Differentiating Mild Traumatic Brain Injury from Post-Traumatic Stress Disorder

June 16, 2015 Brigham and Women's Hospital

PTSD and mTBI share many symptoms, such as depression, irritability, and difficulty concentrating.

Researchers from Brigham and Women’s Hospital (BWH) and the U.S. Army Research Institute of Environmental Medicine (USARIEM) are collaborating to develop a reliable method for determining whether a patient has mild traumatic brain injury (mTBI), post-traumatic stress disorder (PTSD),or both conditions.

Although PTSD is a psychological condition, and mTBI is a neurological disorder caused by physical trauma, it can be difficult to differentiate between the two. This is because they share many symptoms – depression, mood swings, irritability, difficulty concentrating, and memory problems – an overlap that can lead to misdiagnosis and improper treatment.

PTSD and mTBI often coexist, as mTBI typically occurs during a psychologically traumatic event. This is evidenced by the estimated 35 percent of combat veterans with mTBI who also have PTSD. And determining whether a patient has mTBI, PTSD, or both is significant, as each condition requires distinctively different care.

To address this issue, researchers are trying to identify chemical biomarkers that are unique to each condition. BWH’s Alexander Lin, PhD, Director of the Center for Clinical Spectroscopy, Department of Radiology, is using a non-invasive imaging technique called magnetic resonance spectroscopy to measure concentrations of certain chemicals in the brain. Common screening tests for brain injury and post-traumatic stress are then used to help validate Lin’s data.

“We look at different brain regions and what kind of changes we see in chemistry there,” says Lin. “We call it chemical topography.”

Researchers – including Lin’s study partners, research psychologist Dr. Kristin Heaton of USARIEM and Dr. John Irvine of Draper Laboratories – hope that by identifying subtle differences in brain chemistry that are unique to each condition, they’ll lay the groundwork for developing a more reliable means of diagnosing mTBI and PTSD and, thus, prescribing the most appropriate treatments. Lin adds that attaching a chemical profile to each condition also could be helpful for targeting certain medications for treatment.

Visit the BWH Center for Clinical Spectroscopy website for more information about the study of body chemistry.

- Chris P.
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