Functional MRI Predicts Post-Traumatic Stress Disorder in Soldiers

About 20% of US soldiers returning from Iraq and Afghanistan are psychologically damaged, according to a Washington Post study. A substantial number of them suffer from post-traumatic stress disorder (PTSD), which carries with it a high rate of suicide. But doctors will now be able to forecast a soldier’s risk of developing PTSD, with the chance of intervening to prevent military-related suicides. Prof. Talma Hendler of Tel Aviv University’s Department of Psychology and Psychiatry and the founding director of the Tel Aviv Functional Brain Center have developed a new predictive tool for detecting at-risk soldiers. The tool will allow clinicians to diagnose and treat these soldiers immediately before the stressors of combat lead to chronic psychological problems. Studying a group of 50 Israeli soldiers—trained medics who experienced extreme stress in live combat zones—Hendler and her graduate student Roee Admon in collaboration with Col. Dr. Gad Lubin from the Israel Defense Forces were able to predict which soldiers would develop significant increases in stress symptoms such as mood decline, intrusive thoughts, and sleep disturbance. Hendler’s research shows functional magnetic resonance imaging (fMRI) can be used to forecast which soldiers might be vulnerable to stress psychopathology in the future. The non-invasive imaging method records the brain activity of military personnel before they enter active duty. Using this baseline as a reference, the researchers can predict which soldier is more prone to exhibit after-exposure combat-related stress symptoms that can trigger PTSD or major depression. The researchers measured the levels of “stress symptoms” twice: first when the soldiers were drafted, then again a year-and-a-half later, during their active duty in combat units. The soldiers were also asked a series of questions evaluating their experience in the army. With this data, researchers developed predictive brain measurements for whether or not a soldier would develop stress. Having such an early biological marker, says Hendler, means that diagnosis and treatment can begin immediately following exposure to situational trauma. It is the first fMRI-based study in the world to measure brain activation under stress over a long period of time with respect to prior to stress. “Looking at the part of the brain called the amygdala, we were able to predict how many stress symptoms of PTSD an individual soldier would develop,” says Hendler. She notes that other brain activity was modified by the stress giving indications of the appropriate intensity and approach of treatment after the stress and trauma set in. Hendler is currently planning a larger study in this direction. While Hendler doesn’t believe that the fMRI should be used prejudicially to weed soldiers from certain units, she says that it does give specialists a new set of clues as to how to treat soldiers early and effectively, decreasing the rates of military suicide. This field of science is applied in a growing specialty known as “personalized medicine.” “This tool can help provide tailored therapy to the afflicted and at a very early stage could identify the extreme cases that might otherwise go unnoticed, says Hendler.

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