title: Decreased cerebrospinal fluid allopregnanolone levels in women with posttraumatic stress disorder.
abstract: BACKGROUND
  Alterations in the gamma-amino-butyric acid (GABA) neurotransmitter system have been identified in some populations with posttraumatic stress disorder (PTSD).
  
  
  METHODS
  To further investigate factors of relevance to GABAergic neurotransmission in PTSD, we measured cerebrospinal fluid (CSF) levels of allopregnanolone and pregnanolone combined (ALLO: congeners that potently and positively modulate effects of GABA at the GABA(A) receptor), 5alpha-dihydroprogesterone (5alpha-DHP: the immediate precursor for allopregnanolone), dehydroepiandrosterone (DHEA: a negative modulator of GABA(A) receptor function), and progesterone with gas chromatography, mass spectrometry in premenopausal women with (n = 9) and without (n = 10) PTSD. Subjects were free of psychotropic medications, alcohol, and illicit drugs; all were in the follicular phase of the menstrual cycle except three healthy and four PTSD subjects receiving oral contraceptives.
  
  
  RESULTS
  There were no group differences in progesterone, 5alpha-DHP, or DHEA levels. The PTSD group ALLO levels were < 39% of healthy group levels. The ALLO/DHEA ratio correlated negatively with PTSD re-experiencing symptoms (n = -.82, p < 008; trend) and with Profile of Mood State depression/dejection scores (n = -0.70, p < 0008).
  
  
  CONCLUSIONS
  Low CSF ALLO levels in premenopausal women with PTSD might contribute to an imbalance in inhibitory versus excitatory neurotransmission, resulting in increased PTSD re-experiencing and depressive symptoms.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA. ann.rasmusson@yale.edu
authors.forename: Ann M
authors.initials: AM
authors.lastname: Rasmusson
authors.forename: Graziano
authors.initials: G
authors.lastname: Pinna
authors.forename: Prashni
authors.initials: P
authors.lastname: Paliwal
authors.forename: David
authors.initials: D
authors.lastname: Weisman
authors.forename: Christopher
authors.initials: C
authors.lastname: Gottschalk
authors.forename: Dennis
authors.initials: D
authors.lastname: Charney
authors.forename: John
authors.initials: J
authors.lastname: Krystal
authors.forename: Alessandro
authors.initials: A
authors.lastname: Guidotti
mesh_terms: D043582:5-alpha-Dihydroprogesterone / Q000134:cerebrospinal fluid; D000328:Adult; D000339:Affect; D000704:Analysis of Variance; D003687:Dehydroepiandrosterone / Q000134:cerebrospinal fluid; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000134:cerebrospinal fluid; D011280:Pregnanolone / Q000134:cerebrospinal fluid*; D011374:Progesterone / Q000134:cerebrospinal fluid*; D011963:Receptors, GABA-A / Q000378:metabolism*; D012016:Reference Values; D013313:Stress Disorders, Post-Traumatic / Q000134:cerebrospinal fluid* / Q000378:metabolism
chemical_list: D011963:Receptors, GABA-A; D003687:Dehydroepiandrosterone; D011374:Progesterone; D043582:5-alpha-Dihydroprogesterone; D011280:Pregnanolone