Brain Scans Help Shed Light On The Ptsd Brain But They Cannot Diagnose Ptsd
by Arash Javanbakht, The Conversation
Celebrities and public figures have recently been more open about mental health conditions they deal with. This is a positive sign of shrinking stigma around mental illness, and it also helps in reducing it. The most recent in this line was Ariana Grande’s mention of post-traumatic stress disorder, or PTSD and a brain scan.
I am a psychiatrist and neuroscientist specializing in research, diagnosis and treatment of PTSD, and I see this as an opportunity to discuss PTSD, how it is diagnosed, and its treatments.
What is post-traumatic stress disorder?
PTSD is a clinical condition, and a consequence of exposure to extreme traumatic experiences such as motor vehicle accidents, assault, robbery, rape, combat and torture, at any stage of life including childhood situations that are threatening to the integrity of the person.
Trauma may happen to the person, or be witnessed happening to others. As a result, the brain switches to “survival mode,” doing its best to avoid another exposure to such experiences.
The person is always anxious and hypervigilant, and constantly screens for danger. This leads to avoidance of any situation, cue or memory that can be relevant to, or reminder of the traumatic experience.
PTSD is common, affecting 8% of the U.S. population, up to 30% of the combat exposed veterans, and 30%-80% of refugees and victims of torture.
What are brain scans?
How do we diagnose PTSD?
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Issues To Consider Prior To An Mri
Medical considerations prior to the MRI scan may include:
- Metal some metal objects can be affected by the magnetic field of the MRI scan. Tell your doctor about any internal device or implant you may have, such as a heart pacemaker, metal pins or a medication pump. Dont ever have an MRI scan if you have a heart pacemaker!
- Pregnancy the affect of MRI scanning on a fetus is unknown. Tell your doctor if you are pregnant or if you think you may be pregnant.
- Fasting before undergoing a pelvic or abdominal MRI scan, you will be advised not to eat or drink for at least five hours before the procedure. In most other cases, it is usually not necessary to avoid food or drink prior to the scan. However, be advised by your doctor.
- Claustrophobia tell your doctor if you experience claustrophobia. Some patients find the confined space within the MRI scan unsettling. The doctor may offer you medication to help you relax during the procedure.
- Children often children are given anti-anxiety medication prior to the procedure to help them relax. Talk to your doctor if you have any concerns about this.
Does Ptsd Show Up On Mri
Two studies published by the research team at Amen Clinics showed that brain SPECT imaging is able to differentiate PTSD from TBI with a 94% accuracy rate. By comparison, MRI and CT scans often show normal results in people with PTSD, which makes them think they are imagining their symptoms.
Control Of Magnetic Power
An MRI machine is used to create a three-dimensional image of a corporal component with electric currents and radio waves of a mental illness disease. Its technology is complex and tough to understand. Nevertheless, a man who passes an MRI machine is fired with a series of radio waves, which affects the bodys tissues. These radio waves produce a picture, which perhaps contains information about how much energy every tissue produces in the body.
The arteries and veins can be seen with an MRI machine. There is the fact that standard MRI cannot see flowing fluid, like blood running in an artery. The machine can see the arteries and veins due to a contrast dye injected into the bloodstream. Tumors and arteriovenous malformations are treated with comparison as well. It is relatively easy to obtain such details because an MRI machine is ordinarily complete in about an hour or two. Its not enjoyable for the person on this MRI machine because the magnets appear noisy. They toggle on and off and appear to be just a few centimeters away from a persons nose. In the meantime, most MRI machines need people to sit in small tubes and keep themselves silent. Sometimes mental illness patients find it challenging to endure the entire experience.
Often people go to an MRI because they have unexplained behaviour changes due to mental illness, and they dont know why these changes occur.
Yet it may be worth spending an hour in an MRI machine because the patient wants information about:
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How Do You Explain Ptsd Triggers
A trigger is anythinga person, place, thing, or situationthat reminds your loved one of the trauma and sets off a PTSD symptom, such as a flashback. Sometimes, triggers are obvious. For example, a military veteran might be triggered by seeing his combat buddies or by the loud noises that sound like gunfire.
What Are The Limitations Of Mri Of The Head
High-quality images depend on your ability to remain perfectly still and follow breath-holding instructions while the images are being recorded. If you are anxious, confused or in severe pain, you may find it difficult to lie still during imaging.
A person who is very large may not fit into certain types of MRI machines. There are weight limits on the scanners.
Implants and other metallic objects can make it difficult to obtain clear images. Patient movement can have the same effect.
A very irregular heartbeat may affect the quality of images. This is because some techniques time the imaging based on the electrical activity of the heart.
MRI is generally not recommended for seriously injured patients. However, this decision is based on clinical judgment. This is because traction devices and life support equipment may distort the MR images. As a result, they must be kept away from the area to be imaged. Some trauma patients, however, may need MRI.
Although there is no reason to believe that MRI harms the fetus, pregnant women should not have an MRI exam during their first trimester unless medically necessary.
MRI may not always distinguish between cancer tissue and fluid, known as edema.
MRI typically costs more and may take more time to perform than other imaging methods. Talk to your insurance provider if you have concerns about the cost of MRI.
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Demographics And Clinical Scores
Data from 17 earthquake survivors with PTSD, 20 trauma-exposed non-PTSD and 20 non-traumatized healthy controls was utilized in the current study. Two-sample t-tests were performed to assess the differences in age, years of education and clinical score, and Chi square test was performed to assess the difference in gender. There were no significant differences in terms of gender, age or years of education in pairwise comparison of the three groups. Compared with TEC, patients with PTSD have significant higher CAPS total score . The detailed demographic and clinical data are shown in Table 1.
Table 1. Demographic and clinical characteristics of participants.
Can An Mri Show Anxiety
MRIs show common structural abnormalities among patients with depression and anxiety. Magnetic resonance images have shown a common pattern of structural abnormalities in the brains of people with major depression disorder and social anxiety disorder , according to a study to be presented at RSNA 2017.
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What Mris Can Tell Us About Ptsd
MRIs can help healthcare experts examine PTSDs effects on the brain. For instance, as United Press International explains, an MRI might reveal how structural and functional changes in the areas of the brain that respond to fear and anxiety, regulate emotions, or are responsible for cognitive processing and memory could impact people with PTSD. These insights can help neuroscientists, therapists, and other experts better understand the complexities of the condition, and provide the best possible care.
If youve been recommended for an MRI whether to aid with diagnosing PTSD symptoms or other physical difficulties turn to Heartland Imaging, where youll be able to choose the time, location, and options that best suit your needs. Schedule an appointment online, or call .
Heartland Imaging is a full-service imaging center in Louisville, KY, dedicated to providing consistent, quality, state-of-the-art outpatient imaging services. Withlocations in Louisville and Elizabethtown, our professionally trained and board-certifiedradiologists offer affordable medical imaging without compromising expertise or a compassionate experience.
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The Hippocampus’ Role In Ptsd
Many people with PTSD experience memory-related difficulties. They may have difficulty recalling certain parts of their traumatic event. Alternatively, some memories may be vivid and always present for these individuals.
People with PTSD may also have problems overcoming their fear response to thoughts, memories or situations that are reminiscent of their traumatic event. Due to the hippocampus’ role in memory and emotional experience, it is thought that some of the problems people with PTSD experience may lie in the hippocampus.
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Mri May Help Doctors Differentiate Causes Of Memory Loss
Using a software program, UCLA Health researchers were able to measure the volume of different regions of the brain, identifying areas where shrinkage may have occurred.
A UCLA-led study has found that MRI scans can help doctors distinguish whether a persons memory loss is being caused by Alzheimers disease or by traumatic brain injury.
The study, which also involved researchers at Washington University in St. Louis, is important because it could help prevent doctors from misdiagnosing Alzheimers disease a diagnosis that can be devastating for patients and their families, and can prevent them from receiving appropriate treatment. 30831-7/abstract rel=nofollow> A 2016 study by researchers affiliated with the University of Toronto found that up to 21 percent of older adults with dementia may be misdiagnosed with Alzheimers.)
The current study, published in the Journal of Alzheimers disease, involved 40 patients whose average age was just under 68 and who were being treated by UCLA neurologists. All of the patients had suffered traumatic brain injury and later developed memory problems.
Dr. Cyrus Raji, the studys corresponding author and an assistant professor of radiology at Washington University, said one of the benefits of the approach is that it doesnt require specialized equipment beyond an MRI machine and the software the researchers used so it could potentially be performed at many medical centers.
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Study Identifies Ptsd Biomarker
The early search for PTSD biomarkers indicated the need for additional studies. Preliminary results showed the potential for this sort of observable data, justifying the need for large-sample studies to further investigate the possibility of biomarkers.
As additional studies have been completed, the presence of PTSD biomarkers is understood with greater clarity. These markers tell us more about the impact of the symptoms of trauma and why some people experience these symptoms with greater severity than others. If an individual has biomarkers that indicate an increased likelihood of PTSD, this could result in a variety of treatment options that may reduce the negative influence of the disorder.
It is common for people with PTSD to abuse substances in response to their challenging symptoms. In fact, approximately 50% of those with PTSD resort to substance abuse. The use of drugs and alcohol with PTSD worsens the impact of the disorder and creates additional problems that impact relationships with others and social and emotional functioning. The study of the PTSD-affected brain has the potential to guide treatment options for substance use disorder and may help anticipate the ways substances will influence the symptoms of PTSD.
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Downsides And Upsides Understanding Of Mental Illness
Families who consider a mental-health MRI scan for mental illness patients may have to think about the scan either its worth their time and effort or not. Often considering the expense will make a choice for those families a little easier.
According to an analysis reported in the Kaiser Health News, an MRI test frequently costs more than $1,000 per patient in the U.S., and patients who have no insurance can be asked to pay even more, as medical centers like hospitals can raise uninsured test costs to ensure their facilities are profitable.
This is a considerable cost for a family to bear, and they may be hesitant to pay for a too costly test because the results may or may not be significant. However, scanning could be a smart option for families who could only deal with a physical problem cancer.
MRI scans help psychiatrists and psychologists comprehend the complexities of a patients disorder, enabling them to design effective treatment strategies. A disorder like anorexia nervosa, bulimia nervosa, and schizophrenia is extremely difficult to treat, especially if the cause is unknown. MRI in Mental Illness Diagnosis helps pinpoint the disorders precise cause by showing images of the parts of the brain that are overactive or underactive. Once this has been determined, then the same treatment can be administered.
Value Of Mri After Traumatic Brain Injury
A traumatic brain injury can be just as debilitating as amputations, burns and spinal cord injuries. Its a lot different, though. It can upset your life on several levels social, physical, psychological and even spiritual. It can affect the root of who you are your ability to communicate, to think and to connect with others.
Each year in the U.S., around 1.7 million TBI cases occur, according to the American Association of Neurological Surgeons. Approximately 5.3 million individuals live with a traumatic brain injury-related disability in the U.S. alone. And, every year, there are about 235,000 hospitalizations due to TBI, which is over 20 times the number of spinal cord injury hospitalizations.
TBI can affect everyone and everything in your life. TBI can severely hinder your ability to work and can put a strain on family life. It can make it difficult to make new friends, and it can affect your existing relationships. Therefore, its crucial you understand the value of MRI after traumatic brain injury.
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Unfortunately, these injuries can cause long-term complications and even death.
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Predicting Chronic Neurologic Problems
MRI might be better than a CT scan at identifying if you are likely to experience chronic neurologic problems because of your mild TBI, according to a clinical trials findings. Around 15% of individuals with mild TBI end up with measurable neurologic deficits a year after their injury. However, doctors dont have a definitive technique to predict patient outcomes. To address this clinical need, the researchers of the clinical trial examined MRIs potential of predicting patient outcome a few months after mild TBI. They followed 135 individuals and evaluated for an acute head injury, determining that MRI can improve long-term outcomes for TBI patients.
Mri Imaging Reveals Evidence Of Dissociative Symptoms Linked To Childhood Trauma
Coping mechanisms after experiencing trauma may include dissociative symptoms. Researchers from McLean Hospital have discovered evidence of trauma-related dissociative symptoms in brain scan imaging.
Dissociative symptoms include emotional numbness, amnesia, or out-of-body experience. The lingering symptoms may result in mental dysfunction and affect overall cognition.
Using an artificial intelligence technique, the team analyzed the magnetic resonance imaging results of 65 women who experienced abuse as children and have post-traumatic stress disorder . The brain scans revealed how connections between different parts of the brain were associated with the women’s dissociative symptoms.
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Fnci: The Scan That Can Detect Post
A fNCI scan is a specialized scan that can detect post-concussion syndrome. Since fNCI can provide information about how oxygen is carried to the different regions of your brain, it can detect the dysfunctional communication that is caused by PCS.
With fNCI, near-real-time changes in blood flow are measured while a patient completes several different cognitive tests. This is especially important for detecting post-concussive syndrome, because PCS symptoms often worsen under cognitive load.
fNCI uses an fMRI to look at blood flow to the brain in real time and monitor changes. fMRIs are famous for helping scientists see brain activity. It can do this by monitoring which parts of the brain become more active, i.e. have increased blood flow, when someone does cognitive tasks .
fNCI looks at something called neurovascular coupling . NVC is the connection between neurons and the blood vessels that bring them oxygen.
With PCS, the connection between the brain cells and the blood vessels that supply them is disturbed, making it difficult for certain cells to work properly. Some clusters of neurons may be getting too little blood flow, while others may be getting too much. This is because of damage the neurons themselves sustained during or after the concussion.
Note: To see if fNCI is an option for you, .
Changes In Brain Structure & Ptsd
Changes in the hypothalamic-pituitary-adrenal centers of the brain are impacted by increased cortisol levels and influence a wide variety of biological factors within the mind and body. Neurotransmitters that communicate synapses within the brain increase the arousal system, which impacts the brains endogenous opioid systems. This disruption influences the propensity for addiction and even alters the sensations of pain and discomfort. The results of these changes within the brain are often an extreme startle response, hypervigilance and feeling as if you are in danger or risk of harm even in the absence of threat.
Bessel van der Kolk, MD, a leading expert in the impact of trauma, explains the three major changes in the traumatized brain and the ways these changes impact a persons quality of life. PTSD alters the quality of life for those living with it by impacting the ability to interpret information and new experiences. The three changes to the brain involve threat perception, self-sensing and the filtering system . These altered systems in the brain impact the relationship people with PTSD have with others, their view of themselves and the perceptions of the world around them. This increased understanding of the mechanics of the brain with PTSD can help guide treatment options.
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