A new study by Tel Aviv University, Ichilov Hospital and the IDF Medical Corps among paramedics serving in the IDF reveals: using a functional MRI test (fMRI) it is possible to identify those who may suffer from mental distress as a result of exposure to significant stress
A new study conducted among paramedics serving in the IDF reveals: using a functional MRI test (fMRI) it is possible to identify those who may suffer from mental distress as a result of exposure to significant stress. In the future, the test may help guide the early treatment of people prone to developing pathological mental syndromes following trauma. "The brain findings show that there is flexibility of the brain which implies that early diagnosis and treatment aimed at the individual will help in the treatment and probably prevent mental complications after trauma." Summarized by Prof. Thelma Hendler, Director of the Center for Brain Functions at the Tel Aviv Medical Center (Ichilov) and a member of the faculty of the Departments of Psychology and Psychiatry at Tel Aviv University
The research was conducted as part of Roi Edmon's doctoral thesis and under the guidance of Prof. Thelma Handler at the Sackler Faculty of Medicine at Tel Aviv University and at the Center for Brain Functions (Ichilov Hospital) and in collaboration with Col. Dr. Gad Lubin from the Mental Health Division of the Medical Corps. The research was published this week in the prestigious scientific journal PNAS (Proceedings of the National Academy of Sciences).
40% of the population will experience at least one significant traumatic experience during their lifetime. Most of those exposed to a traumatic event react immediately after it, with symptoms characteristic of PTSD such as low mood and anxiety, disturbing thoughts and sleep disturbances. It is important to note that these reactions are normal and probably related to the recovery process. However, about 20% of those exposed to a traumatic event may suffer from a long-term mental syndrome such as depression and post-traumatic anxiety. To this day, it is not clear what differentiates those who recover from those who remain injured for a long time. Until now, it was also not possible to identify the personal vulnerability at an early stage after the event, which causes a significant delay in diagnosis and treatment. It is known that an early and tailored diagnosis close to the event increases the chances of recovery among those exposed to a traumatic event.
During the study, the researchers conducted functional brain scans (using magnetic resonance imaging, MRI), and examined three designated areas of the brain among 50 paramedics who serve in the IDF and may experience significant stressful experiences during their military service. Paramedics in the IDF are currently the first line of care in combat and they are under significant pressure in relation to immediate medical management. The paramedics were tested for the first time before the training at the beginning of the pre-military course, and after a year and a half when they function as combat paramedics in the various units. The researchers came to the conclusion that by looking at a certain brain area it is possible to predict ahead of time which of the paramedics will develop more mental stress symptoms following the military-medical events, similar to a preliminary brain marking. In contrast, other brain regions showed a change in activity and connections between them following the events, which indicates the potential of situational brain flexibility. Together, the preliminary marking and the degree of flexibility form a brain profile of a person, which can help direct early and individual treatment in case of exposure to trauma.
The course of the research and results:
In psychopathological situations after a traumatic event, changes in the activity of three main areas of the brain have been identified: the amygdala nucleus - which is responsible for emotional processing in the brain and is the one thanks to which we know how to beware of danger, the hippocampus associated with memory processing and the creation of context for life events, and the third area, the prefrontal cortex, which is responsible for providing meaning emotional and personal to stimuli and participates in emotional regulation. In the reported study, the researchers sought to examine whether and how the activity in these areas changes after exposure to significant stress in military service, and whether the connections between areas change with the exposure.
As expected during the service, most of the paramedics experienced events of a significant traumatic nature. All the paramedics reported an increase in exposure to significant stressful events during the service, and among -66% there was a significant increase in the number of symptoms of mental stress such as: a drop in mood, nightmares and repeated thoughts about the event during the day . In the FMRI imaging tests of the brain, it was found that the degree of increase in mental symptoms in a male or female soldier was explained by the activity of the amygdala before the exposure - and the degree of change in the activity of the hippocampus after the exposure to stress during the military service. In other words, the more the paramedic experienced an increase in symptoms, the more his amygdala was active at the beginning and the hippocampus increased its activity later on.
In addition, the tests showed that the more symptoms developed, the less the hippocampus would connect with the frontal lobe related to emotional regulation, meaning flexibility was found in the activity and connectivity of brain areas related to the mental response to stress. This finding points to the potential for brain change through psychological or drug treatment after exposure to trauma, which will help a person to return to living his life without interruption. "The findings show that there is a model of brain activity and response typical of each person, which can direct early and correct treatment individually, following a traumatic stress event." Prof. Handler summarizes,
The research was also assisted by: Keren Rosenberg, Orit Stern, Lee Sela and Haim Ben Ami. The research was also supported by: the Adams Institute for Brain Research, Tel Aviv University, the Infrastructure Program (Markava) of the Ministry of Science and Sports, and the Medical Corps, IDF.
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Can MRI tests help in the diagnosis of children/teenagers with a behavior disorder of unknown origin.
vicky,
Hiding more than it reveals? What is he hiding?
This article hides more than it reveals.
I'm sorry to start this site straight away with a review, but...
The topic is very, very interesting, and it's a shame that it's written like that and not more detailed in the right places.
If you want I will analyze the whole article but not the embroidery if you want...
Ami:
As my father pointed out, the subjects were tested twice.
Otherwise it would not be possible to talk about both measurements predicting the impact of a traumatic event and measurements analyzing its results.
Also note the following quote from the article:
"In the FMRI imaging tests of the brain, it was found that the degree of increase in mental symptoms in a male or female soldier was explained by the activity of the amygdala before the exposure - and the degree of change in the activity of the hippocampus after the exposure to stress during the military service"
In addition to what I said before, it is not possible to talk about the "degree of change in hippocampal activity" without measuring change and change cannot be measured in one measurement.
Each subject underwent the test twice, during the paramedic course and after a year and a half.
It is also interesting to know if the analysis of the image is always in relation to the previous image of the same person - the comparison is always between two MRI images, one before the trauma and the other after? Or maybe the values are approximately absolute and similar between all people so that one scan of the brain is enough and through it can be Understand what the general situation is in this context? Maybe by activity ratio between different areas allows the flexibility of a single image?
Greetings friends,
Ami Bachar
Why don't you specify what percentage can be predicted by the MRI out of everything that really happens, and what percentage are wrong?
I have never understood the studies that when they are written for the public, as if the most important data disappeared in the article.
Very nice!
I think the implications of the research are big and important. Beyond the possibility of knowing whether a certain person is more or less suitable to work in rescue and security services, it is implied that the possibility opens up to better understand how it is possible to treat a person who has experienced some traumatic event in the past and to repair mental damages that are now seemingly irreversible or just "hard nuts" such as, for example, battle shock.