Summary: A recent study suggests that neurostimulation that targets particular head regions may be able to handle PTSD in veterans. Scientists found that veterans with injury to brain locations connected to the brain, the body’s fear center, were less likely to develop PTSD.
The team discovered a brain circuit linked to PTSD by using brain injuries from Vietnam War veterans, eliciting potential treatment options for transcranial magnetic stimulation ( TMS ). It requires more research to establish its effectiveness in larger groups.
Important Information:
- Reduced PTSD threat in soldiers is related to brain damage.
- In PTSD testing, TMS targeting this mental circuit revealed beneficial effects.
- For wider scientific employ and FDA approval, more studies are required.
Origin: Brigham and Women’s Hospital
A new study led by researchers at , Brigham and Women’s Hospital,  , a founding member of the , Mass General Brigham , healthcare system, suggests that using neurostimulation therapies on a specific brain network could treat post traumatic stress disorder ( PTSD ) in veterans.
The team found that those with harm connected to their brain, the dread center of the head, were less likely to develop PTSD by analyzing 193 individuals in the Vietnam Head Injury Study who had penetrating traumatic brain injuries.
Their results are published in , Nature Biology.
” This is a very real brain disease, and we can localize it to certain brain circuits”, said corresponding author , Shan Siddiqi, MD,  , a psychiatrist in the Brigham ‘s , Center for Brain Circuit Therapeutics and an assistant professor of Psychiatry at Harvard Medical School.  ,
” However, people sometimes assume PTSD has to do with how emotionally strong or weak a person is, but it has nothing to do with spiritual personality”.
Siddiqi collaborated with Duke University School of Medicine, Brown University Alpert School of Medicine, and another Brigham’s Center for Brain Circuit Therapeutics experts as well as researchers from the Feinberg School of Medicine at Northwestern University.
He claimed that while past studies have shown that people who have suffered from brain destruction are less likely to experience PTSD, the team was looking for a treatment for the illness.
According to Siddiqi,” The brain is strong in the brain, making it difficult to accurately hit with a stimulation modality without having surgery.”
Researchers in the Center for Brain Circuit Therapeutics have previously uncovered networks to successfully treat , depression , and , addiction , using transcranial magnetic stimulation ( TMS ).  , Michael Fox, MD, PhD,  , a co-author on the , Nature Neuroscience , papers and director of the Center for Brain Circuit Therapeutics, said they hoped to build on their achievements by identifying goals for situations such as PTSD.
Finding the right medical goal is one of the biggest challenges facing the development of a brain-stimulating treatment for PTSD, according to Fox.
Fox claimed that the same circuit his group created for despair has previously been tried in trials for PTSD, but this destination has failed.
” More than remain with a trial-and-error method of testing different goals, we turned to head tumors to map out the circuit”, he said.
The crew examined 193 people with penetrating traumatic brain injury from the Vietnam Head Injury Study led by co-author, Jordan Grafman, PhD, at Northwestern. They examined whether those soldiers experienced PTSD 20 times after the Vietnam War.
Many of these veterans who received debris in their heads later developed PTSD, according to Fox. ” The people really suffered PTSD less than other soldiers who had not suffered brain damage.”
Fox claimed that the information that Grafman had gathered was crucial for this study because he had pinpointed the actual location of each patient’s damage and identified its neurological repercussions.
Researchers then hypothesized that a loop had exist that, when damaged, protects against PTSD. They used their wiring chart, the animal electric, to chart where brain harm had occurred and where each disease connected. Then, they compared the data to 180 soldiers with PTSD, some of whom had head injury, and 180 of whom had PTSD.
They discovered that the circuit’s accessibility was related to whether or not someone had PTSD. Finally, the team examined earlier studies involving TMS for PTSD to determine whether this loop would be a great destination for therapy.
According to Fox,” the tests where stimulus was hitting the loop we identified tended to be the studies that had excellent results in individuals.” We even inquired about whether our findings could help us identify the target, which we believe are suitable for TMS therapy.
A person with extreme PTSD requested TMS at Acacia Mental Health in California during the investigation, and Siddiqi was consulted to help with the treatment plan. The patient’s medical team at Acacia treated him using the study’s circuit, which eventually improved his symptoms, following a thorough informed consent process.  ,
Fox claimed that the event serves as an example of how the study’s findings may be applied to a medical setting despite the fact that there is only one patient. They will need to do a random controlled test targeting the loop before it can be visible to a larger population to obtain FDA approval.
Siddiqi noted that the study’s limitations are that they are yet to determine how the treatment results might change depending on whether a person is experiencing PTSD-induced fear at the time of treatment or relaxation. Fox added that the study only included veterans, so Fox and Fox are unsure whether PTSD in non-veterans would be transmitted to the same circuit.
While more research is still needed, Fox said,” We’ve taken an important step here to identify a therapeutic target for a condition in patients who desperately need better treatments.”
Authorship:  , In addition to Siddiqi and Fox, Mass General Brigham authors include Michael Ferguson and Stephan Palm. Additional authors include Noah Philip, David Carreon, Amanda Arulpragasam, Jennifer Barredo, Heather Bouchard, Jordan Grafman, and Rajendra Morey.
Disclosures:  ,  , Siddiqi is an owner of intellectual property involving the use of individualized resting-state network mapping to target TMS, which was filed in 2016, has yielded no royalties, and does not cover the present work.
Siddiqi is also a scientific consultant for Magnus Medical, received investigator-initiated research funding from Neuronetics ( 2019 ) and Brainsway ( 2022 ), received speaking fees from Brainsway ( 2021 ) and Otsuka ( for PsychU. org, 2021 ) ), shareholder in Brainsway ( publicly traded ) and Magnus Medical ( not publicly traded ). None of these organizations directly participated in the present project.
Fox works for Magnus Medical as a scientific advisor. Fox also holds unrestricted intellectual property that uses functional connectivity to target TMS for depression, which was filed in 2013 and does not apply to the current work.
 , Philip received clinical trial support ( through VA contracts ) from Wave Neuroscience and Neurolief, and serves on the scientific advisory board for Pulvinar Neuro.
Funding:  , This work was funded by the United States National Institutes of Health ( K23MH121657, R21MH126271 ), Brain and Behavior Research Foundation Young Investigator Grant, Baszucki Brain Research Fund, and Department of Veterans Affairs ( I01CX002293 ).  ,
Fox’s work is funded by the Nancy Lurie Marks Foundation, the Kaye Family Research Endowment, Baszucki Brain Research Fund, and the NIH ( R01MH113929, R21MH126271, R56AG069086, R01MH115949, and R01AG060987 ). Philip’s work is funded by I21 RX002032, I50 RX002864, U01 MH123427, and P20 GM130452.
About this news from PTSD research
Author: Cassandra Falone
Source: Brigham and Women’s Hospital
Contact: Cassandra Falone – Brigham and Women’s Hospital
Image: The image is credited to Neuroscience News
Original Research: Closed access.
” Potential neuromodulation target for PTSD in veterans derived from focal brain lesions” by Shan Siddiqi et al. Nature Neuroscience
Abstract
Potential neuromodulation target for veterans with PTSD brought on by focal brain lesions
The optimal neuroanatomical target is still a mystery, and neuromodulation trials for the treatment of posttraumatic stress disorder ( PTSD ) have had mixed results.
To investigate brain circuitry that is causally related to PTSD in military veterans, we analyzed three datasets.
Lesion locations in veterans with perceptive traumatic brain injuries were preferentially linked to a circuit that included the medial prefrontal cortex, amygdala, and anterolateral temporal lobe, which reduced the risk of PTSD.
PTSD was specifically linked to increased connectivity in this circuit in veterans without lesions.
Even though this circuit was n’t specifically targeted, the circuit’s reduced functional connectivity after transcranial magnetic stimulation was related to symptom reduction.
This lesion-based” PTSD circuit” may serve as a target for clinical trials of neuromodulation in veterans with PTSD.
