Department of Veterans Affairs, Department Of Defense Study a Major Breakthrough For Understanding PTSD

March 28, 2017

WASHINGTON — Researchers from the Department of Veterans Affairs (VA) and Department of Defense (DOD) recently released findings of a new study called Prospective Post-Traumatic Stress disorder Symptom Trajectories in Active Duty and Separated Military Personnel, which examines Post Traumatic Stress Disorder (PTSD) symptoms in Veterans, compared with active-duty populations.

This is the first known study comparing PTSD symptom trajectories of current service members with those of Veterans, and is the product of a collaborative effort from VA and DOD researchers analyzing data from the Millennium Cohort Study (MCS), the largest prospective health study of military service members.

According to VA’s National Center for PTSD, the PTSD rate among Vietnam Veterans was 30.9 percent for men and 26.9 percent for women. For Gulf War Veterans, the PTSD rate was 12.1 percent. Operation Enduring Freedom/Operation Iraqi Freedom Veterans had a PTSD rate of 13.8 percent.

“Knowing there are similarities in how PTSD affects service members and Veterans makes it easier to pinpoint which treatments are the best to control the condition,” said Dr. Edward Boyko, an epidemiologist and internist at the VA Puget Sound Health Care System in Washington state, and VA’s lead researcher on the Millennium Cohort Study.

Officials involved with the project said they are hoping the collaboration will improve the understanding of Veterans’ health needs, relative to their experiences in service.

“The data that MCS researchers have been collecting since 2001 is incredibly valuable for both the DOD and VA,” said Dr. Dennis Faix, director of the Millennium Cohort Study and preventive medicine physician. “Going forward, working with VA will allow both agencies to make sure we are getting the best information to develop a comprehensive understanding of the continuum of health in current and former service members.”

The results of the joint VA DOD study will appear in the Journal of Psychiatric Research’s June 2017 issue. It is the first of many joint future publications expected to result from the collaboration between VA and MCS.

You can learn more about the study here: http://millenniumcohort.org/.

VA Study Finds EEG Can Help Tell Apart PTSD & Mild Traumatic Brain Injury

December 20,2016

WASHINGTON – A recent VA study points to a possible breakthrough in differentiating between post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI), otherwise known as a concussion.

The two disorders often carry similar symptoms, such as irritability, restlessness, hypersensitivity to stimulation, memory loss, fatigue and dizziness. Scientists have tried to distinguish between mTBI and PTSD in hopes of improving treatment options for Veterans, but many symptom-based studies have been inconclusive because the chronic effects of the two conditions are so similar. If someone is rating high on an mTBI scale, for example, that person may also rate high for PTSD symptoms.

The researchers used electroencephalogram, or EEG, a test that measures electrical activity in the brain. The size and direction of the brain waves can signal abnormalities.

Analyzing a large set of EEGs given to military personnel from the wars in Iraq and Afghanistan, the researchers saw patterns of activity at different locations on the scalp for mTBI and PTSD. They saw brain waves moving slowly in opposite directions, likely coming from separate places in the brain.

The researchers emphasize that these effects don’t pinpoint a region in the brain where the disorders differ. Rather, they show a pattern that distinguishes the disorders when the EEG results are averaged among a large group.

“When you’re looking at an EEG, you can’t easily tell where in the brain signals associated with TBI and PTSD are coming from,” said Laura Manning Franke, Ph.D., the study’s lead researcher and research psychologist at the Hunter Holmes McGuire VA Medical Center in Richmond, Virginia. “You get kind of a coarse measure – left, right, anterior, posterior. We had a different distribution, which suggests that different parts of the brain are involved. In order to determine what patterns are tracking their TBI and PTSD, you need an average to do that,” Franke added.

The study linked mTBI with increases in low-frequency waves, especially in the prefrontal and right temporal regions of the brain, and PTSD with decreases in low-frequency waves, notably in the right temporoparietal region.

The differences in the levels of the waves may explain some of the symptoms of the two disorders, suggesting a decline in responsiveness for someone with mTBI, for example, and more anxiety for someone with PTSD.

Franke also noted that more low-frequency power has also been linked to cognitive disorders such as Alzheimer’s disease and less low-frequency power to problems such as drug addiction. Additionally, spotting distinct patterns of mTBI and PTSD in separate parts of the brain is key for two reasons: the possibility these conditions can be confused with each other is reduced. That can help improve diagnosis and treatment and the patterns show that electrical activity appears to be affected long after combat-related mTBI, suggesting long-term changes in neural communication, the signaling between cells in the nervous system. “That could help, in part, explain the reason for persistent problems.”

The study included 147 active-duty service members or Veterans who had been exposed to blasts in Iraq and Afghanistan. Of those, 115 had mTBI, which accounts for nearly 80 percent of all traumatic brain injuries. Forty of the participants had PTSD, and 35 had both conditions.

Despite the new findings, Franke and her team believe more work is needed to better explain the differences in the patterns of both conditions in the brain’s electrical activity. Researchers need to analyze the differences in scans from larger numbers of patients.

Meanwhile, though, she said she hopes the research will play a role in helping medical professionals better diagnose someone’s condition through an individual EEG—whether that person has PTSD, a brain injury, or a combination of the two.

“That’s the holy grail,” said Franke. “We want to use the EEG to differentiate the problems, but also to predict recovery and be able to measure how people are doing in a more biological way than just measuring symptoms, although those are still relevant. But symptoms are also problematic because they’re influenced by so many things that aren’t the disease that we’re interested in.”

For more information about VA research on PTSD and TBI, visit Posttraumatic Stress Disorder and Traumatic Brain Injury. Information about Franke’s study may be found at the International Journal of Psychophysiology

South Dakota Congressional Delegation Meets With VA Secretary McDonald Following Hot Springs Visit

December 6, 2016

Washington, DC – U.S. Sens. Mike Rounds (R-S.D.), a member of the Senate Veterans’ Affairs Committee, and John Thune (R-S.D.), and Rep. Kristi Noem (R-S.D.) today met with Department of Veterans Affairs (VA) Secretary Robert McDonald following his Nov. 30, 2016, visit to the Hot Springs, South Dakota VA campus. During the meeting, the delegation encouraged Secretary McDonald to carefully consider input he received from veterans, staff and other community stakeholders before making any final decision on the future of the campus. The delegation also reiterated to Secretary McDonald that any reconfiguration of the Black Hills Health Care System should be made within the construct of a national realignment strategy for the Veterans Health Administration, as prescribed by law.

“Making sure veterans in the Hot Springs area have access to quality health care remains my top priority,” said Rounds. “While I would have preferred to join Secretary McDonald on his trip to Hot Springs, I am glad to have had the opportunity to meet with him today to hear about his visit and seek assurances that a decision on the future of Hot Springs has not been predetermined. The VA must continue to focus on what is best for South Dakota veterans and the Hot Springs community.

“I was encouraged by Secretary McDonald’s willingness to listen to the delegation’s perspective about how we view the future of the Hot Springs VA and by his commitment to continue engaging with the community it serves,” said Thune. “My recommendation to the secretary hasn’t changed. I still believe our veterans would be best served if the Hot Springs VA remained open and operational, especially the facility’s PTSD care, which is credited with saving countless veterans’ lives. It’s my hope that after today’s meeting and Secretary McDonald’s visit to South Dakota last week that he’ll make the right decision for our veterans.

“There is something very special about the ‘Veterans Town,’ both for the veterans it serves but also for the community of Hot Springs itself,” said Noem.  “With so much at stake, it is essential the VA Secretary approach this decision with accurate information, an unbiased perspective, and the shared goal of delivering the best quality healthcare to our nation’s veterans.  These are items we’ve insisted upon from the beginning and areas in which we will continue to hold the VA accountable going forward.  Our veterans deserve nothing less.”

Last week, Secretary McDonald toured part of the Hot Springs VA campus and held a town-hall meeting in Hot Springs to hear from veterans, VA staff and local residents. The delegation recently sent a letter expressing their disappointment and concern over Secretary McDonald’s decision to visit Hot Springs while Congress was in session, thus preventing their participation in the visit.