Journal Article

Traumatic stress and the circadian system: neurobiology, timing and treatment of posttraumatic chronodisruption

Agorastos, Agorastos, Olff, Miranda

2020

Overview

Background: Humans have an evolutionary need for a well-preserved internal 'clock', adjusted to the 24-hour rotation period of our planet. This intrinsic circadian timing system enables the temporal organization of numerous physiologic processes, from gene expression to behaviour. The human circadian system is tightly and bidirectionally interconnected to the human stress system, as both systems regulate each other's activity along the anticipated diurnal challenges. The understanding of the temporal relationship between stressors and stress responses is critical in the molecular pathophysiology of stress-and trauma-related diseases, such as posttraumatic stress disorder (PTSD). Objectives/Methods: In this narrative review, we present the functional components of the stress and circadian system and their multilevel interactions and discuss how traumatic stress can affect the harmonious interplay between the two systems. Results: Circadian dysregulation after trauma exposure (posttraumatic chronodisruption) may represent a core feature of trauma-related disorders mediating enduring neurobiological correlates of traumatic stress through a loss of the temporal order at different organizational levels. Posttraumatic chronodisruption may, thus, affect fundamental properties of neuroendocrine, immune and autonomic systems, leading to a breakdown of biobehavioral adaptive mechanisms with increased stress sensitivity and vulnerability. Given that many traumatic events occur in the late evening or night hours, we also describe how the time of day of trauma exposure can differentially affect the stress system and, finally, discuss potential chronotherapeutic interventions. Conclusion: Understanding the stress-related mechanisms susceptible to chronodisruption and their role in PTSD could deliver new insights into stress pathophysiology, provide better psychochronobiological treatment alternatives and enhance preventive strategies in stress-exposed populations. * The human circadian and stress system are both essential for biobehavioural regulation with numerous reciprocal interaction. * Posttraumatic chronodisruption (i.e., circadian dysregulation after trauma) represents a core feature of PTSD, mediating neurobiological correlates of trauma through multilevel temporal order loss.

• Publisher: Taylor & Francis,Taylor & Francis Ltd,Taylor & Francis Group
• Subject: autonomic nervous system / Circadian system / cortisol / Eje HHA / estrés / Gene expression / glucocorticoides / glucocorticoids / HPA axis / HPA轴 / Neurosciences / Pathophysiology / Post traumatic stress disorder / posttraumatic stress disorder (PTSD) / Review / Sistema Circadiano / sistema nervioso autónomo / sleep / stress / sueño / trastorno de estrés postraumático (TEPT) / trauma / 创伤 / 创伤后应激障碍 (PTSD) / 应激 / 昼夜节律 / 激素 / 皮质醇 / 睡眠 / 糖皮质 / 自主神经系统