Neurobiological Correlates of Post Traumatic Stress Disorder (PTSD) During Rapid Eye Movement (REM) Sleep

Study Overview
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Brief Summary
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The overarching aim of this Exploratory/Developmental Research Grant Award (R21) is to explore the neurobiological correlates of PTSD during REM sleep by using state-of-the science positron emission tomography (PET) sleep imaging. This study will allow us to gain insight into the differences in sleep and waking brain mechanisms between veterans with PTSD and those without PTSD.

Official Title
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Neurobiological Correlates of PTSD During REM Sleep (REM-P)

Conditions
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Post-Traumatic Stress Disorder

Intervention / Treatment
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* Other: Sleep data recording
* Other: PET scan - waking
* Other: PET scan - REM Sleep


Participation Criteria
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Eligibility Criteria
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General Inclusion Criteria: Male OIF/OEF returnees between the ages of 18 and 45 years old Combat Exposure Scale score > 17 Not taking medications known to affect sleep or wake function for at least 2 weeks (6 weeks for fluoxetine). No history of trauma before age 18 Specific Inclusion Criteria for Subjects with PTSD: Meet diagnostic criteria for current PTSD according to the CAPS-1 CAPS-1 score is less than 80 Specific Inclusion Criteria for Subjects without PTSD: Total CAPS-1 scores < 17 Does not meet criteria for PTSD Exclusion Criteria: Trauma occurred less than 3 months prior to study entry CES score < 17 Taking medications known to affect sleep and / or brain glucose metabolism Current diagnosis of depression as determined by the SCID or BDI score > 13 History of psychotic or bipolar disorder Current history (within 3 months) of substance or alcohol abuse as determined by the SCID Positive alcohol blood test at screening or during the PET protocol Significant or unstable acute or chronic medical conditions Other current sleep disorders, such as insufficient sleep syndrome, delayed sleep phase syndrome, narcolepsy, restless legs syndrome, periodic leg movement disorder, obstructive sleep apnea, and current night shift work, suspected during the structured interview. Individuals who are found to have a apnea-hypopnea index (AHI) > 10 or an index of periodic leg movements with arousal > 15 will be excluded. Presence of implanted devices such as cardiac pacemaker, aneurysm clip, ear implant, shrapnel, neurostimulators or other metal devices Fear of closed spaces Previous radiation. Due to the risk of radiation exposure, we will exclude subjects who have had PET scans or other radiotracer exposure in the previous year. History of open head injury.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Combat Veterans with PTSD<br>Male Veterans of Operation Iraqi Freedom (OIF) and/or Operation Enduring Freedom (OEF), ages 18-50, with Combat Exposure Scale score > 17, who are not on medication and do not have trauma history before age 18. | Other: Sleep data recording<br>* After completing the screening procedures, eligible participants will sleep in the laboratory for three consecutive nights of EEG sleep studies, one waking [18F]-FDG PET scan, and one REM sleep PET scan according to published methods.<br>Other: PET scan - waking<br>* After completing the screening procedures, eligible participants will sleep in the laboratory for three consecutive nights of EEG sleep studies, one waking [18F]-FDG PET scan, and one REM sleep PET scan according to published methods.<br>Other: PET scan - REM Sleep<br>* After completing the screening procedures, eligible participants will sleep in the laboratory for three consecutive nights of EEG sleep studies, one waking [18F]-FDG PET scan, and one REM sleep PET scan according to published methods.<br>|
| Combat Veterans without PTSD<br>Male Veterans of Operation Iraqi Freedom (OIF) and/or Operation Enduring Freedom (OEF), ages 18-50, with combat experience, who are not suffering from PTSD, and who are not on medication. | Other: Sleep data recording<br>* After completing the screening procedures, eligible participants will sleep in the laboratory for three consecutive nights of EEG sleep studies, one waking [18F]-FDG PET scan, and one REM sleep PET scan according to published methods.<br>Other: PET scan - waking<br>* After completing the screening procedures, eligible participants will sleep in the laboratory for three consecutive nights of EEG sleep studies, one waking [18F]-FDG PET scan, and one REM sleep PET scan according to published methods.<br>Other: PET scan - REM Sleep<br>* After completing the screening procedures, eligible participants will sleep in the laboratory for three consecutive nights of EEG sleep studies, one waking [18F]-FDG PET scan, and one REM sleep PET scan according to published methods.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Brain glucose metabolism |  | During waking | 
| Brain glucose metabolism |  | During REM sleep | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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PTSD, Post Traumatic Stress Disorder, Brain, Imaging, PET, Neural, Sleep, REM Sleep