Evidence of changes found in brain chemicals involved in learning and memory of PTSD patients
In an important step towards improved diagnosis and treatment of post-traumatic stress disorder (PTSD), the first evidence that specific brain chemicals previously associated with learning and memory are affected in people suffering from PTSD have been published in Nature Translational Psychiatry.
This study, led by Translational Research Institute CEO and Director of Research Professor Carolyn Mountford, demonstrates a number of brain chemicals, including those recently assigned by the team as fucosylated glycans, are significantly altered in people with PTSD. The same sugar-based neurochemicals have previously been associated with learning and memory in animal studies conducted by researchers at The California Institute of Technology.
These chemical changes were detected using Magnetic Resonance Spectroscopy (MRS), a non-invasive medical scan performed on a conventional Magnetic Resonance Imaging (MRI) scanner.
Professor Mountford explains “This is the first time changes in fucosylated glycans have been associated with PTSD, and demonstrates the power of magnetic resonance technology as a means to objectively diagnose PTSD - by detecting specific chemical changes in the brain”.
In 2010, the Australian Defence Force estimated the 12-month prevalence of mental disorders as 22 per cent (11,016 members) in an ADF population of 50,049. Among those, 6196 were Army personnel – that is 24.4 per cent of the total Army of 25,356. Mental disorder, particularly PTSD, is a significant issue among many returned service personnel in Australian and coalition forces.
These figures concerned the Director of Science for Australian Army Dr Helen Cartledge, who was the project manager for the Australian Defence Science and Technology (DST) Group. She asked Professor Mountford what could be achieved using Magnetic Resonance technology. The study is jointly funded by Australian DST Group and USA Defense Combating Terrorism Technical Support Office (CTTSO). CTTSO also had concerns about the increasing incidence of PTSD in Frontline Defenders, including Border Control, Federal and State Police as well as the Armed Forces and Blast exposure in the armed forces. In 2011 the US Department of Veterans’ Affairs indicated that of the 1.64 million service members who had served in Afghanistan and Iraq, 20 per cent, or 328,000, were experiencing depression, anxiety, stress or PTSD.
Dr Scott Quadrelli, first author on the paper, said “Currently PTSD diagnosis relies on a patient reporting symptom to their doctor, and the patient accurately reporting the extent and severity of their symptoms on an assessment scale.”
Professor Carolyn Mountford explains “Our study demonstrate we can now use MRS to detect specific neurochemical changes in those suffering with PTSD. This is the first technology thus far that has been shown to provide an objective means of diagnosis, potentially enabling patients to seek treatment earlier.”
“It may also help clinicians to work out whether a particular treatment option is effective, which can help determine whether a patient would benefit from changing to a different treatment option”, Professor Mountford added.
Professor Mountford said “This program commenced at the University of Newcastle with strong support from the local Front Line Defenders. Now we have participants from all over the country. Here in Australia, we are fortunate to have volunteers willing to help researchers solve a problem by taking part in this study. Without these volunteers, this breakthrough would not have occurred.”
Professor Mountford added “This study shows that two-dimensional magnetic resonance spectroscopy has opened up a new era in our capacity to monitor the effect of altered neurochemistry in PTSD, and other areas of neurobiology, human development and neurological deficits.”
She said a current challenge with the PTSD program is to predict whether people experiencing high levels of anxiety will progress to PTSD. Not all will.
The challenge now is to automate analysis of this data by developing ‘diagnostic classifiers’ for PTSD, train radiographers to collect the clinical data efficiently, and make the technology available worldwide with commercial partners Siemens Healthineers, who have been important partners in this technology development for over 20 years.
“Right now, we are still looking for more participants to help us reach our target recruitment numbers for this study. If you have PTSD, know someone with the condition, or would like to participate in our study as a healthy control, please get in touch” said Professor Mountford.
For more information, visit https://www.tri.edu.au/ptsd or email [email protected].
This study has been approved by the Metro South Human Rights and Ethics Committee (HREC) and the Australian Defence Human Research Ethics Committee (ADHREC).
Publication: Quadrelli, S. Tosh, N. Urqhart, A. Trickey, K. Tremewan, R. Galloway, G. Rich, L. Lea, R. Malycha, P. Mountford, C. Post-traumatic stress disorder affects fucose-α(1–2)-glycans in the human brain: preliminary findings of neuro deregulation using in vivo two-dimensional neuro MR spectroscopy. Nature Translational Psychiatry, 9: 27 (2019). https://www.nature.com/articles/s41398-018-0365-6.pdf
Image caption: Two-dimensional MRS results of certain brain chemicals in people without PTSD (top) compared to those with PTSD (bottom). Image reproduced from Quadrelli et al (2019).
