Understanding the cellular and molecular alterations in PTSD brains: The necessity of post-mortem brain tissue

The personal, social and economic burden of post-traumatic stress disorder (PTSD) is high and therapeutic approaches are only partially effective. Therefore, there is an urgent need to understand the cellular and molecular alterations in PTSD brains in order to design more effective treatment strategies. Although brain imaging strategies have considerably improved our understanding of PTSD, these strategies cannot identify molecular and cellular changes. Post-mortem examination of the brain is a crucial strategy to advance our understanding of the underlying neuropathology, neurochemistry and molecular pathways of PTSD. Unfortunately, there is a worldwide serious shortage of human psychiatric brain tissue available for post-mortem research. Therefore, the Netherlands Brain Bank launched a prospective donor programme to recruit brain donors with psychiatric diseases in 2012: Netherlands Brain Bank for Psychiatry (NBB-Psy). NBB-Psy aims to establish a resource of brain tissue of seven psychiatric disorders: post-traumatic stress disorder, major depressive disorder, schizophrenia, bipolar disorder, obsessive-compulsive disorder, autism spectrum disorder, and attention-deficit hyperactivity disorder. Participants of several large and clinically characterized research cohorts of psychiatric patients, including relatives and controls, were asked prospectively to register as brain donors. Registered donors complete medical questionnaires annually. The number of registered donors with a psychiatric disorder at the NBB has risen from 312 (most of which were patients with major depressive disorder) in the year 2010 to 1187 in 2017, of which 146 are PTSD patients. The NBB guarantees worldwide open access to biomaterials and data. Any researcher affiliated with a research institute can apply

Brain donation in psychiatry : Results of a Dutch prospective donor program among psychiatric cohort participants

Background: Human brain tissue is crucial to study the molecular and cellular basis of psychiatric disorders. However, the current availability of human brain tissue is inadequate. Therefore, the Netherlands Brain Bank initiated a program in which almost 4.000 participants of 15 large Dutch psychiatric research cohorts were asked to register as prospective brain donors. Methods: We approached patients with schizophrenia, bipolar disorder, major depressive disorder, obsessive-compulsive disorder, post-traumatic stress disorder, families with a child with autism or Attention Deficit Hyperactivity Disorder, healthy relatives and healthy unrelated controls, either face-to-face or by post. We investigated whether diagnosis, method of approach, age, and gender were related to the likelihood of brain-donor registration. Results: We found a striking difference in registration efficiency between the diagnosis groups. Patients with bipolar disorder and healthy relatives registered most often (25% respectively 17%), followed by unrelated controls (8%) and patients with major depressive disorder, post-traumatic stress disorder, and obsessive-compulsive disorder (9%, 6% resp. 5%). A face-to-face approach was 1.3 times more effective than a postal approach and the likelihood of registering as brain donor significantly increased with age. Gender did not make a difference. Conclusions: Between 2013 and 2016, our prospective brain-donor program for psychiatry resulted in an almost eightfold increase (from 149 to 1149) in the number of registered psychiatric patients at the Netherlands Brain Bank. Based on our results we recommend, when starting a prospective brain donor program in psychiatric patients, to focus on face to face recruitment of people in their sixties or older

The Netherlands Brain Bank for Psychiatry

The Netherlands Brain Bank (NBB) performs rapid autopsies of donors who gave written informed consent during life for the use of their brain tissue and medical files for research. The NBB initiated the Netherlands Brain Bank for Psychiatry (NBB-Psy), a prospective donor program for psychiatric diseases. NBB-Psy wants to expand the tissue collections in order to provide a strong incentive to increase research in psychiatry. The ultimate goal of NBB-Psy is to reduce the burden of psychiatric disorders for patients, their families, and for society as a whole. NBB-Psy consists of an antemortem and postmortem donor program. This chapter focuses on the design of NBB-Psy and the antemortem donor program, where patients and relatives are actively informed on the possibility to become a brain donor. Since the initiation of NBB-Psy, the number of registered donors with a psychiatric diagnosis has increased from 149 in 2010 to 1018 in May 2016