Monday, November 9, 2009

New MRI Techniques Allow for Detecting PTSD and TBI Damage

Full Article at: Scanning invisible damage of PTSD, brain blasts
By LAURAN NEERGAARD (AP

New MRI techniques "may allow far easier diagnosis for patients — civilian or military — who today struggle to get help for these largely invisible disorders. For now it brings a powerful message: Problems too often shrugged off as "just in your head" in fact do have physical signs, now that scientists are learning where and how to look for them."

"There's something different in your brain," explains Dr. Jasmeet Pannu Hayes of Boston University, who is helping to lead that research at the Veterans Affairs' National Center for PTSD. "Just putting a real physical marker there, saying that this is a real thing," encourages more people to seek care.

Up to one in five U.S. veterans from the long-running combat in Iraq and Afghanistan is thought to have symptoms of PTSD. An equal number are believed to have suffered traumatic brain injuries, or TBIs — most that don't involve open wounds but hidden damage caused by explosion's pressure wave.

Many of those TBIs are considered similar to a concussion, but because symptoms may not be apparent immediately, many soldiers are exposed multiple times, despite evidence from the sports world that damage can add up, especially if there's little time between assaults."

MRI technique allows for "tracking of how water flows through tiny, celery stalk-like nerve fibers in his brain — and found otherwise undetectable evidence that those fibers were damaged in a brain region that explained his memory problems and confusion.

It's a noninvasive technique called "diffusion tensor imaging" that merely adds a little time to a standard MRI scan. Water molecules constantly move, bumping into each other and then bouncing away. Measuring the direction and speed of that diffusion in nerve fibers can tell if the fibers are intact or damaged. Those fibers are sort of a highway along which the brain's cells communicate. The bigger the gaps, the more interrupted the brain's work becomes."

"There's a remarkable overlap of symptoms between those brain injuries and PTSD, says Dr. James Kelly, a University of Colorado neurologist tapped to lead the military's new National Intrepid Center of Excellence. It will open next year in Bethesda, Md., to treat both conditions.

Yes, headaches are a hallmark of TBI while the classic PTSD symptoms are flashbacks and nightmares. But both tend to cause memory and attention problems, anxiety, irritability, depression and insomnia. That means the two disorders share brain regions."

Yale Undertakes Study of Readjustment of Women Combat Veterans

Full Article at: Effects of Combat on Returning Female Veterans Focus of Fippinger Grant

"In one of the first studies of its kind, Women’s Health Research at Yale will launch a collaborative study to identify gender differences among returning soldiers.

Of the two million Americans who have fought in Afghanistan and Iraq since 2001, some 220,000 have been women, and many of these women have been in combat. In fact, this is the largest cadre of U.S. military women exposed to combat to date.

Women’s Health Research at Yale is undertaking its study of gender differences among veterans in collaboration with the Northeast Program Evaluation Center ( NEPEC ) of the Veterans Administration.

The pilot study is being funded by a grant from the Grace J. Fippinger Foundation.
The principal investigator on this study, Rani Desai, is associate professor of psychiatry at Yale School of Medicine and is on the staff at NEPEC, where she is the director in charge of evaluating post-traumatic stress disorder treatment programs in the Veterans Administration nationwide.

Desai will work with Carolyn M. Mazure, professor of psychiatry and psychology, and director of Women’s Health Research at Yale, and Sherry McKee, associate professor of psychiatry. The research program’s Women and Trauma Core, which previously has partnered with NEPEC to examine gender differences in male and female veterans in treatment for PTSD, will collaborate on the pilot study.

Although there is no evidence that women perform any differently than men in combat arenas, it is not known whether women and men differ in their experiences upon returning to civilian life.

There has been concern that women military veterans are more susceptible to post-traumatic stress disorder than men, given similar experiences. There also has been some concern that the trauma women experience in combat may be compounded because women on average enter the military having had more civilian trauma than men and may suffer trauma at the hands of their comrades more than male veterans. However, none of this speculation has been investigated with empirical studies; this is what the researchers aim to accomplish with the pilot study and a future, wider investigation.

Women’s Health Research at Yale was founded in 1998 to address disparities in medical research by initiating and nurturing groundbreaking studies of the health of women and gender-specific aspects of health and disease. The program has since grown into one of the largest interdisciplinary research centers of its kind in the country—and has become a national model."

For more information on Women’s Health Research at Yale, visit www.yalewhr.org.