A recently published study by GMRF, led by Dr Madeline Romaniuk, explored neurological associations with PTSD and found links to brain structure in areas relating to fear response, emotional processing, retrieval of negative memories and anticipating aversive stimuli.

The research, a collaboration between GMRF’s Veteran Mental Health Unit and CSIRO Health and Biosecurity, contributes to a growing understanding of PTSD and the potential affects it can have on both the body and brain.

About the research

The study involved Vietnam veterans ranging in age from 64 to 88 who had experienced trauma and been involved in combat during their military service. 16 of the veterans had a PTSD diagnosis and had experienced PTSD symptoms for an average of 30 years.

“It is not uncommon for combat veterans with PTSD to continue to experience sub-threshold symptoms for decades, even when they have received available first-line treatments,” said Dr Madeline Romaniuk, Principal Investigator at GMRF, “which can have a substantial impact on quality of life”.

“The duration of PTSD symptoms in our veteran participants allowed us to explore any neurological abnormalities that might be linked to an enduring, long-term course of symptoms.”

The study used MRI to measure the volume of the brain’s grey matter. Diffusion tensor imaging was also used to measure the brain’s white matter microstructure, which gives an indication of white matter integrity and potential plasticity.

Research findings

• Veterans with PTSD had smaller grey matter volume in areas of the brain that have been linked with fear responses and emotional processing, compared to those without PTSD.
• Veterans with PTSD had larger grey matter volume in an area of the brain that has been associated with the retrieval of negative memories and anticipating aversive stimuli, compared to those without PTSD.
• PTSD severity was associated with reduced integrity to white matter tracts that connect central networks involved in cognition and emotion.
• These findings suggest that PTSD symptoms may contribute to changes in the brain in areas that regulate emotions, memory, and fear responses. Past research has proposed that these neurological differences might also contribute to the duration of symptoms, and may have an impact on how effective particular psychological therapies may be.

“First-line cognitive therapies require some complex or abstract thinking to identify patterns in thought, evaluate thoughts and beliefs, and generate new thinking patterns.” said Dr Romaniuk.

Why is this important?

This is the first Australian study to examine white matter microstructural differences in veterans with PTSD. Given up to 50% of PTSD sufferers do not respond to first-line treatments, with chronic sufferers (like the current study) notably more difficult to treat, it is hoped further research in this area will move towards improving targeted psychological therapies for this group.

“Compromised white matter microstructure in areas of the prefrontal cortex, as this study found, may make therapies that require abstract and complex thinking more demanding,” said Dr Romaniuk.

“Uncovering the neurological associations and establishing the biological impact of PTSD may help us understand chronic or treatment-resistant symptoms in this group of veterans better, and plan and adjust treatment accordingly.” said Dr Romaniuk.

Read the research article