Consequences of PTSD and Memory Processing on Neural

Structures:Can Psychotherapy Influence

Dendritic Reformation?Dr Hena JawaidWaliyah Mughis

Disclosure The purpose of our research is to explore all the possibilities and potential of psychotherapy on a molecular level. The aim is not to discourage or diminish the importance of medication, but to

further discover other avenues that can be used in conjunction with SSRIs and other

medications.

Session outline• Understanding neural structures• Understanding hippocampal function in

trauma processing• The role of psychotherapeutic

interventions at a molecular level• Study aims and objectives• Hypothesis• Discussion on neuroimaging

The neuronDendritic spine dynamics

(Kasai et al, 2010)

The hippocampus in trauma

The hippocampus is involved in explicit

memory processing (Tsien et al, 2013) and contextual retrieval of fear-related memories (Corcoran &

Maren, 2001; Corcoran et al, 2005).

PTSD and the hippocampus

• Reduction in size of hippocampal neurons?

GlucocorticoidsEnergy utilization

PTSD and the amygdala

• Processing of fear• Hyper vigilance• Negative appraisal

PTSD and the mPFC

• Hyporesponsive • Regulates extinction of fear conditioning

Role of psychotherapyin emotional reprocessing

• Cognitive processing therapy and prolonged exposure

• Regulates emotions through memory channelization

• Modes used: reading, writing, recounting events to themselves or to their therapists

• Retrieval, reprocessing, reimagination, reinforcement, rehearsal

• Facilitating reprocessing: Critical incident stress debriefing, CBT, exposure, eye movement desensitization, reprocessing therapy

Our hypothesis• Can emotional/memory reprocessing help with– Dendritic reformation– Cell body growth– Synaptogenesis in the hippocampus

• Through retrieval, reimagination, exposure• With emotionally charged memories being

appropriately processed & discharged, can dendritic connections be reformed?

AbstractTraumatic events such as assault, abuse, war and violence can impact the human brain both structurally and functionally. Dendrites in the hippocampus are among some of the affected structures, as emotionally charged memories are stored in them before due processing in the cell bodies. If these memories are not appropriately processed in the hippocampus, individuals suffering from post-traumatic stress disorder experience intrusive thoughts, flashbacks and high stress levels as a result of the high emotional charge of such memories. In this paper we postulate that if trauma-related emotions can be discharged through psychotherapeutic techniques such as exposure and memory reprocessing, would there also be a structural or anatomical change in hippocampal neurons, such as reformation of aberrant dendritic extensions, followed by an improvement in synaptic conductance between neurons?

FeedbackNeuroimaging – how to look at it

•What kind of neuroimaging modalities can measure cell body growth and dendritic structures?

mMRI

Molecular MRI of a mouse brain presenting acute inflammation in the right hemisphere.

mMRI• Proposed method: molecular MRI• Hengerer & Grimm, 2006: mMRI comprises

the contrast agent-mediated alteration of tissue relaxation times for the detection and localisation of– molecular disease markers (such as cell surface

receptors, enzymes or signaling molecules),– cells (e.g. lymphocytes, stem cells) or– therapeutic drugs (e.g. liposomes, viral particles)

References• Kasai et al, 2010, Structural dynamics of dendritic spines in memory and cognition.• Tsien et al, 2013, On initial brain activity mapping of episodic and semantic memory code in the

hippocampus.• Corcoran et al, 2005, Hippocampal inactivation disrupts the acquisition and contextual encoding of

fear extinction.• Corcoran & Maren, 2001, Hippocampal inactivation disrupts contextual retrieval of fear memory

after extinction.• Mechanic, 1998, A comparison of normal forgetting, psychopathology, and information-processing

models of reported amnesia for recent sexual trauma• Shin et al, 2006, Amygdala, medial prefrontal cortex and hippocampal function in PTSD.• Sadeh et al, 2014, Aberrant Neural Connectivity during Emotional Processing Associated with

Posttraumatic Stress.• Van der Kolk et al, 1996, A general approach to treatment of posttraumatic stress disorder