Researchers at Wake
Forest Baptist Medical Center and the U.S. Department of Veterans Affairs (VA)
are teaming up for a research project aimed at advancing the treatment of
military personnel suffering from post-traumatic stress disorder (PTSD) and
traumatic brain injury (TBI).
“PTSD and mild TBI are serious problems for
our vets coming home from Iraq and Afghanistan,” said Dwayne W. Godwin, Ph.D., a
neuroscientist at Wake Forest Baptist and co-principal investigator on the
project. “It’s a problem that will only continue to grow in the future as our
troops return home from these conflicts. This challenge provides a unique
opportunity to learn more about this disorder from data that exists on a
well-defined pool of patients who have been medically evaluated and
tested.”
Using a high-tech tool for brain activity imaging called
magnetoencephalography (MEG), researchers will conduct neurological tests on
military veterans with and without a PTSD diagnosis, and with varying levels of
impairment. The participants will be asked to perform tasks, similar to games,
which engage the parts of the brain involved in executive function – determining
what to do, how to do it, and assessing the relative risk of a situation – while
sitting in the scanner. Researchers will then compare the images of brain
activity from individuals with PTSD and/or mild TBI with the images of
individuals without the condition to see whether these particular parts of the
brain function differently between people with and without the
disorder.
PTSD not only affects military personnel – it can happen to
anyone after experiencing or witnessing traumatic events, such as being
attacked, a natural disaster or human tragedy. In the aftermath of the September
11 attacks, many of the first responders developed PTSD as a result of the
devastation they observed.
The causes of this disorder are not well
understood, however. “We know that there are social factors – such as what kind
of support network an individual has – as well as genetic factors that may
determine what kind of PTSD a person will experience and how severe it will be,
but it’s still largely misunderstood for a disorder that affects so many
people,” Godwin said. “It’s important to have a group of individuals in whom the
disorder is well-defined in order to study it effectively.”
PTSD may
often be accompanied by traumatic brain injury, especially in combat veterans.
Military personnel who have experienced a concussion, for example, are more
likely to also have PTSD than individuals who haven’t had any TBI. So
researchers are hoping to determine if there is an interactive effect between
the two conditions, and if the symptoms of PTSD are exaggerated in an individual
who also has TBI, as opposed to an individual without it.
"PTSD is
accompanied by a range of different symptoms that may reflect changes in
underlying brain networks that relate to executive control," Godwin said. Many
of those affected by PTSD possess a heightened awareness called hypervigilance.
“These individuals may have a range of symptoms, including difficulty
concentrating, exaggerated responses to normal things, irritability, experience
anger management issues, have more risky behaviors, disruptions or trouble
sleeping,” he said. “It’s a disorder that has a large impact on a person’s
ability to navigate through daily life.”
In addition to assessing
functional brain networks with MEG, the investigators will examine the structure
of white matter pathways of the brain to see whether the physical connections
between brain areas may also differ among those with and without the disorder.
The major goal of the study is to define biomarkers of PTSD and TBI so that
doctors will have a way to very quickly identify patients with PTSD and get them
treatment without delay, as well as to chart their progress in response to
treatment.
“The MEG is a special form of imaging,” Godwin said. “It
provides information that you can’t get easily, or at all, with other methods.
When a person thinks something, we can immediately detect the underlying brain
processes. It's not 'mind reading', because we can't tell what the content of
the thought may be, but with the right kind of test, we can resolve patterns of
activation that relate to executive function. We’re in a very special place with
our ability to answer these kinds of questions using this type of
imaging.”
MEG is a brain imaging technique that measures the magnetic
fields emitted by brain cells (neurons), allowing the mapping of brain activity
with great precision in the time scale in which the brain operates. Wake Forest
Baptist is one of only about 35 clinical sites in the country, and the only site
in North Carolina and surrounding states, to use MEG. It is non-invasive, highly
sensitive and accurate, and completely safe, as patients are not exposed to
radiation.
“This is a very exciting collaboration for us,” Godwin said.
“If we can find biomarkers of PTSD, there’s hope that we’ll be able to improve
diagnosis and treatment. It's an incredible challenge, but we have a great
team." The initial one-year study is being sponsored by The Veteran's
Administration and the WFU Translational Science Institute.
This articles was first published in www.newswise.com