Identification and characterization of HPA-axis reactivity endophenotypes in a 
cohort of female PTSD patients

Zaba, Monika; Kirmeier, Thomas; Ionescu, Irina A.; Wollweber, Bastian; Büll, Dominik R.; Gall-Kleebach, Dominique J.; Schubert, Christine F.; Novak, Bozidar; Huber, Christine; Köhler, Katharina; Holsboer, Florian; Pütz, Benno; Müller-Myhsok, Bertram; Höhne, Nina; Uhr, Manfred; Ising, Marcus; Herrmann, Leonie; Schmidt, Ulrike

doi:10.1016/j.psyneuen.2015.02.005

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Identification and characterization of HPA-axis reactivity endophenotypes in a cohort of female PTSD patients

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/persons/resource/persons183495

Zaba, Monika
Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons80398

Kirmeier, Thomas
Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons80378

Ionescu, Irina A.
Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons80597

Wollweber, Bastian
Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons80282

Büll, Dominik R.
Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons80331

Gall-Kleebach, Dominique J.
Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons185103

Schubert, Christine F.
Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons185107

Novak, Bozidar
Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons185105

Huber, Christine
Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons185126

Köhler, Katharina
Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons80372

Holsboer, Florian
Dept. Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons80482

Pütz, Benno
Dept. Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons80450

Müller-Myhsok, Bertram
Dept. Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons80369

Höhne, Nina
Dept. Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons80563

Uhr, Manfred
Dept. Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons80379

Ising, Marcus
Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons80362

Herrmann, Leonie
Max Planck Institute of Psychiatry, Max Planck Society;

/persons/resource/persons80515

Schmidt, Ulrike
Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society;

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Citation

Zaba, M., Kirmeier, T., Ionescu, I. A., Wollweber, B., Büll, D. R., Gall-Kleebach, D. J., et al. (2015). Identification and characterization of HPA-axis reactivity endophenotypes in a cohort of female PTSD patients. PSYCHONEUROENDOCRINOLOGY, 55, 102-115. doi:10.1016/j.psyneuen.2015.02.005.

Cite as: https://hdl.handle.net/11858/00-001M-0000-0028-854D-9

Abstract

Analysis of the function of the hypothalamic-pituitary-adrenal (HPA)-axis in patients suffering from posttraumatic stress disorder (PTSD) has hitherto produced inconsistent findings, inter alia in the Trier Social Stress Test (TSST). To address these inconsistencies, we compared a sample of 23 female PTSD patients with either early life trauma (ELT) or adult trauma (AT) or combined ELT and AT to 18 age-matched non-traumatized female healthy controls in the TSST which was preceded by intensive baseline assessments. During the TSST, we determined a variety of clinical, psychological, endocrine and cardiovascular parameters as well as expression levels of four HPA-axis related genes. Using a previously reported definition of HPA-axis responsive versus non-responsive phenotypes, we identified for the first time two clinically and biologically distinct HPA-axis reactivity subgroups of PTSD. One subgroup ("non-responders") showed a blunted HPA-axis response and distinct clinical and biological characteristics such as a higher prevalence of trauma-related dissociative symptoms and of combined AT and ELT as well as alterations in the expression kinetics of the genes encoding for the mineralocorticoid receptor (MR) and for FK506 binding protein 51 (FKBP51). Interestingly, this non-responder subgroup largely drove the relatively diminished HPA axis response of the total cohort of PTSD patients. These findings are limited by the facts that the majority of patients was medicated, by the lack of traumatized controls and by the relatively small sample size. The here for the first time identified and characterized HPA-axis reactivity endophenotypes offer an explanation for the inconsistent reports on HPA-axis function in PTSD and, moreover, suggest that most likely other factors than HPA-axis reactivity play a decisive role in determination of PTSD core symptom severity. (C) 2015 Elsevier Ltd. All rights reserved.