Neurobiology of Posttraumatic Stress Disorder: Circuits, Genomics, and Treatment

Posttraumatic stress disorder (PTSD) is unique in its requirement of an external stressor for the development of disease, leading to dysregulated mood, intrusive memories, and avoidance symptoms. Over the past decade, insights from human neuroimaging, mechanistic neural circuitry studies in animal models, and genomic work have revolutionized our understanding of this psychiatric illness, with emerging data from large-scale PTSD genome-wide association studies providing novel insights into the mechanism of PTSD. Despite these advances, therapeutic interventions remain limited, and psychotherapy remains the first-line treatment over pharmacological interventions. Here, we review the basic epidemiology of PTSD with an overview of common types of trauma, neurocircuits and molecular mechanisms contributing to fear learning, genomics studies, and current and emerging treatments. Although PTSD remains highly prevalent, recent advances and emerging identification of neural circuits and putative molecular targets offer an exciting opportunity to advance the treatment of this debilitating condition.