VA Study Finds EEG Can Help Tell Apart PTSD & Mild Traumatic Brain Injury

December 20,2016

WASHINGTON – A recent VA study points to a possible breakthrough in differentiating between post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI), otherwise known as a concussion.

The two disorders often carry similar symptoms, such as irritability, restlessness, hypersensitivity to stimulation, memory loss, fatigue and dizziness. Scientists have tried to distinguish between mTBI and PTSD in hopes of improving treatment options for Veterans, but many symptom-based studies have been inconclusive because the chronic effects of the two conditions are so similar. If someone is rating high on an mTBI scale, for example, that person may also rate high for PTSD symptoms.

The researchers used electroencephalogram, or EEG, a test that measures electrical activity in the brain. The size and direction of the brain waves can signal abnormalities.

Analyzing a large set of EEGs given to military personnel from the wars in Iraq and Afghanistan, the researchers saw patterns of activity at different locations on the scalp for mTBI and PTSD. They saw brain waves moving slowly in opposite directions, likely coming from separate places in the brain.

The researchers emphasize that these effects don’t pinpoint a region in the brain where the disorders differ. Rather, they show a pattern that distinguishes the disorders when the EEG results are averaged among a large group.

“When you’re looking at an EEG, you can’t easily tell where in the brain signals associated with TBI and PTSD are coming from,” said Laura Manning Franke, Ph.D., the study’s lead researcher and research psychologist at the Hunter Holmes McGuire VA Medical Center in Richmond, Virginia. “You get kind of a coarse measure – left, right, anterior, posterior. We had a different distribution, which suggests that different parts of the brain are involved. In order to determine what patterns are tracking their TBI and PTSD, you need an average to do that,” Franke added.

The study linked mTBI with increases in low-frequency waves, especially in the prefrontal and right temporal regions of the brain, and PTSD with decreases in low-frequency waves, notably in the right temporoparietal region.

The differences in the levels of the waves may explain some of the symptoms of the two disorders, suggesting a decline in responsiveness for someone with mTBI, for example, and more anxiety for someone with PTSD.

Franke also noted that more low-frequency power has also been linked to cognitive disorders such as Alzheimer’s disease and less low-frequency power to problems such as drug addiction. Additionally, spotting distinct patterns of mTBI and PTSD in separate parts of the brain is key for two reasons: the possibility these conditions can be confused with each other is reduced. That can help improve diagnosis and treatment and the patterns show that electrical activity appears to be affected long after combat-related mTBI, suggesting long-term changes in neural communication, the signaling between cells in the nervous system. “That could help, in part, explain the reason for persistent problems.”

The study included 147 active-duty service members or Veterans who had been exposed to blasts in Iraq and Afghanistan. Of those, 115 had mTBI, which accounts for nearly 80 percent of all traumatic brain injuries. Forty of the participants had PTSD, and 35 had both conditions.

Despite the new findings, Franke and her team believe more work is needed to better explain the differences in the patterns of both conditions in the brain’s electrical activity. Researchers need to analyze the differences in scans from larger numbers of patients.

Meanwhile, though, she said she hopes the research will play a role in helping medical professionals better diagnose someone’s condition through an individual EEG—whether that person has PTSD, a brain injury, or a combination of the two.

“That’s the holy grail,” said Franke. “We want to use the EEG to differentiate the problems, but also to predict recovery and be able to measure how people are doing in a more biological way than just measuring symptoms, although those are still relevant. But symptoms are also problematic because they’re influenced by so many things that aren’t the disease that we’re interested in.”

For more information about VA research on PTSD and TBI, visit Posttraumatic Stress Disorder and Traumatic Brain Injury. Information about Franke’s study may be found at the International Journal of Psychophysiology

Canada, Germany, Japan, Kuwait, The Netherlands, and the United States Pledging 2 Billion Dollars in Support of Iraq

Office of the Spokesperson
U.S. Department of State

Washington, DC

July 21, 2016

Over $2 billion in new money has been pledged for the people of Iraq in response to Da’esh’s campaign of tyranny that has resulted in enormous suffering, deprivation, and devastation for the Iraqi people. To help address the grave conditions faced by those displaced in Iraq, the international community has surged forward to provide desperately needed humanitarian support such as food, water, and shelter for those in need, and to help create the conditions that will allow the safe and voluntary return of displaced families to liberated areas as quickly as possible. The foundations for long-term stability can be achieved if Iraq’s humanitarian crisis is alleviated and its citizens are able to return to their homes safely, with access to basic services, healthcare, and education, and hope for economic prosperity.

As a result of the conference, led by the co-hosts Canada, Germany, Japan, Kuwait, The Netherlands, and the United States, the international community mobilized to meet near-term funding requirements for Iraq in four critical-need areas:

• humanitarian assistance;
• demining;
• UNDP’s Funding Facility for Immediate Stabilization;
• UNDP’s new Funding Facility for Expanded Stabilization (FFES), endorsed by Prime Minister Abadi to provide pivotal, medium-term stabilization initiatives to foster resiliency and recovery in Da’esh liberated areas.

The humanitarian assistance raised yesterday primarily supports United Nations agencies operating in Iraq, as well as other international organizations and non-governmental organizations. Through these organizations, the international community has provided resources for assistance to every governorate in Iraq, helping people who need it most—ultimately saving lives and alleviating human suffering amid daily threats of violence from Da’esh. The stabilization pledges generated through this initiative will contribute meaningfully to longer-term reconciliation efforts within Iraq, the success of which is vital for the country’s longer-term stability and recovery from Da’esh oppression.

The donors that gathered remain committed to assisting Iraq, and strongly urge all governments, organizations, and individuals to support the lifesaving efforts of the UN and its funds and agencies, in addition to other humanitarian partners. We are particularly gratified by the presence at yesterday’s conference of the Organization of Islamic Cooperation, and welcome its efforts to broaden advocacy efforts on behalf of the Iraqi people.

As donors, we remain cognizant as well that success on the battlefield enacts a disproportionate toll on the civilian population. The United Nations announced July 20 that it will require an additional $284 million in order to plan for the humanitarian impact of Mosul’s liberation, while far more will likely be needed to mitigate this challenge as Da’esh is defeated in Mosul. We therefore hope the results of the initiative allow donors to more speedily align their pledged contributions against elements of the United Nations latest appeal.

While not a comprehensive listing of the pledges tabled during the event, the following highlights signal achievements of the Pledging Conference in Support of Iraq. The list excludes 2017 and 2018 commitments from those donors not able to specify publicly their out-year programming.

Conference Highlights:

Responsive and Robust Humanitarian Assistance Pledges

A total of 26 donors pledged contributions totaling more than $590 million for humanitarian assistance in support of Iraq, through bilateral and multilateral channels. These funds will support the needs identified in the United Nations 2016 Humanitarian Response Plan for Iraq, in addition to other organizations providing aid in Iraq and the region, and lay the groundwork for a more effective international response to the anticipated humanitarian challenges attendant to the Mosul campaign.

Support for Stabilization Programming

Fourteen nations announced new funding for critical stabilization programming in Iraq, pledging more than $350 million. An even larger number of countries made additional pledges totaling $125 million for UNDP’s Funding Facility for Immediate Stabilization, a significant advance towards meeting the $180 million requirement identified by the United Nations for 2017.

Dedicated Funds for Humanitarian Demining Activities

More than ten nations made over $80 million in new pledges for demining efforts in Iraq. This support will provide approximately three-quarters of the total amount of funding the United Nations estimates is required for one year of demining activities in Iraq.

Launching the Funding Facility For Expanded Stabilization

The United States was the first major donor, with $50 million, to pledge funding to the new UNDP Funding Facility for Expanded Stabilization. FFES facilitates recovery and resilience in Da’esh liberated areas, providing project-specific funding to support rehabilitation of facilities to restore critical, public services and create jobs. The UN estimates that teaching colleges, hospitals, and universities eligible for FFES support will be able to employ an estimated 17,000 to 20,000 people in each of the areas previously devastated by Da’esh.

Long-Term Commitment to the People of Iraq

In addition to securing immediate funds for near-term humanitarian needs and critical stabilization programming, the Pledging Conference in Support of Iraq secured more than $200 million in commitments for 2017 and 2018 to address demining, stabilization and humanitarian needs. This funding pipeline provides international organizations and NGOs with the flexibility and programing safety-net required to address unforeseen humanitarian crises or respond rapidly to evolving stabilization challenges.