title: Glutamatergic system abnormalities in posttraumatic stress disorder.
abstract: BACKGROUND
  Accumulating evidence suggests involvement of the glutamatergic system in the biological mechanisms of posttraumatic stress disorder (PTSD), but few studies have demonstrated an association between glutamatergic system abnormalities and PTSD diagnosis or severity.
  
  
  OBJECTIVE
  We aimed to examine whether abnormalities in serum glutamate and in the glutamine/glutamate ratio were associated with PTSD diagnosis and severity in severely injured patients at risk for PTSD and major depressive disorder (MDD).
  
  
  METHODS
  This is a nested case-control study in TPOP (Tachikawa project for prevention of posttraumatic stress disorder with polyunsaturated fatty acid) trial. Diagnosis and severity of PTSD were assessed 3 months after the accidents using the Clinician-Administered PTSD Scale. The associations of glutamate levels and the glutamine/glutamate ratio with diagnosis and severity of PTSD and MDD were investigated by univariate and multiple linear regression analyses.
  
  
  RESULTS
  Ninety-seven of 110 participants (88 %) completed assessments at 3 months. Serum glutamate levels were significantly higher for participants with full or partial PTSD than for participants without PTSD (p = 0.049) and for participants with MDD than for participants without MDD (p = 0.048). Multiple linear regression analyses showed serum glutamate levels were significantly positively associated with PTSD severity (p = 0.02) and MDD severity (p = 0.03). The glutamine/glutamate ratio was also significantly inversely associated with PTSD severity (p = 0.03), but not with MDD severity (p = 0.07).
  
  
  CONCLUSIONS
  These findings suggest that the glutamatergic system may play a major role in the pathogenesis of PTSD and the need for new treatments targeting the glutamatergic system to be developed for PTSD.
authors: Department of Psychiatry, National Disaster Medical Center, 3256 Midoricho, Tachikawa, Tokyo, 190-0014, Japan.|CREST, Japan Science and Technology Agency, 3256 Midoricho, Tachikawa, Tokyo, 190-0014, Japan.
authors: Daisuke
authors: D
authors: Nishi
authors: CREST, Japan Science and Technology Agency, 3256 Midoricho, Tachikawa, Tokyo, 190-0014, Japan.|Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
authors: Kenji
authors: K
authors: Hashimoto
authors: Department of Psychiatry, National Disaster Medical Center, 3256 Midoricho, Tachikawa, Tokyo, 190-0014, Japan.|CREST, Japan Science and Technology Agency, 3256 Midoricho, Tachikawa, Tokyo, 190-0014, Japan.
authors: Hiroko
authors: H
authors: Noguchi
authors: CREST, Japan Science and Technology Agency, 3256 Midoricho, Tachikawa, Tokyo, 190-0014, Japan.|Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan.
authors: Kei
authors: K
authors: Hamazaki
authors: CREST, Japan Science and Technology Agency, 3256 Midoricho, Tachikawa, Tokyo, 190-0014, Japan.|Toyama Jonan Onsen Daini Hospital, 1-13-6 Toromaru-nishimachi, Toyama, Toyama, 939-8271, Japan.
authors: Tomohito
authors: T
authors: Hamazaki
authors: Department of Psychiatry, National Disaster Medical Center, 3256 Midoricho, Tachikawa, Tokyo, 190-0014, Japan. matsuoka-psy@umin.ac.jp.|CREST, Japan Science and Technology Agency, 3256 Midoricho, Tachikawa, Tokyo, 190-0014, Japan. matsuoka-psy@umin.ac.jp.
authors: Yutaka
authors: Y
authors: Matsuoka
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000097:blood / Q000175:diagnosis / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D018698:Glutamic Acid / Q000097:blood*; D005973:Glutamine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000097:blood* / Q000175:diagnosis* / Q000523:psychology
chemical_list: D015415:Biomarkers; D005973:Glutamine; D018698:Glutamic Acid
keywords: Accident; Depression; Glutamate; Glutamine; Posttraumatic stress disorder