.1016/j.ynstr.2021.100384
Abstrakt:	Background: Cross-sectional studies have found that individuals with posttraumatic stress disorder (PTSD) exhibit deficits in autonomic functioning. While PTSD rates are twice as high in women compared to men, sex differences in autonomic functioning are relatively unknown among trauma-exposed populations. The current study used a prospective design to examine sex differences in posttraumatic autonomic functioning. Methods: 192 participants were recruited from emergency departments following trauma exposure ( Mean age = 35.88, 68.2% female). Skin conductance was measured in the emergency department; fear conditioning was completed two weeks later and included measures of blood pressure (BP), heart rate (HR), and high frequency heart rate variability (HF-HRV). PTSD symptoms were assessed 8 weeks after trauma. Results: 2-week systolic BP was significantly higher in men, while 2-week HR was significantly higher in women, and a sex by PTSD interaction suggested that women who developed PTSD demonstrated the highest HR levels. Two-week HF-HRV was significantly lower in women, and a sex by PTSD interaction suggested that women with PTSD demonstrated the lowest HF-HRV levels. Skin conductance response in the emergency department was associated with 2-week HR and HF-HRV only among women who developed PTSD. Conclusions: Our results indicate that there are notable sex differences in autonomic functioning among trauma-exposed individuals. Differences in sympathetic biomarkers (BP and HR) may have implications for cardiovascular disease risk given that sympathetic arousal is a mechanism implicated in this risk among PTSD populations. Future research examining differential pathways between PTSD and cardiovascular risk among men versus women is warranted. Competing Interests: In the last three years GDS has received research funding from the NSF, NIH and LifeBell AI, and unrestricted donations from AliveCor, Amazon Research, the Center for Discovery, the Gordon and Betty Moore Foundation, MathWorks, Microsoft Research, the Gates Foundation, Google, One Mind Foundation, and Samsung Research. GDS has financial interest in AliveCor and receives unrestricted funding from the company. He is also the CTO of MindChild Medical and CSO of LifeBell AI and has ownership in both companies. These relationships are unconnected to the current work. In the past three years, LTG has served on the Scientific Advisory Board of Sage Bionetworks, for which she received a small honorarium. SLR reports grants from NIH during the conduct of the study; personal fees from SOBP (Society of Biological Psychiatry) paid role as secretary, other from Oxford University Press royalties, other from APP (American Psychiatric Publishing Inc.) royalties, other from VA (Veterans Administration) per diem for oversight committee, and other from Community Psychiatry paid board service, including equity outside the submitted work; and Leadership roles on Board or Council for SOBP, ADAA (Anxiety and Depression Association of America), and NNDC (National Network of Depression Centers). SS has received funding from the Florida Medical Malpractice Joint Underwriter's Association Dr. Alvin E. Smith Safety of Healthcare Services Grant; Allergan Foundation; the NIH/NIA-funded Jacksonville Aging Studies Center (JAX-ASCENT; R33AG05654); and the Substance Abuse and Mental Health Services Administration (1H79TI083101-01); and the Florida Blue Foundation. CWJ reports no direct conflicts related to this paper. He has been an investigator on studies funded by Hologic Inc, Janssen, AstraZeneca, and Vapotherm, for which his department has received research funding. JJ receives consulting payments from Janssen Pharmaceuticals. Over the past three years, DAP has received consulting fees from Albright Stonebridge Group, BlackThorn Therapeutics, Boehringer Ingelheim, Compass Pathway, Concert Pharmaceuticals, Engrail Therapeutics, Neurocrine Biosciences, Otsuka Pharmaceuticals, and Takeda Pharmaceuticals as well as one honorarium from Alkermes. In addition, he has received stock options from BlackThorn Therapeutics, and research support from National Institute of Mental Health, Dana Foundation, Brain and Behavior Research Foundation, and Millennium Pharmaceuticals. No funding from these entities was used to support the current work, and all views expressed are solely those of the authors. JME reports support from the National Institutes of Health (NIH) through Grant Numbers R01HD079076 & R03HD094577, Eunice Kennedy Shriver National Institute of Child Health & Human Development, and National Center for Medical Rehabilitation Research. He also reports funding from the New South Wales Health Spinal Cord Injury Research Grants Program and consulting fees (<$15,000 per annum) from Orofacial Therapeutics, LLC. In the past 3 years, RCK was a consultant for Datastat, Inc., Holmusk, RallyPoint Networks, Inc., and Sage Pharmaceuticals. He has stock options in Mirah, PYM, and Roga Sciences. KJR has received consulting income from Alkermes, research support from NIH, Genomind and Brainsway, and he is on scientific advisory boards for Janssen and Verily, all of which is unrelated to the present work. All other authors have no conflicts of interest to disclose. (© 2021 The Authors.)
Databáze:	MEDLINE
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