Diagnosing and Treating Post Traumatic Stress Disorder

There is great interest in diagnosing and treating post traumatic stress disorder (PTSD).  PTSD develops in people who have experienced a strong psychological event where threat of death or bodily harm could have occurred.  There has been significant coverage concerning men and women who have fought in Iraq or Afghanistan and have suffered traumatic experiences, but there are people who suffer traumatic experiences not in war time environmental conditions that can lead to PTSD.  As it stands now, there is no way to objectively classify PTSD.  Currently, PTSD is diagnosed with a clinical interview.   For the most part, this method works well.   However, current assessment methods can often take a long time to complete and can be expensive.  In the paper reviewed here, researchers at the University of Minnesota have tried to make a quick and objective way of diagnosing PTSD.  In fact, I think this is the first instance of a group of researchers trying to create a biomarker for PTSD.  They have found that they can, with greater than 90% accuracy, diagnose PTSD from a magnetoencephalography (MEG) image.  The technique of MEG is non-invasive and is used to measure magnetic fields generated by small electrical currents in the brain. Thus, MEG provides direct information about the neural activity and the location of their sources in the brain, and the researchers believe they can use MEG brain images to distinguish positive from negative.  One advantage of using this imaging method is that images can be acquired quickly, usually on the order of minutes.  Moreover, in addition to the speed of image acquisition and the predictive value of the image in diagnosing PTSD, they also found a positive correlation between the strength of the MEG signals and severity of symptoms.  So, patients who show severe symptoms have a robust MEG signal compared to control groups and others who say their symptoms are not as severe.  That lends more evidence that their method for classifying PTSD has some validity.  Finally, and perhaps most importantly, they found that there were robust differences between control individuals and people who suffer from PTSD.  Even though their statistical method is beyond the scope of this blog, the conclusions about how this system can be advantageous for potential diagnosis of PTSD, and well as other brain maladies, is an intriguing step forward. 

All in all, this is a research effort to create a biomarker for PTSD.  Even though it may take some time before it is clinically validated and using MEG maybe  impractical in the long run (due to the cost of machine, and some technical limitations of the technique); nonetheless, the results are encouraging for clinicians who treat PTSD and encouraging for researchers who study brain disorders and who are looking for ways to begin classifying conditions with a more objective brain scan.  

Next week I will review some additional studies that use other methods to detect PTSD and other conditions from brain scans.

Georgopoulos AP, Tan HR, Lewis SM, Leuthold AC, Winskowski AM, Lynch JK, Engdahl B.  The synchronous neural interactions test as a functional neuromarker for post-traumatic stress disorder (PTSD): a robust classification method based on the bootstrap.  J Neural Eng. 2010;7(1):16011. Epub 2010 Jan 20.