Brain imaging can help predict post traumatic stress disorder (PTSD) after brain injury, new research has revealed.
Through using magnetic resonance imaging (MRI), researchers have found potential brain biomarkers of PTSD in people with traumatic brain injury.
The study could help shed new light on how the symptoms of PTSD – including anxiety, depression and cognitive disturbances – arise, and researchers conclude that treatments and outcomes could potentially be improved if doctors could better predict who would develop the psychiatric disorder.
“The relationship between TBI and PTSD has garnered increased attention in recent years as studies have shown considerable overlap in risk factors and symptoms,” says Murray Stein, Distinguished Professor of Psychiatry and Family Medicine & Public Health at the University of California San Diego, lead author of the study.
“In this study, we were able to use data from TRACK-TBI, a large longitudinal study of patients who present in the Emergency Department with TBIs serious enough to warrant CT (computed tomography) scans.”
Through the research project – which appears in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging – over 400 TBI patients were followed and assessed for PTSD at three and six months after their brain injury.
At three months, 77 participants, or 18 per cent, had likely PTSD; at 6 months, 70 participants or 16 percent did. All subjects underwent brain imaging after injury.
“MRI studies conducted within two weeks of injury were used to measure volumes of key structures in the brain thought to be involved in PTSD,” says Dr. Stein.
“We found that the volume of several of these structures were predictive of PTSD 3-months post-injury.”
Specifically, smaller volume in brain regions called the cingulate cortex, the superior frontal cortex, and the insula predicted PTSD at 3 months. The regions are associated with arousal, attention and emotional regulation. The structural imaging did not predict PTSD at 6 months.
The findings are in line with previous studies showing smaller volume in several of these brain regions in people with PTSD and studies suggesting that the reduced cortical volume may be a risk factor for developing PTSD.
Together, the findings suggest that a “brain reserve,” or higher cortical volumes, may provide some resilience against PTSD.
Although the biomarker of brain volume differences is not yet robust enough to provide clinical guidance, Dr. Stein adds: “It does pave the way for future studies to look even more closely at how these brain regions may contribute to (or protect against) mental health problems such as PTSD.”
