Thomas Mäder1,2, Katelyn I Oliver3,4, Carolina Daffre3,4, Sophie Kim3,4, Scott P Orr3,4,5, Natasha B Lasko3,4,5, Jeehye Seo3,4,5,6, Birgit Kleim1,2,7, Edward Franz Pace-Schott3,4,5. 1. Department of Psychology, University of Zurich, Zurich, Switzerland. 2. Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland. 3. Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA. 4. Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA. 5. Department of Psychiatry, Harvard Medical School, Charlestown, MA, USA. 6. Department of Psychological & Brain Sciences, University of Massachusetts, Amherst, MA, USA. 7. Neuroscience Centre Zurich, University of Zurich, Zurich, Switzerland.
Abstract
BACKGROUND: Nightmares are a hallmark symptom of posttraumatic stress disorder (PTSD). This strong association may reflect a shared pathophysiology in the form of altered autonomic activity and increased reactivity. Using an acoustic startle paradigm, we investigated the interrelationships of psychophysiological measures during wakefulness and PTSD diagnosis, posttraumatic nightmares, and nontraumatic nightmares. METHODS: A community sample of 122 trauma survivors were presented with a series of brief loud tones, while heart rate (HRR), skin conductance (SCR), and orbicularis oculi electromyogram (EMGR) responses were measured. Prior to the tone presentations, resting heart rate variability (HRV) was assessed. Nightmares were measured using nightmare logs. Three dichotomous groupings of participants were compared: (1) current PTSD diagnosis (n = 59), no PTSD diagnosis (n = 63), (2) those with (n = 26) or without (n = 96) frequent posttraumatic nightmares, and (3) those with (n = 22) or without (n = 100) frequent nontraumatic nightmares. RESULTS: PTSD diagnosis was associated with posttraumatic but not with nontraumatic nightmares. Both PTSD and posttraumatic nightmares were associated with a larger mean HRR to loud tones, whereas nontraumatic nightmare frequency was associated with a larger SCR. EMGR and resting HRV were not associated with PTSD diagnosis or nightmares. CONCLUSIONS: Our findings suggest a shared pathophysiology between PTSD and posttraumatic nightmares in the form of increased HR reactivity to startling tones, which might reflect reduced parasympathetic tone. This shared pathophysiology could explain why PTSD is more strongly related to posttraumatic than nontraumatic nightmares, which could have important clinical implications.
BACKGROUND: Nightmares are a hallmark symptom of posttraumatic stress disorder (PTSD). This strong association may reflect a shared pathophysiology in the form of altered autonomic activity and increased reactivity. Using an acoustic startle paradigm, we investigated the interrelationships of psychophysiological measures during wakefulness and PTSD diagnosis, posttraumatic nightmares, and nontraumatic nightmares. METHODS: A community sample of 122 trauma survivors were presented with a series of brief loud tones, while heart rate (HRR), skin conductance (SCR), and orbicularis oculi electromyogram (EMGR) responses were measured. Prior to the tone presentations, resting heart rate variability (HRV) was assessed. Nightmares were measured using nightmare logs. Three dichotomous groupings of participants were compared: (1) current PTSD diagnosis (n = 59), no PTSD diagnosis (n = 63), (2) those with (n = 26) or without (n = 96) frequent posttraumatic nightmares, and (3) those with (n = 22) or without (n = 100) frequent nontraumatic nightmares. RESULTS: PTSD diagnosis was associated with posttraumatic but not with nontraumatic nightmares. Both PTSD and posttraumatic nightmares were associated with a larger mean HRR to loud tones, whereas nontraumatic nightmare frequency was associated with a larger SCR. EMGR and resting HRV were not associated with PTSD diagnosis or nightmares. CONCLUSIONS: Our findings suggest a shared pathophysiology between PTSD and posttraumatic nightmares in the form of increased HR reactivity to startling tones, which might reflect reduced parasympathetic tone. This shared pathophysiology could explain why PTSD is more strongly related to posttraumatic than nontraumatic nightmares, which could have important clinical implications.
Authors: Margaret A Carson; Linda J Metzger; Natasha B Lasko; Lynn A Paulus; Amanda E Morse; Roger K Pitman; Scott P Orr Journal: J Trauma Stress Date: 2007-10
Authors: Annika Gieselmann; Malik Ait Aoudia; Michelle Carr; Anne Germain; Robert Gorzka; Brigitte Holzinger; Birgit Kleim; Barry Krakow; Anna E Kunze; Jaap Lancee; Michael R Nadorff; Tore Nielsen; Dieter Riemann; Hinuga Sandahl; Angelika A Schlarb; Carolin Schmid; Michael Schredl; Victor I Spoormaker; Regina Steil; Annette M van Schagen; Lutz Wittmann; Maria Zschoche; Reinhard Pietrowsky Journal: J Sleep Res Date: 2019-01-29 Impact factor: 3.981
Authors: Jeehye Seo; Katelyn I Oliver; Carolina Daffre; Kylie N Moore; Samuel Gazecki; Natasha B Lasko; Mohammed R Milad; Edward F Pace-Schott Journal: Sleep Date: 2022-03-14 Impact factor: 6.313
Authors: Dan Denis; Ryan Bottary; Tony J Cunningham; Shengzi Zeng; Carolina Daffre; Kaitlyn L Oliver; Kylie Moore; Samuel Gazecki; Augustus Kram Mendelsohn; Uriel Martinez; Karen Gannon; Natasha B Lasko; Edward F Pace-Schott Journal: Front Psychiatry Date: 2021-11-19 Impact factor: 4.157