Neuroendocrine pathways underlying risk and resilience to PTSD in women

• Type of Material: Article
• Authors: Meghna Ravi, Emory University; Jennifer Stevens, Emory University; Vasiliki Michopoulos, Emory University
• Language: English
• Date: 2019-10-01
• Publisher: ACADEMIC PRESS INC ELSEVIER SCIENCE
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.yfrne.2019.100790
• Title of Journal or Parent Work: FRONTIERS IN NEUROENDOCRINOLOGY
• Volume: 55
• Start Page: 100790
• End Page: 100790
• Grant/Funding Information: This review was supported in part by the National Institute of Health: MH115174 (VM), MH117009 (JSS) and HD085850. Supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002378. The authors declare no conflict of interest.
• Keywords: FUNCTIONAL CONNECTIVITY; Science & Technology; LONG-TERM POTENTIATION; Life Sciences & Biomedicine; Fear psychophysiology; POSTTRAUMATIC-STRESS-DISORDER; Women; Endocrinology & Metabolism; CORTICOTROPIN-RELEASING HORMONE; FEAR-POTENTIATED STARTLE; MEDIAL PREFRONTAL CORTEX; MESSENGER-RNA EXPRESSION; Neurosciences; SEX-DIFFERENCES; Neuroimaging; HYPOTHALAMIC PARAVENTRICULAR NUCLEUS; Estrogen; Neurosciences & Neurology; PTSD; Progesterone; MENSTRUAL-CYCLE

Abstract

Women are twice as likely than men to suffer from posttraumatic stress disorder (PTSD). While women have increased exposure to traumatic events of many types and have greater prevalence of comorbid psychiatric disorders compared to men, these differences do not account for the overall sex difference in the prevalence of PTSD. The current review summarizes significant findings that implicate the role of estradiol, progesterone, and allopregnanolone in female risk for PTSD symptoms and dysregulation of fear psychophysiology that is cardinal to PTSD. We also discuss how these steroid hormones influence the stress axis and neural substrates critical for the regulation of fear responses. Understanding the role of ovarian steroid hormones in risk and resilience for trauma-related adverse mental health outcomes across the lifespan in women has important translational, clinical, and intergenerational implications for mitigating the consequences of trauma exposure.