Researchers at Wake Forest Baptist Medical Center are
collaborating with the U.S. Department of Veterans Affairs on a one-year
study to use imaging technology to better understand post-traumatic
stress syndrome and traumatic brain injury. Wake Forest Baptist is one
of 35 clinical sites across the nation using the equipment.
Researchers
compare the images of brain activity from individuals with PTSD and/or
mild traumatic brain injury (TBI) with the images from individuals
without the condition to see whether particular parts of the brain
function differently.
"If we can find biomarkers of PTSD, there's hope that we'll be able to improve diagnosis and treatment," said Dwayne Godwin, a neuroscientist at Wake Forest Baptist and co-principal investigator on the project.
Researchers are using a high-tech tool for brain activity imaging called magnetoencephalography (MEG) to conduct neurological tests on military veterans with and without a PTSD diagnosis, and with varying levels of impairment.
Participants perform tasks, similar to games, which engage 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.
In a sign of the growing focus on the disorders, first lady Michelle Obama will announce today a new physician-training initiative with 105 U.S. academic medical centers in 42 states, including Wake Forest Baptist. It involves the White House's wounded warriors and veterans programs.
Among the goals are embedding PTSD and TBI training into medical-school curriculum, reaching out to physicians and specialists and sharing best practices among the academic medical centers. No new federal funding is associated with the initiative.
Wake Forest Baptist was mentioned specifically by officials involved in the Joining Forces initiative as "having great work going on" and "taking a leadership role with sophisticated lessons to share."
Brad Cooper, executive director of Joining Forces, said PTSD and TBI affects one in five veterans.
About 25 million Americans will deal with PTSD at some point in their lives, according to The National Center for PTSD.
Women are more likely to experience PTSD because of a sexual assault or sexual abuse as a child. Men are more likely to experience it through accidents, physical assault, combat, disaster or witnessing a death or injury.
"A trauma is something horrible and scary that you see or that happens to you," according to the PTSD center's website. "During this type of event, you think that your life or others' lives are in danger. You may feel afraid or think that you have no control over what is happening."
Cooper said the effort carries urgency since more veterans are seeking medical help outside veterans' facilities, with private physicians and public health centers.
"Overall, these doctors need to have better comprehension on the issues," Cooper said. "Some doctors already do, but many don't. It is a long-term issue for our country because many of the people suffering from these disorders are so young."
Although PTSD has been a recognized disorder for decades, traditionally most of the medical focus on military personnel has been on the visible, physical side of coming back from a war zone with debilitating injuries.
As a result, some veterans often don't get the mental-health assistance they need, leaving some to wander homeless or show up in hospital emergency departments.
The study draws participants served by the Salisbury Veteran's Administration hospital, Godwin said. The hospital specializes in post-deployment mental-health issues.
"PTSD and mild TBI are serious problems for our vets coming home from Iraq and Afghanistan," Godwin said. "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."
In order to develop more effective treatments for PTSD and TBI, researchers need to understand the underlying neurobiology, said Dr. John Krystal, chairman of the psychiatry department at Yale University School of Medicine. Krystal collaborates with the Veteran's Administration on PTSD issues.
"MEG is a technology that enables scientists to study — non-invasively — electrical activity within the brain," Krystal said. "Applying this approach to PTSD may help to characterize dysfunction within brain circuits contributing to both conditions."
Laurie Coker, a local behavioral-health advocate and director of the N.C. Consumer Advocacy, Networking and Support Organization, said two levels of the research "could be exciting."
"If researchers find there are actually physiological changes in the brain after a person experiences trauma, then perhaps returning soldiers who are struggling with mood and other problems will be able to accept the concreteness of the fact that trauma injures the brain," Coker said.
"It would be easier for them to seek support and treatment if they realized that these symptoms reflect nothing about character or courage, but that trauma is simply dangerous.
"Second, we now know that many people who have a mental illness have had specific traumatic events which have triggered their mental reactions," Coker said. "This might help us look at various ways besides or along with medications that people can help themselves heal."
Godwin said having a strong support group often helps people suffering from PTSD to cope with the disorder.
"Many of those affected by PTSD possess a heightened awareness called hyper-vigilance," Godwin said. "These individuals may have a range of symptoms, including difficulty concentrating, exaggerated responses to normal things, irritability, experiencing anger-management issues, having more risky behaviors, disruptions or trouble sleeping."
In addition to assessing functional brain networks, researchers will examine brain pathways to see whether the connections between brain areas may differ between those with and without the disorder.
Another goal 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.
"It's not mind reading, because we can't tell what the content of the thought may be," Godwin said. "But with the right kind of test, we can resolve patterns of activation that relate to executive function."
"If we can find biomarkers of PTSD, there's hope that we'll be able to improve diagnosis and treatment," said Dwayne Godwin, a neuroscientist at Wake Forest Baptist and co-principal investigator on the project.
Researchers are using a high-tech tool for brain activity imaging called magnetoencephalography (MEG) to conduct neurological tests on military veterans with and without a PTSD diagnosis, and with varying levels of impairment.
Participants perform tasks, similar to games, which engage 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.
In a sign of the growing focus on the disorders, first lady Michelle Obama will announce today a new physician-training initiative with 105 U.S. academic medical centers in 42 states, including Wake Forest Baptist. It involves the White House's wounded warriors and veterans programs.
Among the goals are embedding PTSD and TBI training into medical-school curriculum, reaching out to physicians and specialists and sharing best practices among the academic medical centers. No new federal funding is associated with the initiative.
Wake Forest Baptist was mentioned specifically by officials involved in the Joining Forces initiative as "having great work going on" and "taking a leadership role with sophisticated lessons to share."
Brad Cooper, executive director of Joining Forces, said PTSD and TBI affects one in five veterans.
About 25 million Americans will deal with PTSD at some point in their lives, according to The National Center for PTSD.
Women are more likely to experience PTSD because of a sexual assault or sexual abuse as a child. Men are more likely to experience it through accidents, physical assault, combat, disaster or witnessing a death or injury.
"A trauma is something horrible and scary that you see or that happens to you," according to the PTSD center's website. "During this type of event, you think that your life or others' lives are in danger. You may feel afraid or think that you have no control over what is happening."
Cooper said the effort carries urgency since more veterans are seeking medical help outside veterans' facilities, with private physicians and public health centers.
"Overall, these doctors need to have better comprehension on the issues," Cooper said. "Some doctors already do, but many don't. It is a long-term issue for our country because many of the people suffering from these disorders are so young."
Although PTSD has been a recognized disorder for decades, traditionally most of the medical focus on military personnel has been on the visible, physical side of coming back from a war zone with debilitating injuries.
As a result, some veterans often don't get the mental-health assistance they need, leaving some to wander homeless or show up in hospital emergency departments.
The study draws participants served by the Salisbury Veteran's Administration hospital, Godwin said. The hospital specializes in post-deployment mental-health issues.
"PTSD and mild TBI are serious problems for our vets coming home from Iraq and Afghanistan," Godwin said. "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."
In order to develop more effective treatments for PTSD and TBI, researchers need to understand the underlying neurobiology, said Dr. John Krystal, chairman of the psychiatry department at Yale University School of Medicine. Krystal collaborates with the Veteran's Administration on PTSD issues.
"MEG is a technology that enables scientists to study — non-invasively — electrical activity within the brain," Krystal said. "Applying this approach to PTSD may help to characterize dysfunction within brain circuits contributing to both conditions."
Laurie Coker, a local behavioral-health advocate and director of the N.C. Consumer Advocacy, Networking and Support Organization, said two levels of the research "could be exciting."
"If researchers find there are actually physiological changes in the brain after a person experiences trauma, then perhaps returning soldiers who are struggling with mood and other problems will be able to accept the concreteness of the fact that trauma injures the brain," Coker said.
"It would be easier for them to seek support and treatment if they realized that these symptoms reflect nothing about character or courage, but that trauma is simply dangerous.
"Second, we now know that many people who have a mental illness have had specific traumatic events which have triggered their mental reactions," Coker said. "This might help us look at various ways besides or along with medications that people can help themselves heal."
Godwin said having a strong support group often helps people suffering from PTSD to cope with the disorder.
"Many of those affected by PTSD possess a heightened awareness called hyper-vigilance," Godwin said. "These individuals may have a range of symptoms, including difficulty concentrating, exaggerated responses to normal things, irritability, experiencing anger-management issues, having more risky behaviors, disruptions or trouble sleeping."
In addition to assessing functional brain networks, researchers will examine brain pathways to see whether the connections between brain areas may differ between those with and without the disorder.
Another goal 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.
"It's not mind reading, because we can't tell what the content of the thought may be," Godwin said. "But with the right kind of test, we can resolve patterns of activation that relate to executive function."
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