Abstract
Little is understood about cognitive mechanisms that confer risk and resiliency for posttraumatic stress disorder (PTSD). Prepulse Inhibition (PPI) is a measure of pre-attentional response inhibition that is a stable cognitive trait disrupted in many neuropsychiatric disorders characterized by poor behavioral or cognitive inhibition, including PTSD. Differentiating between PTSD-related phenotypes that are pre-existing factors vs. those that emerge specifically after trauma is critical to understanding PTSD etiology and can only be addressed by prospective studies. This study tested the hypothesis that sensorimotor gating performance is associated with risk/resiliency for combat-related PTSD. As part of a prospective, longitudinal study, 1226 active duty Marines and Navy Corpsman completed a PPI test as well as a clinical interview to assess PTSD symptoms both before, and 3 and 6 months after a combat deployment. Participants that developed PTSD 6 months following deployment (N=46) showed lower PPI across pre and post-deployment time points compared to participants who did not develop PTSD (N=1182) . Examination of the distribution of PTSD across PPI performance revealed a lower than expected number of cases in the highest performing quartile compared to the rest of the distribution (p < 0.04). When controlling for other factors that predict PTSD in this population, those in the top 25% of PPI performance showed a >50% reduction in chance to develop PTSD (OR = 0.32). Baseline startle reactivity and startle habituation were not significantly different between PTSD risk and control groups. These findings suggest that robust sensorimotor gating may represent a resiliency factor for development of PTSD following trauma.
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Funding
Support for this work includes NIMH P50MH096889 (DGB and VBR), a Department of Veterans Affairs Merit Award and NIH R01AA026560 (VBR), project No. SDR 09-0128 (DGB and VBR) from the Veterans Administration Health Service Research and Development, the US Marine Corps and Navy Bureau of Medicine and Surgery (DGB and VBR), and the Center of Excellence for Stress and Mental Health (all authors). VBR is also the recipient of a Research Career Scientist award (# IK6BX006186) from the Department of Veterans Affairs. The project described was also supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1 TR001414. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
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VBR, MAG, and DGB designed the study and supervised data collection and edited the manuscript, DTA contributed to data collection, conducted the analysis, and lead the manuscript preparation, CMN, KAY, and VBR aided data collection, processing, and analysis and edited the manuscript.
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Acheson, D.T., Baker, D.G., Nievergelt, C.M. et al. Prospective longitudinal assessment of sensorimotor gating as a risk/resiliency factor for posttraumatic stress disorder. Neuropsychopharmacol. 47, 2238–2244 (2022). https://doi.org/10.1038/s41386-022-01460-9
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DOI: https://doi.org/10.1038/s41386-022-01460-9
