Post-traumatic stress disorder (PTSD) is a huge risk for first responders like emergency medical technicians, police officers and firefighters. They deal with horrific scenes of disaster that most of us only watch in Hollywood movies.
Though PTSD is a poorly understood condition with no methodologies for long-term care, help is on the way from Israel for better prediction of susceptibility -- and therefore better treatment for each individual.
Professors Talma Hendler and Nathan Intrator from Tel Aviv University are working on groundbreaking tools that pair a commonplace electroencephalography (EEG) and a more complex functional magnetic resonance imaging (fMRI) to track PTSD deep in the brain. Their approach is to locate the traces of PTSD in the brain and monitor those areas over time to determine “stress vulnerability” in each patient.
“The unique thing about our research is that we are looking at individuals over time -- not just when they have the disease -- in order to see the vulnerability measurements for PTSD,” says Hendler. “We were able to predict developing symptoms after a year and a half.”
The two professors and other researchers worked with a test group of Israeli military medics through the Functional Brain Center of the Wohl Institute for Advanced Imaging at Tel Aviv Sourasky Medical Center. The subjects were examined before they entered their mandatory military service and after their subsequent exposure to stressful events while deployed in combat units.
Hendler says this group represented a rare opportunity for studying PTSD: Unlike most other combat medics around the world, Israeli medics are on active duty; they comprise a slice of the general population; and due to the small size of the country, the researchers were able to easily access the soldiers over time to monitor their condition.
Finding the potential to heal
Hendler says another unique aspect of the study was identifying areas of “plasticity,” or places in the brain that were able to bounce back from PTSD injury.
“We saw events like these which are changing the brain, and this is happening in the brain areas of memory and learning like in the hippocampus,” says Hendler. “These regions are changing over time, which suggests that this might be a good target for treatment if you catch it at the right time.”
The symptoms of PTSD manifest differently in different people, and can range from anxiety and depression to suicidal tendencies. Medical practitioners around the world are looking for better ways to diagnose and manage the poorly understood but widely experienced disorder.
The Israeli approach has been documented in journals such as Proceedings of the National Academy of Sciences (PNAS) and Cerebral Cortex.
Partnering with MIT
Using EEG to record electrical impulses in the brain and fMRI to study oxygenated blood in the brain, the researchers subjected the test participants to stress stimuli. Advanced algorithms were then built to identify brain activity associated with certain emotional experiences, and these emotions were linked to cognitive areas in the brain.
In the future, the algorithms they devised can be applied on EEG readouts to gain a better understanding of brain pathology, without the use of the more expensive and less readily available fMRI. This powerful tool, the researchers hope, will eventually give doctors an easier way of customizing treatment for patients with PTSD before significant psychopathological effects have taken place.
Work toward bringing the Israeli PTSD research to medical communities everywhere is now underway at Tel Aviv University and the Massachusetts Institute of Technology.