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Neurobiological effects of work-related stress: protocol for a case-control neuroimaging study.

INTRODUCTION
Stress is one of the greatest burdens of our society and often implies impairments in cognitive and emotional functions. Here, we hypothesise that changes in the brain's dopamine (DA)-based mesocorticolimbic projec-tions in patients with work-related stress (adjustment disorder) will manifest themselves as altered glucose metabolism in relation to neural activity, and as altered DA radiotracer binding potentials at the relevant receptors.


METHODS
Subjects and healthy controls undergo neuropsychiatric tests and PET/MRI with three tracers: 18F-fluorodeoxyglucose to measure glucose metabolism as a marker of neural activity, 11C-raclopride to explore binding potentials in the striatum, and 11C-FLB 457 to study possibly impaired mesocortical dopaminergic transmission in the cortex. To demonstrate differences of glucose metabolism, more than 2 × 41 patients/controls are needed. We expect to find that symptoms of cognitive and motivational reward deficits are attributable to changes in the frontal lobe and striatal glucose metabolism in the majority of patients, and that changes of D2-receptor availability and impaired dopaminergic transmission in the striatum and prefrontal cortex are contributing factors.


CONCLUSIONS
This project is designed to generate entirely new and objective evidence of stress-induced cerebral illness, and to provide a basis for in-depth research and for a more rational management of this strenuous disorder.


FUNDING
Private, industrial and public funds.


TRIAL REGISTRATION
Clinicaltrails.gov/NCT03334045.