Resetting PTSD brains

New ways scientists are helping people deal with bad memories

DALLAS, Texas – Post-traumatic stress disorder, PTSD, affects nearly 30 percent of troops who served in Iraq and Afghanistan. After they come home, these men and women often experience intense and fearful memories that they just can't forget.  Now, new therapies are helping them reset their brains and cope with their emotions.

"It really changed my personality. War changes everybody," said Retired Marine Sergeant Josh Lewis.

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"I mentally and emotionally became numb to adverse situations," said Retired Navy Religious Program Specialist KeeShaun Coffey.

Lewis had four tours of duty to the Middle East when he was in the Marines. During that time, he made friends and lost friends.

"Every time you lose a friend, you kind of lose a little bit of yourself," Lewis said.

When he returned to civilian life, Lewis was diagnosed with a traumatic brain injury and PTSD.

"I had tremendous headaches that just took me out for a day or two," Lewis said. "I was basically stuck at home in bed, just trying to get through it."

Coffey worked as a navy religious program specialist. He saw bodies every day, but when his best friend became one of them Coffey realized something was wrong.

"I couldn't cry. I didn't know what to do," Coffey said.

Coffey withdrew from the Navy, but he also struggled with PTSD when he returned to his normal life.

"I was just having nightmares to where I just slept in my closet," Coffey explained.

Dr. John Hart, Medical Science Director, Center for BrainHealth, The University of Texas at Dallas, is studying ways to help people like Coffey and Lewis.

"PTSD—I look at it as a memory disorder. There's a horrible memory that is now locked into your head that produces a fearful response," Hart explained.

Hart and researchers at the Center for BrianHealth have recently discovered how bad memories are stored in the brain.

"We found brain waves that hook the fear center to the memory center," Hart said.

When the fear center of the brain, called the amygdala , attaches to memory parts— it sends a signal with a rhythm of four hertz. To disrupt this signal, doctors are using repetitive Transcranial Magnetic Stimulation.

A device is placed on the participants head. A slow electrical current travels to the front part of the brain to target the amygdala and reduce the fear area's attaching to the memory area.

"That's how your brain knows that should be a fearful thing, it attaches to the memory," Hart explained.

Another way to help is a method called cognitive processing therapy. First, participants talk about their fears and relive them in a safe setting.

"The pain is the cure for the pain. The anxiety is the cure for the anxiety," said Tina Bass, MS, LPC, Psychotherapist, The Center for BrainHealth, The University of Texas at Dallas.

Therapists also use a brain-training program to help men and women deal with stress by teaching them how to focus their thoughts and come up with solutions. In a study, veterans who participated in the program reported up to a 50 percent improvement in mood.

Lewis participated in this SMART training and went from having a headache every six weeks to having one every six months. He says he's learned to slow down his thinking.

"We kind of learn to zoom out and look at the problem as a whole," Lewis said.

Coffey says the magnetics treatment has helped him cope with his emotions.

"I can definitely grieve and show emotion now. It takes a real man or woman to actually step up and say that you have an issue," Coffey said.

As part of a clinical study, the repetitive Transcranial Magnetic Stimulation treatments are coupled with the cognitive processing therapy and given once a week for 12 weeks. Dr. Hart says he is currently enrolling patients in the Dallas area, and there is no cost for the treatments or therapy sessions.

Additional Information:

When in danger, a person's natural response is to be afraid.  This fear triggers many changes in the body to prepare to defend against the danger or to avoid it, which is a healthy reaction. However, in post-traumatic stress disorder (PTSD), this reaction is damaged or changed.  People who have PTSD may feel stressed or frightened even when they are no longer in danger.  PTSD develops after a terrifying experience that involved physical harm or the threat of harm. It can result from a variety of traumatic incidents, such as rape, mugging, torture, being kidnapped, child abuse, train wrecks, plane crashes, bombings, natural disasters, and war.  In fact, the Department of Veterans Affairs released a report in 2012 that revealed that since 9/11 about 30 percent of the 800,000 plus Iraq and Afghanistan War veterans treated at V.A. hospitals and clinics have been diagnosed with PTSD.  (Source: http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml and http://www.thedailybeast.com/articles/2012/10/21/nearly-30-of-vets-treated-by-v-a-have-ptsd.html)

CAUSES:  Currently, researchers are focusing on genes that play a role in creating fear memories.  Understanding how the memories are created may help to find new interventions for reducing the symptoms of PTSD.  For instance, researchers have pinpointed genes that make stathmin, a protein needed to form fear memories.  In one study, mice that did not make the protein were less likely to "freeze," a natural response to danger, after being exposed to a fearful experience. The mice also showed less innate fear by exploring open spaces more willingly than normal mice. Scientists have also found a version of the 5-HTTLPR gene, which controls levels of serotonin (a brain chemical related to mood-that appears to fuel the fear response). Like other mental disorders, it is likely that many genes with small effects are at work in PTSD. (Source: http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml)

NEW RESEARCH:  The Center for BrainHealth is studying the efficacy of a therapeutic approach to treat veterans who are diagnosed with PTSD.  Researchers are combining cognitive processing therapy (CPT) with magnetic stimulation (repetitive Transcranial Magnetic Stimulations rTMS) to reduce PTSD symptoms.  Researchers say the threatening feelings once triggered are lessened by rTMS treatments and cognitive therapies during periods when patients are not overly emotional.   Repetitive Transcranial Magnetic Stimulation is FDA approved for the treatment of certain anxiety and depressive disorders.  Researchers place the device on the patient's head.  A slow electric current travels to the frontal lobe to target the amygdala—fear center of the brain—and stop the fear area from attaching to the memory area.  CPT will re-train the patient's response to stimuli that produce hyper arousal symptoms that are a core feature of PTSD. Researchers are currently recruiting in the Dallas area.  For more information on enrolling, call Cedric Jones, USMC, at 972-883-3317. (Source: http://www.brainhealth.utdallas.edu/research/participate/post-traumatic-stress-disorder-in-returning-service-members)