Hacia una comprensión neurocientífica del trastorno por estrés postraumático en las víctimas del atentado terrorista del 11 de septiembre de 2001

Abstract

IntroductionOf all the individuals exposed to a traumatic event, only as small percentage of them develop a post-traumatic stress disorder (PTSD). Neurosciences have suggested that there is a certain genetic predisposition that would increase the vulnerability to develop the disorder, as well as the deregulation of several neurochemical systems as correlates of the disorder. Furthermore, a hypothesis has been put forward of the possible inter-generational transmission of the aforementioned disorder. Material and methodTo review and summarise the results obtained in relation to the psycho-biological factors that increase the vulnerability to develop PTSD after the aftermath of the 9/11 attacks on the Twin Towers, as well as the potential correlates with such disorders. The scientific literature was reviewed using searches in PubMed/Medline and Google Scholar. Results9/11 victims, in particular those that developed a PTSD, an specific number of allelic variants of the hypothalamic-pituitary-adrenal (HPA) axis, the oxytocinergic and serotoninergic systems that may confer a greater vulnerability to develop this disorder. Furthermore, at a neuro-anatomical level there could be modifications in the endocannabinoid and serotoninergic systems. Likewise, way they signal the reduction in the activity of the retrosplenial cortex, the dorsal regions of the prefrontal cortex, the precuneus, the caudal and parahippocampal gyrus, as well as the bilateral over-activation of the amygdala, as possible correlates of the characteristic symptoms of PTSD. Lastly, despite the fact that normal daily fluctuations at HPA axis level are sustained by the secretion of cortisol, individuals affected by PTSD may have a low baseline plasma cortisol, but with a relatively conserved stress response. DiscussionAll of these changes could facilitate the inter-generational transmission of the disorder, since they would be determining factors in the prenatal environment. In this way, the composition of the amniotic fluid would be affected by the stress arising from the traumatic event, as well as to the exposure to the environmental contaminants released during the terrorist attack. Therefore, the extent of the terrorist attacks should not only consider those individually affected by it, but also to their descendants. The understanding of the aetiological underlying mechanisms of PTSD could lead the way into the development of new intervention strategies.