Diagnosing PTSD and TBI

The Department of Veterans Affairs has come up with a new way to tell the difference between post-traumatic stress disorder (PTSD) and mild traumatic brain injury (TBI).

The difficulty with diagnosing one versus the other is that they both share some common symptoms, such as fatigue, memory loss, irritability, hypersensitivity and dizziness. A recent study used an electroencephalogram to measure the electrical activity in the brain.

When researchers studied a large group of EEGs, patterns emerged — the activity was coming from different parts of the brain. While it doesn’t pinpoint the exact place in the brain, it does indicate an overall location.

TBI, for example, showed low-frequency waves in the prefrontal and right temporal regions of the brain. PTSD, on the other hand, showed decreased low-frequency waves in the right temporoparietal region. (Low frequency also is indicated in other disorders, such as Alzheimer’s disease.)

By learning which area of the brain is affected, doctors can diagnose more accurately. This is key, especially with mild TBI that’s been present a long time but hasn’t responded to treatment.

Researchers looked at the records of 147 veterans and servicemembers who’d been exposed to blasts. Of those, 115 had mild TBI, 40 had PTSD and 35 had both. Despite the progress, this study isn’t the complete answer. Researchers need to analyze more large groups to further pinpoint the brain locations.

Still, being able to make a more accurate diagnosis based on an EEG goes a long way toward getting it right the first time and being able to offer treatment that’s more likely to be accurate.

If you’d like to know more, read about the study at www.ncbi.nlm.nih.gov/ pubmed/27238074, as well as www.research.va.gov/topics/ptsd.cfm and www.research.va.gov/topics/tbi.cfm.