Commentary| Volume 73, ISSUE 11, P1039-1040, June 01, 2013

The First Steps on the Path Toward Genomic Predictors of Behavioral Therapy for Posttraumatic Stress Disorder

  • Mary-Anne Enoch
    Address correspondence to Mary-Anne Enoch, M.D., NIH/NIAAA/DICBR/LNG, 5625 Fishers Lane, Suite 3S32, MSC 9412, Bethesda, Maryland 20892-9412
    Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
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      Not everyone who has personally experienced, or has been exposed to, severe trauma develops posttraumatic stress disorder (PTSD). The risk-resilience equation is complex and, as we are becoming increasingly aware, includes both genetic predictors and environmental stressors, starting in early childhood. For example, as Binder and colleagues (
      • Binder E.B.
      • Bradley R.G.
      • Liu W.
      • Epstein M.P.
      • Deveau T.C.
      • Mercer K.B.
      • et al.
      Association of FKBP5 polymorphisms and childhood abuse with risk of posttraumatic stress disorder symptoms in adults.
      ) first showed, FKBP5, a gene influencing activity of the hypothalamic-pituitary-adrenal axis, together with exposure to childhood trauma but not adult stressors, predicted the development of PTSD in a low-income, urban African American sample. There is much to be understood about the etiology of PTSD and equally there is much to be learned about developing new treatment options and improving the rates of response to the current first-line treatment for PTSD: cognitive behavioral therapy (CBT).
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        • Binder E.B.
        • Bradley R.G.
        • Liu W.
        • Epstein M.P.
        • Deveau T.C.
        • Mercer K.B.
        • et al.
        Association of FKBP5 polymorphisms and childhood abuse with risk of posttraumatic stress disorder symptoms in adults.
        JAMA. 2008; 299: 1291-1305
        • Andero R.
        • Ressler K.J.
        Fear extinction and BDNF: translating animal models of PTSD to the clinic.
        Genes Brain Behav. 2012; 11: 503-512
        • Lipsky R.H.
        • Marini A.M.
        Brain-derived neurotrophic factor in neuronal survival and behavior-related plasticity.
        Ann N Y Acad Sci. 2007; 1122: 130-143
        • Frielingsdorf H.
        • Bath K.G.
        • Soliman F.
        • Difede J.
        • Casey B.J.
        • Lee F.S.
        Variant brain-derived neurotrophic factor Val66Met endophenotypes: implications for posttraumatic stress disorder.
        Ann N Y Acad Sci. 2010; 1208: 150-157
        • Binder E.B.
        • Salyakina D.
        • Lichtner P.
        • Wochnik G.M.
        • Ising M.
        • Pütz B.
        • et al.
        Polymorphisms in FKBP5 are associated with increased recurrence of depressive episodes and rapid response to antidepressant treatment.
        Nat Genet. 2004; 36: 1319-1325
        • Mushtaq D.
        • Ali A.
        • Margoob M.A.
        • Murtaza I.
        • Andrade C.
        Association between serotonin transporter gene promoter-region polymorphism and 4- and 12-week treatment response to sertraline in posttraumatic stress disorder.
        J Affect Disord. 2012; 136: 955-962
        • Felmingham K.L.
        • Dobson-Stone C.
        • Schofield P.R.
        • Quirk G.J.
        • Bryant R.A.
        The brain-derived neurotrophic factor Val66Met polymorphism predicts response to exposure therapy in posttraumatic stress disorder.
        Biol Psychiatry. 2013; 73: 1059-1063
        • Bryant R.A.
        • Felmingham K.L.
        • Falconer E.M.
        • Pe Benito L.
        • Dobson-Stone C.
        • Pierce K.D.
        • et al.
        Preliminary evidence of the short allele of the serotonin transporter gene predicting poor response to cognitive behavior therapy in posttraumatic stress disorder.
        Biol Psychiatry. 2010; 67: 1217-1219
        • Hartley C.A.
        • McKenna M.C.
        • Salman R.
        • Holmes A.
        • Casey B.J.
        • Phelps E.A.
        • Glatt C.E.
        Serotonin transporter polyadenylation polymorphism modulates the retention of fear extinction memory.
        Proc Natl Acad Sci U S A. 2012; 109: 5493-5498
        • Kolassa I.T.
        • Kolassa S.
        • Ertl V.
        • Papassotiropoulos A.
        • De Quervain D.J.
        The risk of posttraumatic stress disorder after trauma depends on traumatic load and the catechol-o-methyltransferase Val(158)Met polymorphism.
        Biol Psychiatry. 2010; 67: 304-308

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