Battling PTSD

Post-traumatic stress disorder (PTSD) has been diagnosed in more than 200,000 U.S. military veterans returning from combat in Iraq and Afghanistan. The disorder is also commonly found in civilians who have been involved in an accident or an assault, or have suffered the unexpected loss of a loved one. Approximately 8% of the U.S. population will suffer from PTSD at some point in their lives. The disorder can lead to panic attacks, substance abuse, depression, suicide and a host of other serious medical complications, including, most notably, cardiovascular disorders.

Estimates suggest that half of the patients suffering from PTSD are undiagnosed, and treatment for those who are diagnosed is only partially effective. But a new consortium of nationally recognized PTSD experts aims to improve diagnostic tools and treatment outcomes. The consortium, convened by Draper Laboratory in Cambridge, Massachusetts, will include researchers and clinicians from Harvard Medical School and its affiliated hospitals, including Massachusetts General Hospital, Brigham and Women’s Hospital and the VA Boston Healthcare System.

The current state of the art in PTSD diagnosis is based on clinical interviews, forcing clinicians to rely on patients’ subjective reports of their own symptoms. Although the clinical history is a good start, PTSD diagnoses would benefit if reliable biomarkers of the condition were available, as is the case in many other areas of medicine.

The team plans to develop more objective and personalized diagnostic and treatment protocols by using sophisticated algorithms to integrate data from a spectrum of biomarkers, including neuroimaging, psychophysiology, chemical assays and gene expression. The resulting tools will complement today’s primarily subjective means of evaluation and treatment selection.

“Although some biological characteristics that point to a PTSD diagnosis have already been identified, more comprehensive study is critical to examine the integrated roles of multiple potential biological factors of the condition,” according to HMS professor of psychiatry Roger Pitman. “This will help clinicians develop personalized treatment plans to improve outcomes, rather than relying on ‘one-size-fits-all’ approaches.”

Reducing inconclusive diagnoses and avoiding ineffective treatments, in turn, will help significantly reduce costs, both for patients and society, said Pitman, who is also director of the PTSD and Psychophysiology Laboratory at Mass General.

The technology platform underlying the proposed solutions to PTSD diagnosis and treatment isbased on systems that Draper has developed to synthesize complex data from multiple sources. One version currently helps run the International Space Station.

“We have the most advanced data-fusion technology in critical decision making available to apply to PTSD diagnosis and personalized treatment care,” said Len Polizzotto, Draper’s vice president in charge of the program.

Bringing together a national team of leading PTSD experts from a variety of disciplines and institutions offers several advantages over pursuing the problem from within a single organization, including the ability to look at a diverse spectrum of factors from neuroimaging to gene expression, and the capacity to conduct human and animal studies in parallel, thus accelerating knowledge and development of solutions, consortium researchers said.

“No one of us could do this alone, but collaboratively, we will be able to create a solution to one of the most expensive healthcare problems our nation is facing, both in financialand human cost,” said David Diamond, professor of psychology at the University of South Florida.

Adapted from a Draper Laboratorynews release.