Original scientific paper
Effect of Elevated Catecholamine Levels on Cerebral Hemodynamics in Patients With Chronic Post-Traumatic Stress Disorder
Marinko Dikanović
Vida Demarin
Dragutin Kadojić
Mira Kadojić
Zlatko Trkanjec
Marina Titlić
Milan Bitunjac
Silva Soldo-Butković
Abstract
The aim of the study was to assess the correlation between the levels of catecholamines and cerebral hemodynamics in
patients with chronic post-traumatic stress disorder (PTSD). The study included 50 patients with chronic PTSD hospitalized
for psychiatric treatment for the first time, and 50 healthy control subjects. All study subjects were in the 30–50
age group. In PTSD group, determination of vanllylmandelic acid (VMA), an epinephrine and norepinephrine metabolite,
in 24-h urine and transcranial Doppler (TCD) sonography of the circle of Willis vasculature were performed on the
first day of hospital stay. The same diagnostic procedures were repeated upon the completion of 21-day medicamentous
psychiatric treatment. Initial analysis revealed concurrently elevated 24-h VMA in 29 (58.00%) patients and increased
values of the mean blood flow velocity (MBFV) in the circle of Willis vasculature in 34 (68.00%) patients, indicating a
high correlation of the respective parameters (p=0.3290). Second analysis performed after 21-day psychiatric treatment
showed concurrently elevated 24-h VMA in eight (16.00%) patients and increased MBFV in the circle of Willis vasculature
in nine (18.00%) patients, also pointing to a high correlation of the parameters observed (p=0.7906). In the control
group, only two (4.00%) subjects had elevated MBFV in the circle ofWillis vessels, whereas the level of 24-h VMA was
normal in all control subjects. Study results pointed to a significant association between elevated levels of stress hormones
and increased MBFV in the circle ofWillis vasculature caused by cerebral vasospasm.Medicamentous psychiatric
treatment for PTSD administered for three weeks significantly reduced the proportion of PTSD patients with elevated
levels of the catecholamine metabolite and cerebral vasospasm. Study results showed a high correlation between diurnal
VMA level and elevated MBFV in the circle of Willis vessels, clearly demonstrating the effect of prolonged elevation of
catecholamine levels on cerebral hemodynamics.
Keywords
chronic post-traumatic stress disorder; catecholamines; cerebral hemodynamics; transcranial ultrasonography
Hrčak ID:
69130
URI
Publication date:
24.6.2011.
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