Improvement in cerebral function with treatment of posttraumatic stress disorder

• Published in: Annals of the New York Academy of Sciences 2010-10, Vol.1208 (1), p.142-149
• Main Authors: Roy, Michael J., Francis, Jennifer, Friedlander, Joshua, Banks-Williams, Lisa, Lande, Raymond G., Taylor, Patricia, Blair, James, McLellan, Jennifer, Law, Wendy, Tarpley, Vanita, Patt, Ivy, Yu, Henry, Mallinger, Alan, Difede, Joann, Rizzo, Albert, Rothbaum, Barbara
• Format: Article
• Language: English
• Subjects: Adult; Afghan Campaign 2001; Brain - physiopathology; Brain Injuries - complications; Brain Injuries - diagnosis; Brain Injuries - physiopathology; combat stress; exposure therapy; Female; functional magnetic resonance imaging; Humans; Implosive Therapy - methods; Iraq War, 2003-2011; Magnetic Resonance Imaging; Male; Medical research; Military Personnel - psychology; Post traumatic stress disorder; posttraumatic stress disorder; Stress Disorders, Post-Traumatic - complications; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - therapy; traumatic brain injury; United States; User-Computer Interface; Veterans - psychology; virtual reality
• ISSN: 0077-8923; 1749-6632
• DOI: 10.1111/j.1749-6632.2010.05689.x

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.