Posttraumatic stress disorder (PTSD) is a complex psychiatric disorder brought on by physical and / or psychological trauma. How his symptoms, including anxiety, depression, and mental arousal arise is still not fully understood and predicted. Remedies and outcomes could be improved if doctors could better predict who would develop PTSD. Now, researchers are using magnetic resonance imaging (MRI) to detect potential brain biomarkers of PTSD in people with traumatic brain injury (TBI).
The study appears in Biological Psychology: Cognitive Neuroscience and Neuroimaging, published by Elsevier.
The relationship between TBI and PTSD has attracted more attention in recent years as studies have shown that there is too much overlap in risk factors and symptoms. In this study, we were able to use data from TRACK-TBI, a large long-term study of patients present in the Emergency Department with TBIs severe enough to qualify for CT (computed tomography) scans. “
Murray Stein, MD, MPH, FRCPC, Lead Author, Distinguished Professor of Psychology and Family Medicine & Public Health, University of California San Diego, San Diego, La Jolla, CA, USA
The researchers followed more than 400 TBI patients, assessing them for PTSD at 3 and 6 months after the brain injury. At 3 months, 77 participants, or 18 percent, appeared to have PTSD; at 6 months, 70 participants or 16 percent performed. All subjects went through brain images after being injured.
“MRI scans performed within two weeks of injury were used to quantify key brain structures that were thought to be involved in PTSD,” Dr. Stein said. “We found that the size of several of these structures was predictable after 3-months PTSD after injury.”
Notably, there was a smaller volume in brain regions known as the cingulate cortex, the superior frontal cortex, and the PTSD predictive insula at 3 months. The areas are related to arousal, attention and emotional control. The structural picture did not predict PTSD at 6 months.
The findings from previous studies show a smaller size in several of these brain regions in people with PTSD and studies suggest that the reduced cortical volume may be a risk factor for developing PTSD. Taken together, the findings suggest that “brain reserve,” or higher cortical dimensions, may provide some flexibility against PTSD.
Although the biomarker of brain size differences is not yet robust enough to provide clinical guidance, Dr Stein said, “it is a way for future studies to take a closer look at how these brain regions may contribute to (or protect against) mental health problems such as PTSD. “
Cameron Carter, MD, Editor Biological Psychology: Cognitive Neuroscience and Neuroimaging, said of the work, “This very important study uses magnetic resonance imaging to take the field one step closer to understanding why some people develop PTSD after trauma and some It also sets the groundwork for future research aimed at using brain imagery to help predict that a person is at greater risk and could benefit. from targeted interventions to reduce the clinical impact of a traumatic event. “
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Magazine Reference:
Stein, MB, et al. (2020) Smaller regional brain sizes predict posttraumatic stress disorder at 3 months after mild traumatic brain injury. Biological Psychology: Cognitive Neuroscience and Neuroimaging. doi.org/10.1016/j.bpsc.2020.10.008.