Because CT and MRI scans are unable to detect with sensitivity and specificity what a SPECT scan can when diagnosing mild TBI and PTSD, a group of researchers (Daniel G. Amen ,Cyrus A. Raji , Kristen Willeumier , Derek Taylor , Robert Tarzwell , Andrew Newberg , and Theodore A. Henderson) chose to use SPECT scans to see if they could find a true difference between the brain of those with TBI and PTSD. SPECT scans provide the clinical utility of the “delineation of the neural circuitry underlying PTSD ” and the improved detection of TBI. The SPECT scans in this study contain populations of those with PTSD, TBI, co-morbidities as well as those unaffected by either. The following is a collection of the statistics of those with PTSD and TBI in both military and civilian populations in the United States.
- DoD reported 307,283 diagnosed cases of TBI from 2000–2014.
- Congressional Research Service reporting 103,792 diagnosed cases of PTSD from 2000–2012.
- Over 400,000 military personnel and veterans have been diagnosed with PTSD or TBI since 2001 [17, 18], and many have been diagnosed with both. The overlap of these two populations has been estimated at 33% [34, 35] to 42% . among veterans. Those who have experienced a blast-related TBI have more than double the risk of developing PTSD.
- About 7.7 million in the US population suffer from PTSD.
- TBI is also quite prevalent, with 2.5 million annual visits to emergency rooms for suspected TBI.
- 49% of those with TBI are likely to be diagnosed with a psychiatric illness the following year.
Although the majority of TBI symptoms can resolve over time, a significant proportion of cases develop a persistent post-concussive syndrome (PCS). Long-term consequences of seemingly trivial head injuries may be significant. TBI scans found these areas of the brain to be of particular interest (orbitofrontal cortex, temporal poles, and anterior cingulum) while PTSD scans found these more interesting (amygdala , corpus callosum , insula , anterior cingulum [12–14] and hippocampus [15, 16]). A recent meta-analysis showed that PTSD patients had significant activation in midline areas implicated in self-referential processing and autobiographical memory.
The treatments for PTSD and TBI/PCS are different. Therefore, by reliably separating them and accurately identifying cases in which both are present, the use of the SPECT scan emerges as a genuine diagnostic need. All PTSD-identifying regions were hyperactive on SPECT when compared across all groups, and the TBI-identifying regions were correspondingly hypoactive.
Perfusion is defined by Merriam-Webster Medical Dictionary as “the pumping of a fluid through an organ or tissue”; in this instance, through the brain. When you look at the scans above, you can truly see the differences in perfusion across the four groups receiving SPECT scans. A healthy control shows normal higher perfusion to the cerebellum. The PTSD subject shows increased perfusion in the brain—particularly in the frontal lobes. The TBI subject shows decreased perfusion throughout by comparison. The subject with both PTSD and TBI shows perfusion that is lower than the person with PTSD but higher than the subject with TBI. These results suggest that TBI is associated with hypoperfusion while PTSD is associated with regional hyperperfusion, which both provide important insights in regards to the pathophysiological differences between the disorders.
Many research studies have found the positive benefits that pure therapeutic ketones have on the perfusion across the brain, along with the neural communication across its lobes. If you or anyone you know are interested in getting a SPECT scan of your brain, visit one of the Amen Clinics across the nation! My goal is to get this information into the hands of those affected by TBI and PTSD, and hopefully this will aid in doing so!
With warm regards,
Coral A.J. Gibson