TAU research: Brain scans could pinpoint suicide risk to soldiers

Functional magnetic resonance imaging (fMRI) ofthe brain can be used to screen soldiers (and civilians) for a highrisk of committing suicide, according to a study of 50 IDF personnelconducted by Tel Aviv University researchers.

Thestudy, headed by Prof. Talma Hendler of the university's SacklerFaculty of Medicine's psychology and psychiatry department and Tel AvivSourasky Medical Center's brain function center, was recently publishedin Proceedings of the National Academy of Sciences (PNAS), a US journal.

High risk for suicide was gauged by assessing which soldierswere vulnerable to symptoms connected to post-traumatic stress disorder(PTSD). The brain regions most relevant to the prediction are theamygdala (responsible for emotional processing in the brain and warningpeople to avoid danger), the hippocampus (which processes memory), andthe prefrontal cortex (which gives emotional and personal significanceto stimuli).

Two-fifths of all individuals will at some time in their lifeexperience at least one significant traumatic event, and most of themwill react soon after with PTSD symptoms such as anxiety, bad moods,sleep problems and upsetting thoughts.

About one-fifth of these are liable to suffer fromlong-term PTSD symptoms such as depression and post-traumatic anxiety,while others will recover without therapy.

Until now, except for certain blood tests developedexperimentally at Hadassah University Medical Center in Ein Kerem,there has been no objective way to determine who will recover on theirown and who will need help. Since early diagnosis and treatment arevital for preventing long-term PTSD, a harmless scan could provebeneficial, said Hendler.

IDF paramedics - who volunteered for the studyand constitute the first line of soldiers who treat the wounded - weretested before their basic training and 18 months later when they werealready working as battlefield paramedics.

During their service, two-thirds of the paramedics reportedhaving increased stress symptoms such as nightmares, repeatedunpleasant thoughts and a bad moods. The fMRI scans showed that thesesymptoms increased when the amygdala was more active just beforeexposure to traumatic events and the hippocampus was more active afterthe events.

The tests also showed that as the negative symptoms developed,the hippocampus communicated less with the prefrontal cortex. Thisdemonstrates flexibility in brain activity and brain regions connectedwith emotional reactions to stress, Hendler said. This finding pointsto the potential of changing the brain using medications orpsychological treatment after exposure to trauma.

The findings, she concluded, show that "there is a model ofactivity and brain reaction characteristic of every individual, who canbe sent for early individual treatment after being exposed to atraumatic event."

However, Hendler suggested that fMRI should not be used as atool to keep individual soldiers out of sensitive military units but tohelp psychiatrists and psychologist treat the more susceptible soldiersearlier and better.

Meanwhile, World Suicide Prevention Day will be marked aroundthe globe on Thursday. The International Association for SuicidePrevention (established nearly 50 years ago) set aside the day topromote the prevention of suicidal behavior, alleviating its effectsand providing a forum for academics, mental health professionals,crisis workers, volunteers and suicide survivors.