Improvement in cerebral function with treatment of posttraumatic stress disorder.
Posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) are signature illnesses of the Iraq and Afghanistan wars, but current diagnostic and therapeutic measures for these conditions are suboptimal. In our study, functional magnetic resonance imaging (fMRI) is used to try to differentiate military service members with: PTSD and mTBI, PTSD alone, mTBI alone, and neither PTSD nor mTBI. Those with PTSD are then randomized to virtual reality exposure therapy or imaginal exposure. fMRI is repeated after treatment and along with the Clinician-Administered PTSD Scale (CAPS) and Clinical Global Impression (CGI) scores to compare with baseline. Twenty subjects have completed baseline fMRI scans, including four controls and one mTBI only; of 15 treated for PTSD, eight completed posttreatment scans. Most subjects have been male (93%) and Caucasian (83%), with a mean age of 34. Significant improvements are evident on fMRI scans, and corroborated by CGI scores, but CAPS scores improvements are modest. In conclusion, CGI scores and fMRI scans indicate significant improvement in PTSD in both treatment arms, though CAPS score improvements are less robust.
Roy
Michael J
MJ
Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA. mroy@usuhs.mil
Francis
Jennifer
J
Friedlander
Joshua
J
Banks-Williams
Lisa
L
Lande
Raymond G
RG
Taylor
Patricia
P
Blair
James
J
McLellan
Jennifer
J
Law
Wendy
W
Tarpley
Vanita
V
Patt
Ivy
I
Yu
Henry
H
Mallinger
Alan
A
Difede
Joann
J
Rizzo
Albert
A
Rothbaum
Barbara
B
D000328:Adult; D055826:Afghan Campaign 2001-; D001921:Brain / Q000503:physiopathology*; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods; D054542:Iraq War, 2003-2011; D008279:Magnetic Resonance Imaging; D008297:Male; D008889:Military Personnel / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D014481:United States; D014584:User-Computer Interface; D014728:Veterans / Q000523:psychology