期刊
CLINICAL AUTONOMIC RESEARCH
卷 30, 期 5, 页码 409-421出版社
SPRINGER HEIDELBERG
DOI: 10.1007/s10286-020-00729-7
关键词
PTSD; Sex differences; MSNA; Heart rate variability; Baroreflex; Inflammation
资金
- National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) [UL1TR002378, KL2TR002381]
- NIH training grant [T32 DK-00756]
- NIH Mental Health (NIMH) [R01 MH115174]
- Emory Specialized Center of Research Excellence (SCORE) on Sex Differences [U54 AG062334]
- United States Department of Veterans Affairs Clinical Sciences Research and Development Program Merit Review Award [I01CX001065]
- American Heart Association National Affiliate, Collaborative Sciences Award [15CSA24340001]
- NIH, National Heart Lung Blood Institute (NHLBI) [R01 HL135183]
- NIH National Center for Complementary and Integrative Health (NCCIH) [R61 AT010457]
- NIH [T32 DK-00756]
Aim Over 7 million U.S. adults and about 20% of the military population have post-traumatic stress disorder (PTSD), a debilitating condition that is independently linked to a significantly greater risk of developing cardiovascular disease (CVD). Women have twice the probability of developing PTSD after experiencing a traumatic event compared to men. Existing literatures have reported higher inflammation and autonomic dysfunction including impaired baroreflex sensitivity, increased sympathetic reactivity and decreased parasympathetic activity in PTSD. However, most of these findings stem from studies conducted predominantly in males. Methods We attempt in this narrative review to summarize the mixed literature available on sex differences in autonomic dysfunction and inflammation in PTSD, at rest and in response to stress in PTSD. Results This review reveals that there is a paucity of research exploring autonomic function in females with PTSD. Recent studies have included female participants without probing for sex differences. A small number of studies have been conducted exclusively in women. Available data suggest that sympathetic nervous system output tends to be heightened, while parasympathetic activity and arterial baroreflex sensitivity appear more blunted in females with PTSD. Although few studies have investigated sex differences in inflammation in PTSD, data within females suggest chronic increases in inflammation with PTSD. This autonomic dysregulation and inflammation have also been described in males with PTSD. Conclusion In sum, given the inherent biological differences in CVD clinical presentation and characteristics between men and women, human and animal studies aiming at elucidating sex differences in the pathophysiology of PTSD are needed.
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