PROBING PTSD: Researchers find differences in the brain networks of PTSD patients that could help diagnose and treat the disorder.
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An event such as sexual assault or a battlefield injury is physically agonizing at the time, but it also can eventually sentence a person to a host of mental symptoms—often vivid flashbacks, anxiety and emotional detachment—known as post-traumatic stress disorder (PTSD). The disorder afflicts 3.4 percent of men and 9.7 percent of women in the U.S., according to research estimates.
Diagnosing PTSD is not necessarily simple. Psychological evaluations for PTSD cannot always easily distinguish it from other mental illnesses, such as depression, or determine if a patient is over- or underreporting the symptoms. Now, a brain- scanning technique called magnetoencephelography (or MEG) could offer the first biological test to help specifically diagnose and treat those with PTSD. In a study published January 20 in Journal of Neural Engineering, MEG correctly identified 97 percent of patients that psychologists previously determined were suffering from PTSD.
MEG, which was developed in the 1960s for military purposes, offers a unique insight into the neural communications within the brain, says Apostolos Georgopoulos, a neuroscientist at the University of Minnesota Medical School and lead author of the study. The instrument measures the magnetic field created as electrical current passes between areas of the brain. In MEG studies about two years ago, Georgopoulos found that, whereas healthy people shared similar patterns of neural communication, people with Alzheimer's and schizophrenia had distinct, disease-specific patterns.
In the current study Georgopoulos and his colleagues scanned 74 people diagnosed with various degrees of PTSD through a standard question-and-answer session with psychologists, along with 250 people who reported having no mental problems. For their MEG scans, the participants simply sat under a dome-shaped instrument for one minute. They fixed their eyes on a spot of light so that researchers could measure the brain in an "idle" state, when it is not stimulated by having a task to perform. During that minute, the instrument captured a map of the brain's electrical activity once every millisecond. (For comparison, functional magnetic resonance imaging, which measures brain activity indirectly, takes measurements about every three seconds.)
For 72 of the 74 patients previously diagnosed with PTSD, MEG scans detected a pattern of neural communications that was different from the healthy participants, but shared among the PTSD group. On the flip side, 31 of the 250 healthy patients had abnormal scan results.
"I think [the specificity] is what still has us shaking our heads in disbelief," says Brian Engdahl, a psychologist at the U.S. Department of Veterans Affairs Medical Center in Minneapolis, who helped evaluate the patients included in the study. He adds that he and others hope to perform a more thorough evaluation to see if those 31 supposedly healthy patients might have PTSD.
Engdahl adds that MEG might serve several uses in addition to diagnosis. For one, neural patterns detected by MEG could be used to assess how well PTSD treatments, from antidepressants and sleep medications to counseling, are working for a patient. In addition, having MEG results could help patients who are reluctant to report their PTSD symptoms. "You can think about it as a means to help people feel less stigma. Because there's something different with [the] brain…it doesn't have to do with personal weakness," he says. "That's almost a sigh-of-relief moment for the patient."
Bringing MEG to patients will not, however, be possible for many hospitals in the U.S. Georgopoulos estimates that only 20 to 30 have a $2-million MEG instrument. "[But] I think it will become a major application as we speak…for all kinds of ways of looking very sensitively at brain function," he says.
Rajendra Morey, a psychiatrist at the Duke–U.N.C. Brain Imaging and Analysis Center in Durham, N.C., who was not involved in the study, says that he could see MEG being used "as an adjunct to the more conventional way of diagnosing." Although a biology-based diagnosis for PTSD would be helpful, he says, using MEG in the clinic is still a ways off.
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16 Comments
Add CommentProgress in distribution, availability and diagnosis will help so much where individual and family intervention is concerned. Yes, it's "in their head," but they are not crazy. Just knowing it is real may aid in recovery for some.
Reply | Report Abuse | Link to thisThis technique can also prove useful in civil cases of complex PTSD as another reliable indicator of consequent neurophysiological insult. Such evidence removes the legal distinction between the effects of, for example, prolonged bullying, and grevious bodily harm, as the test demonstrates that permanent physical change has occurred. It is a good adjunct to fMRI.
Reply | Report Abuse | Link to thisThis technique can also prove useful in civil cases of complex PTSD as another reliable indicator of consequent neurophysiological insult. Such evidence removes the legal distinction between the effects of, for example, prolonged bullying, and grevious bodily harm, as the test demonstrates that permanent physical change has occurred. It is a good adjunct to fMRI.
Reply | Report Abuse | Link to thisFor some people it isn't just recognizing it as a weakness in yourself. Another stigma surrounding reporting mental health especially for those that are ex-military may find after some investigation that reporting such a condition is grounds for the government to say they are not allowed to own self defense tools. Look at the forms they ask are you treated or diagnosed with any mental illnesses? Well if you ask that individual I would bet that they feel they fought for those rights so why should they commit to testifying against themselves only to lose the rights they fought for?
Reply | Report Abuse | Link to thisI agree that this has great potential for good, but it all depends on how the results are used, communicated, and understood. The relationship between mental health and our perceptions of one another is a complicated one, so we can't say that this diagnosis will necessarily bring peace of mind to the patients.
Reply | Report Abuse | Link to thishttp://www.sciencedaily.com/releases/2010/01/100113122310.htm
Xlander brings up another good point. If those percentages in the first paragraph of the article are accurate, 1 in 29 men and 1 in 10 women are going to face some threats to their civil liberties.
In response to xlander, one shouldn't assume that a mental health diagnosis would preclude them from owning "self defense tools," by which I assume you mean a firearm. Just as one with Alzheimer's may not be able to operate an automobile or manage their own finances, there are some circumstances where someone with PTSD (or some other mental illness) simply may not be safe (to themselves and/or others).
Reply | Report Abuse | Link to thisThis is a great discovery, and for veterans will hopefully ease the hotly debated issues of disability status with this condition. Not only may it help with easing stigma and clarifying diagnosis, but perhaps one day facilitate the triage to treatment.
I'm a little lost on why this technology would be helpful in diagnosing PTSD. Is it hard to diagnose in the office? Is it really better to wait weeks or months for a scan? Isn't this kind of like running viral cultures on everyone who has the Common Cold?
Reply | Report Abuse | Link to thisI can certainly see how this may lead to information about the anatomy and neurophysiology of PTSD, and therefore could lead to improved treatments over time, but I just don't see the utility of using it for diagnosis.
Interesting.
Reply | Report Abuse | Link to thiswhy no mention of active areas and times?
Reply | Report Abuse | Link to thisI hope its use becomes as widespread as other so-called measurements.
very interesting))))
Reply | Report Abuse | Link to thisIm glad that they can find out these problems in some peopls bodies. I just wish that with some dieases they can find a way to stop the diease like cancer. But I guess one thing at a time.
Reply | Report Abuse | Link to thisThere are so many people with this type of illness, that i am glad some one has found a way to find what it is and how to treat it . Depression isn't a easy thing to live with. I personally know couple of people with some sort of depression.
Reply | Report Abuse | Link to thisIts a great start to help people not to go through so many test to figure out one problem but to do a single test and then try to find solution to it.
Reply | Report Abuse | Link to thisThis is an interesting discovery. I hope more is looked into this and positive out comes.
Reply | Report Abuse | Link to thisThis is a very interesting discovery. I am hoping this discovery has a positive out come. I hope this discovery can help people in any different ways.
Reply | Report Abuse | Link to thisWow, I wish they would use it now, since it is so difficult to pin down without a machine.
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