Traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) have virtually indistinguishable symptoms, yet each requires a different approach for effective treatment. Now, in what is thought to be the largest functional neuroimaging study to date, researchers have identified biological differences between TBI and PTSD by using single-photon emission computed tomography (SPECT) to scan the brain.
Both of the conditions may present with symptoms including anxiety, depression, mood dysregulation, irritability and other cognitive breakdowns. The study evaluated almost 21,000 participants at 9 U.S. sites. The subjects either had TBI, PTSD, both of the disorders, or neither of them.
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| Dr. Theodore Henderson |
"This discovery is breakthrough information for anyone diagnosed with either TBI or PTSD or both," said Dr. Theodore Henderson, co-author of the study that was published last week in PLOS ONE. "Now that we can tell the difference between TBI and PTSD, clinicians can apply more targeted and appropriate treatments, and achieve advances with their patients."
The researchers found that PTSD patients, as compared to those with TBI, has increased perfusion in the limbic regions, cingulum, basal ganglia, insula, thalamus, prefrontal cortex and temporal lobes. TBI, however, is associated with hypoperfusion that can, of course, be located in any region of the brain depending on where the injury occurred.
The study found that these indicators could be used to achieve a clinically relevant level of sensitivity, specificity and accuracy.
"This study contained a subset of closely matched patients and a larger dataset of 'real world' patients with multiple psychiatric or neurological conditions. The accuracy of the closely matched study was 100% which replicates our research on Veterans with TBI or PTSD (wherein the accuracy was 94%)," said Henderson. "It clearly delineates the potential of SPECT as a biomarker in differentiating TBI from PTSD--a critical issue for anyone suffering from symptoms with no answers."
Dr. Henderson emphasized the importance of obtaining an accurate diagnoses for TBI or PTSD. "They may have similar symptoms, but treatments are very different," he said.
Some PTSD treatments can be useless or even harmful for TBI patients, making it crucial to distinguish between the two. PTSD is typically treated with psychotherapy and/or medication, while TBI is usually addressed with pain or seizure medication, as necessary, and can require surgery and rehabilitation.
Dr. Henderson has researched a TBI treatment that uses the application of an infrared laser directly to the skull of the injured area of the brain. Dubbed transcranial near infrared light therapy, he has found that this can offer TBI patients some clinical improvements.
- here is the release and the study