title: CSF norepinephrine concentrations in posttraumatic stress disorder.
abstract: OBJECTIVE
  Despite evidence of hyperresponsive peripheral and central nervous system (CNS) noradrenergic activity in posttraumatic stress disorder (PTSD), direct measures of CNS norepinephrine in PTSD have been lacking. The goal of this study was to determine serial CSF norepinephrine levels in patients with PTSD.
  
  
  METHODS
  CSF samples were obtained serially over a 6-hour period in 11 male combat veterans with chronic PTSD and eight healthy men through an indwelling subarachnoid catheter. Thus the authors were able to determine hourly CSF norepinephrine concentrations under baseline (unstressed) conditions. Severity of the patients' PTSD symptoms was assessed with the Clinician-Administered PTSD Scale.
  
  
  RESULTS
  CSF norepinephrine concentrations were significantly higher in the men with PTSD than in the healthy men. Moreover, CSF norepinephrine levels strongly and positively correlated with the severity of PTSD symptoms. Plasma norepinephrine concentrations showed no significant relationship with the severity of PTSD symptoms.
  
  
  CONCLUSIONS
  These findings reveal the presence of greater CNS noradrenergic activity under baseline conditions in patients with chronic PTSD than in healthy subjects and directly link this pathophysiologic observation with the severity of the clinical posttraumatic stress syndrome.
authors.affiliation: Mental Health Service, Veterans Affairs Medical Center, 3200 Vine St., Cincinnati, OH 45220, USA. thomas.geracioti@med.va.gov
authors.forename: T D
authors.initials: TD
authors.lastname: Geracioti
authors.forename: D G
authors.initials: DG
authors.lastname: Baker
authors.forename: N N
authors.initials: NN
authors.lastname: Ekhator
authors.forename: S A
authors.initials: SA
authors.lastname: West
authors.forename: K K
authors.initials: KK
authors.lastname: Hill
authors.forename: A B
authors.initials: AB
authors.lastname: Bruce
authors.forename: D
authors.initials: D
authors.lastname: Schmidt
authors.forename: B
authors.initials: B
authors.lastname: Rounds-Kugler
authors.forename: R
authors.initials: R
authors.lastname: Yehuda
authors.forename: P E
authors.initials: PE
authors.lastname: Keck
authors.forename: J W
authors.initials: JW
authors.lastname: Kasckow
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002408:Catheters, Indwelling; D002851:Chromatography, High Pressure Liquid; D002940:Circadian Rhythm; D020773:Headache Disorders; D006801:Humans; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000134:cerebrospinal fluid*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D013129:Spinal Puncture / Q000379:methods; D013313:Stress Disorders, Post-Traumatic / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D013346:Subarachnoid Space
chemical_list: D009638:Norepinephrine