New Brain Scans Can Spot PTSD

Neuroscientists think they may have found a scientific method to identify post-traumatic stress disorder (PTSD) using a brain imaging method called magnetoencephalography (MEG). In the test study, the scientists studied 74 vets with PTSD and 250 civilians without and were able to spot the PTSD sufferers with 90% accuracy. "MEG machines are a fast, sensitive and accurate way to measure electric activity in the brain. Whereas CT scans and MRIs record brain signals every few seconds, MEGs can do it by the millisecond, catching biomarkers and brain activity that the other tests inevitably miss. The study could be a breakthrough for the military, who've been scrambling to address a surge in post-traumatic symptoms among newly returning vets. Right now, troops are evaluated by mental health experts, but diagnosis is a crap-shoot: symptoms can take years to show up, and vary from person to person, even among those exposed to the same traumas. The Pentagon's already been pushing for more objective, systematized diagnosis tools, like portable at-home sleep monitors and genetic testing to detect PTSD vulnerability. They've even launched a program to create stress-mitigating pharmaceuticals."

Comments

what about the other 10%

[dobedobedew]

So if you are in the 10% that doesn't get detected you're SOL? I hope they can increase the accuracy of this.

Re:what about the other 10%

[ArsonSmith]

the other 10% are just faking it for the VA benefits.

Re:what about the other 10%

[Ann O'Nymous-Coward]

IF they can really achieve 90% detection rate (and that's a huge if), then that'd be hugely impressive.

FYI, Mammograms only have roughly an 80% chance of detecting breast cancer. http://breastscreening.cancer.gov/data/performance/diagnostic/rate_age_time.html

Rates of detection of other cancers are often much worse. And rates of early detection (as opposed to self-report) of mental illnesses are worse again.

Re:what about the other 10%

[icebike]

Its not the only diagnostic tool in the kit. In fact you probably wouldn't even encounter this device if you weren't showing some symptoms.

90% of anything detected by brain imaging is pretty amazing, since even tumors can't always be spotted.

Re:what about the other 10%

[fuzzyfuzzyfungus]

Anybody who would use the test, in its current form, as an automated "confirm/deny" mechanism deserves a punch in the face. However, the establishment of a fairly reliable correlation between a psychological condition that could previously only be diagnosed subjectively("subjectively" in the sense that the patient has to introspect and report symptoms for a diagnosis to be made, not in the "Oh, its just subjective, it must just be you" sense) and an objectively measurable electrical phenomenon is pretty cool.

It is more or less a commonplace, for anybody not deeply in the grips of some metaphysical or dualist theory, that psychological phenomena must have material correlates; but actually hunting them down and making them useful is fairly tricky work.

Re:what about the other 10%

[Anonymous Coward]

Not for nothing, but I went 20 years without being diagnosed. I understand the attempt at humor, but it isn't funny to me.

PTSD is not just some dude screaming "incoming" and diving under the table at Thanksgiving. It has a measurable effect upon every decision in a person's life. Just stepping into a restaurant is a tense and fearful experience that can last for hours. Hours in which I must scan every person coming into the room for potential threats, monitor the exits, sit so that no one can approach me without my knowing. My family knows that to catch my unawares is, at the very best, a chance to have me yell at them as if they'd done something wrong by entering the same room without announcing themselves.

When I head into wallmart, I have to plan my route to minimize the stress, I use weird checkout methods, like buying a box of vitamins and then doing my checkout at the pharmacy to avoid the lines where I am vulnerable to attack. For 20 years I thought that everyone looked between the parked cars as they walked down the street, planned the move to cover in case there was gunfire, looked at every window and rooftop for snipers. I didn't realize that what I took for survival instinct was way beyond what almost everyone else did to safe guard themselves. I have been emotionally removed from my daughter's entire life, I have no emotional reaction to the suffering of others, as I instinctively believe that it is their fault for not being ready to deal with whatever the situation.

If this technology can help get people diagnosed and in a proper treatment regimen, then it is a worth while venture. A 10% miss beats 40% (http://ajol.info/index.php/ajpsy/article/viewFile/30263/30480)[pdf]

I for one, salute our new MEG Overloards

Re:what about the other 10%

[ubrgeek]

You're absolutely right. In fact, I was going to use some of my mod points to do just that - mark him as a troll. But I re-read and think his points are valid and even insightful (sans the punch-in-the-face component.) But, the poor choice of moderation points applies to ArsonSmith's posting as well. While his attempt may be at humor, it wasn't funny. It was the equivalent of posting a comment to a story about some new test being able to detect HIV early on and saying, "Hey! At least now they'll know your insurance should cover it before you die." I've spent a lot of time talking with folks who work for me who went through "shock and awe" and battles before and since. Having them talk to me about the dreams they have of friends who get blown up as they stand next to them - friends who have actually come home and are doing fine - is hardly a part of my day about which I'd make jokes.

Re:what about the other 10%

[MmmmAqua]

I'm with you. It has only been five years for me, but a more objective assessment would have helped me a great deal.

I had a four-year fight with the VA to get service-connected for PTSD. After indisputable records of many, many combat stressors, four years of the VA mental health clinical team regularly putting full, five-axis PTSD diagnoses in their chart notes, and my career devolving from well-paid Solaris systems engineer to unemployment, my claims and appeals were denied by bureaucrats who had never seen me in person.

I did finally get the service connection, but the years of bureaucrats telling me I had no problems made my symptoms worse, and my life is a shambles because of it. This technology could have been a near-literal life-saver for me; I hope it proves to be so for future veterans.

p.s. - if you haven't already, try a symptom management group with the VA. The class I attended was very helpful for me. The seven or eight Vietnam vets and the two WWII vets in the class said the same after the last session.

Re:what about the other 10%

[moj0joj0]

The pharmacy is a good one, but the jewelry counter (unless it is right out in the open) or automotive center is also good.

--The location of the pharmacy for one, usually in a less traveled section of the store.
--Less people check out there for two, so there are fewer eyes on you as you are getting your stuff checked out.
--It usually has at least some soft cover or concealment for three.
--Also, it is an unexpected location to be checking out (never take the same route twice).

Error in TFS:

[Ethanol-fueled]

From TFS:

using a brain imaging method call magnetoencephalography (MEG)

> line 1: method magnetoencephalography(java/lang/String;) not found

False positives

[jfengel]

Spotting 100% is easy: you just need a machine with a blinking light that says "PTSD". Unfortunately that puts a lot of healthy people in therapy.

Nobody expects Wired to figure that out, but the original press release (scavenged from the array of irrelevant links) doesn't say, either.

I assume that the actual article (in the Journal of Neural Engineering) actually says something about it. Anybody got a subscription?

Re:False positives

[Tacvek]

Sure, My university has a subscription. Let me give you the numbers:

Test subjects:
All 75 test group members had confirmed PTSD as the primary diagnosis, using the standard structured clinical interviews for PTSD. There were many variations as to cause of PTSD some from combat others from before they became soldiers. 69 test subjects were male, and 5 were women.

Control group:
250 members from the general public in the same age range as the test subjects. 151 men, 49 women.
Complete nurological histories, and multiple interview examinations were performed to help exclude general public members with latent PTSD.

The test with the paramters used by the team had the following results:

72 true positives.
2 false negatives.
31 false positives.
219 true negatives.

According to the paper this is
97.3% Sensitivity
87.6% Specificity
92.4% Accuracy
Chi squared-statistic: 189.8
P value: .001
phi coefficient: .765
odds ratio: 254.3

Possible fault in the sample group

[NevarMore]

"scientists studied 74 vets with PTSD and 250 civilians "

Is it possible that they aren't spotting PTSD but a wiring from a soldier? I am a civillian with NO military experience, but I do hang around several soldiers and police officers. Each group has similar mannerisms and they have ALL had similar experiences within that group (basic training for the green guys, the academy for the blue ones). I see a good chance that this new scan could be picking that up.

A more valid group would be:
  - some vets without PTSD
  - some vets with PTSD
  - some civillians with PTSD
  - some civillians without PTSD

Of those four groups some significant correlation would be helpful too. For example a set of soldiers from Afghanistan with and without PTSD. A set of civillians that had been through the same or similar trauma (say armed robbery or 9/11 or plane accident). Breaking it down by age would also be useful, a Vietnam veteran who has had a few years either with or without treatment would be a lot different than a recent return home from the Sandbox.

Re:Possible fault in the sample group

[tonyreadsnews]

Also,

symptoms can take years to show up

Would the machine be able to tell either? It could be that the brain changes over time (as a person relives the trauma) that makes the symptoms visible.

Re:Possible fault in the sample group

[pz]

These are valid concerns.

The study was published in J. Neural Engineering which, regrettably, my institution does not have a subscription to, so can't be as well-informed as I'd like, unfortunately. Nevertheless, the research was headed by Dr. Apostolos Gerogropoulos, whom I know professionally and by his research publications. Now, Dr. Georgopoulos is no fool. His research team certainly must have thought about these potential issues. There's a hint at why the study might be considered valid despite what at first blush seems like a lack of proper controls in the press release: "the researchers also are able to judge the severity of how much [subjects with PTSD] are suffering," Proper controls (ie, soldiers without PTSD) are necessary, but if there's a good correlation between the observed MEG phenomena and the strength of clinical findings, then maybe the study really has discovered something interesting.

Car accidents

[Itninja]

It's interesting to me that there are new developments in PTSD treatment within less than a decade of of the declaration of 'car accident' being the #1 cause of PTSD. I mean, sure soldiers get it in wartime and 'police action' time, but when the car insurance companies start to lose money...then it's ON...

Stress mitigating pharmaceuticals

[troylanes]

AFAIK stress mitigating pharmaceuticals have been in use by both civilians and military for thousands of years... check out: this

New tools may hep catch more cases

[the Dragonweaver]

This is a very helpful diagnostic tool as there is still a stigma associated with any sort of mental disorder, particularly in the military. Some subsets handle it better than others; while some groups are more in the mindset of "get it treated" the idea of "malingerers" still holds true in some places. Self-diagnosis lags when there's a stigma attached.

I would also be interested to see this used to help diagnose sexual trauma. Among the female population of the military, rape is still the highest inducer of PTSD, and I'm sure that holds true for civilians as well.

The biggest reason for PTSD is that we, as humans in general, are not wired to cope with extreme trauma. Nor are we particularly wired to cause death. We train our military to automate these actions but in some people the brain can't cope with what the body has done. Look up "Achilles in America" for more information on the subject— there have been many studies done in and out of the military, and there are quite a few higher-ups who want to see the best treatments possible— and some who are looking into ways to mitigate the effects before they occur.

How just like the US military

[yttrstein]

To launch headlong into the most expensive, unworkable, unreasonable, ill-thought, entirely not-researched solutions. I'm not talking so much about the brain scan here; Harvard came up with the idea that PTSD could be detected in the brain, along with bi polar disorder and a few other conditions which might have detectable pathologies, and it's a very good idea.

What's a very bad idea is the notion that PTSD can be stopped, or at least mitigated with chemical or mechanical tools. Once you already have PTSD, or indeed any disorder on the dissociative scale (Howell, Chu), then there is some good evidence that pharmaceuticals can help mitigate some, but not all of the symptoms. Currently those pharmaceuticals fall into two major classes: sedative-hypnotics and atypical antipsychotics. Sedative-hypnotics, particularly benzodiazepines, cause massive problems with the creation of short term memories. Atypical antipsychotics have a host of horrible side effects, from flattened affect to tardive dyskenisia-- which is the permanent, uncontrolled flexing of small muscles, like facial tics, thumb-wiggles and circles, and shuffling gait. In short, they should not be used for any condition which is not treatable by any other means.

Also, there is no evidence (as has been noted by Harvard, at least) that there is any sort of genetic pre-disposition to the development of PTSD, or any other environmentally caused dissociative disorder. That is a dead end.

Furthermore, there is also absolutely no evidence that the pre-dosing of atypical antipsychotics or sedatives have any effect whatsoever on the development of PTSD, and in fact in both cases may very probably result in soldiers with far less willingness to shoot the enemy in the face than the military requires.

The fact is that the Pentagon is and has always created an enormous mess out of the minds that manage to survive their plans, and there's simply no way around it. It would be really great, I think, to come up with some way to make war more palatable for the people who have to be in it, but somehow the very root of the notion seems disingenuous.

War is fucking hell.

Corrections

[DynaSoar]

MEG is not new, it's over 40 years old.

Conceptually it's even older. It is the magnetic signals associated with the well known EEG 'brain waves', first recorded in 1928.

It is exactly and only the perpendicular to the EEG signals, and as such are analyzed in much the same way, and represent the same neural processes.

What good it is, is it can detect and localize 'dipole' generators in the folds of the cortex. Since the negative and positive ends of those are the same distance from the scalp, they balance out on EEG and can't be seen. The magnetic field to such a dipole is most prominent in this configuration.

The drawback is that detecting the ~10 femtotesla signals require massive shielding to prevent pretty much any near by electrical activity to interfere. With signals that weak, it's a good thing the magnetic field isn't reduced by the skull and scalp like EEG (by 3 orders of magntitude).

The detectors are superconducting quantum interference devices (SQUIDS). They require massive technical infrastructure and maintenance, ie. great expense.

Except for the localization noted, if MEG can do it, EEG can do it easier, cheaper (three orders of magnitude), faster (in terms of turnover), and operated by personnel with less training. There are portable EEGs capable of being operated in the field, but even a full size unit is about the size of a desktop computer and can be run off a laptop.

I'd be very interested to hear what TFA has to say about why MEG is necessary. Their 248 SQUID machine is high density, but so are the 256 electrode EEG that have been on the market for years. I'd also like to know exactly what the signals of interest are, so I can figure out how to pull it out of EEG with far less sophisticated equipment, such as exists in pretty much every VA neurology department.