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Brain Imaging Helps Separate PTSD From Traumatic Brain Injury

A new study has shown that brain scans could help doctors distinguish between post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) in patients suffering from symptoms that are characteristic of both conditions. Both PTSD and TBI can occur during traumatic incidents and can result in debilitating, life-changing symptoms. It isn’t always easy to tell which condition a patient has or if he has both. With new diagnostic techniques, physicians will be better able to diagnose, treat and help their patients.

TBI vs. PTSD

Both conditions, but especially PTSD, have received much more attention in the last decade than ever before. This is because servicemen and women returning from duty in Iraq and Afghanistan have suffered from PTSD, TBI and in some cases both, in record numbers. TBI is much like a concussion and occurs when you experience a physical blow to or excessive shaking of the head. Direct contact to the head and body by an object is not necessary for someone to experience a TBI. While still not perfectly understood, experts believe that the shockwaves from explosives cause TBI and have been highly problematic for veterans. Symptoms of TBI are often physical (headaches, vision problems, tiredness), but they can also be mental and emotional. Someone with a TBI may have memory and concentration problems and may be depressed, angry or anxious. PTSD, on the other hand, is not a physical injury. Anyone can suffer from PTSD after a traumatic experience. Children who have been abused, for instance, may struggle with PTSD. Veterans often struggle with PTSD after a tour of duty because of some of the terrible things seen and experienced overseas. Symptoms of PTSD include flashbacks and nightmares that feel real, fear and anxiety, withdrawal from others, guilt, shame, depression and avoidance of anything that reminds a person of the trauma.

Scanning for TBI and PTSD

Clearly the symptoms of PTSD and TBI are similar, but treating them requires different approaches. This is why it is essential to be able to diagnose the injury and the disorder distinctly and accurately. Psychiatrist Theodore Henderson, a leading expert in complicated diagnoses, has completed and published a study with his team that used brain scans to find the biological differences between PTSD and TBI. Their novel approach to diagnosis was 94 percent accurate. Because TBI and PTSD often overlap, especially in veterans, diagnosis isn’t simple. Previous studies have attempted to use brain imaging to make a better diagnosis, but they weren’t successful. Being able to look at the brain scans of patients, as was done in the current study, to see whether they suffer from one or both of the disorders is a major breakthrough. It makes diagnosis much simpler, easier and accurate, which means patients can then benefit from the appropriate treatments. Although the two disorders can seem very similar, the most effective treatments are vastly different. Treatments for PTSD can actually make TBI worse, or, in the best-case scenario, not help it at all. Much of the treatment for TBI is physical and medical, while for PTSD it is therapy-based and psychiatric. Dr. Henderson and his colleagues are working on a targeted treatment for TBI, which requires being able to make an accurate image of the brain. The current research will help them create a treatment that they hope will work. PTSD and TBI are both devastating conditions with symptoms that are similar. Both are more common in veterans than the general population and can make the return to civilian life challenging. With better research for making clear diagnoses and developing treatments that work, more of our veterans can be helped.

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