This past year, the research team at Amen Clinics, in collaboration with scientists from UCLA, Thomas Jefferson University, and the University of British Columbia, completed two research studies on the differentiation of traumatic brain injury (TBI) from posttraumatic stress disorder (PTSD). They were both accepted into peer-reviewed journals.
The first study, entitled Functional Neuroimaging with Default Mode Network Regions Distinguishes PTSD from TBI in a Military Veteran Population was published in April 2015 in Brain Imaging and Behavior. The second study, Functional Neuroimaging Distinguishes Posttraumatic Stress Disorder from Traumatic Brain Injury in Focused and Large Community Datasets was published in PLOS ONE in July 2015. The latter is the world’s largest functional brain imaging study on more than 21,000 patients that demonstrated the ability to distinguish between PTSD and TBI using brain SPECT imaging with high accuracy.
We were very pleased to be published in these two excellent medical journals; however, we were really honored when we received the acknowledgment from Discover Magazine about the relevance of our studies to the scientific community. The pioneering research we did on differentiating TBI from PTSD has been highlighted in Discover Magazine as #19 of the top 100 stories in all of science for 2015! Our research was sandwiched between Tesla’s new entry into renewable energy at #18 and the discovery of a new dinosaur species at #20.
Brain SPECT imaging reveals the differences we cannot know just from talking about the patients’ symptoms.
With SPECT (single photon emission computed tomography) we are able to do an overall evaluation of a person’s brain function. The tracer, HMPAO-Tc99, is distributed proportionally to blood flow in the brain. Areas that have lower activity, such as with TBI, draw less blood to them, whereas areas of overactivity, as seen in PTSD, draw more blood. This allows us to differentiate high and low activity from the patient’s normal blood flow. In our study, we were able to distinguish PTSD from TBI with 80% – 100% accuracy.
Using SPECT to Guide Treatment
Because PTSD and TBI have several overlapping symptoms, this capability is particularly important when trying to differentiate between them since the treatments for each are different. Below is a list of symptoms that are among those that can confound the diagnosis for even very experienced clinicians:
- Irritability and/or anger
- Insomnia or other sleep problems
- Symptoms of depression
- Heightened or excessive anxiety
- Social isolation
- Impulse control problems
- Difficulty with concentration
Typically, treatment for PTSD and emotional trauma is psychological in nature and the goal is to try to calm down the brain. Conversely, treatment for TBI is more physiological in nature and focuses on increasing activity in the injured areas of the brain. Knowing which condition a patient has is critical to helping them heal. For example, if someone is feeling depressed and has difficulty concentrating, a doctor may presume it is TBI and prescribe a stimulant. Unfortunately, if the diagnosis is actually PTSD, the patient’s symptoms will be exacerbated.
By using SPECT to help differentiate between PTSD and TBI, it is our hope that the findings from our study and the acknowledgment by Discover Magazine will help millions of people suffering from one or both of these devastating conditions to be correctly diagnosed and more effectively treated.
If you have been working with patients who have PTSD or TBI but they aren’t responding well to treatment, consider referring them for a SPECT evaluation at one of our clinics. By doing so you will obtain the data on the underlying biology of their condition which can improve your treatment decisions and help the patients feel better more quickly. Call us today at 888-288-9834 or schedule a visit today.
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