Seeing invisible injury -- diagnosing PTSD | Margot Taylor | TEDxToronto
TLDRDr. Queenie Lee, a scientist at Sick Kids Hospital, was unexpectedly asked by Defense Canada to diagnose post-traumatic stress disorder (PTSD) in soldiers. Despite initial reluctance, her team decided to tackle the challenge, using specialized imaging technology like MRI and EEG, which were limited in capturing real-time brain activity. They then employed magnetoencephalography (MEG), which combines the spatial resolution of MRI with the temporal capabilities of EEG. Through a study involving soldiers with and without PTSD, as well as civilians with mild traumatic brain injury (MTBI), they discovered distinct brain patterns associated with PTSD, including hyperactivity in high-frequency bands and rapid amygdala activation. This breakthrough not only offers a potential diagnostic tool for PTSD but also holds promise for transforming mental health diagnosis and reducing the stigma associated with invisible injuries.
Takeaways
- 🔍 The speaker, Queenie Lee, a scientist from Sick Kids, was asked by Defense Canada to address a question she initially didn't want to answer, which was related to diagnosing brain dysfunction in soldiers with PTSD.
- 🧠 Queenie's research focuses on children with autism and pre-term infants, using specialized imaging to compare brain structure and function to those without these conditions.
- 📈 She uses MRI and EEG technologies to study the brain, with MRI providing detailed brain anatomy and EEG offering real-time electrical activity measurements.
- 🚫 PTSD is a significant issue among soldiers, often invisible and difficult to diagnose, with symptoms that are not easily observable and often self-reported.
- 🤔 The dilemma faced by Queenie and her team was whether to use their expertise to attempt to diagnose PTSD, which was outside their current research focus.
- 👥 The team felt a moral and social obligation to help soldiers who had been injured, leading them to agree to try to find a way to diagnose PTSD.
- 🧲 They utilized magnetoencephalography (MEG), a technology that combines the spatial resolution of MRI with the temporal capabilities of EEG, to study the brain's magnetic fields in real time.
- 🔬 The research study included four groups: soldiers with PTSD, soldiers without PTSD but with similar combat experience, and civilian groups with and without mild traumatic brain injury (MTBI).
- 📉 Soldiers with PTSD displayed hyperactivity in high-frequency brain networks, particularly in areas associated with memory and attention, which was not observed in the other groups.
- 🔴 The study found that PTSD can be objectively diagnosed through brain function measures, which could lead to earlier detection and treatment, reducing the illness duration and improving quality of life.
- 🌟 The breakthrough in diagnosing PTSD can potentially change the approach to mental health diagnosis and reduce the stigma associated with mental illnesses.
- 💡 Queenie encourages the audience to consider the difficult questions they are avoiding, as facing these challenges can lead to significant breakthroughs and improvements in various fields.
Q & A
What is the primary focus of the speaker's work at Sick Kids?
-The speaker primarily focuses on children with autism and infants born very pre-term, using specialized imaging equipment to study brain structure and function in these children compared to those without these challenges.
What are the limitations of MRI and EEG in studying brain function?
-MRI provides detailed brain anatomy but is slow and does not show real-time activity. EEG offers real-time measurement of electrical brain activity but lacks accuracy in pinpointing the exact location of activity.
Why was the speaker initially reluctant to answer the question posed by Defense Canada?
-The speaker was reluctant because the question was about diagnosing PTSD, which was outside their current research scope, and they were unsure if it was a question that could be answered given the complexity and invisible nature of the condition.
What is PTSD and why is it difficult to diagnose?
-Post-traumatic stress disorder (PTSD) is a mental health condition triggered by experiencing or witnessing traumatic events, often seen in soldiers returning from war zones. It is difficult to diagnose because it is an invisible injury with symptoms that need to be self-reported, and many soldiers remain silent due to shame or anxiety.
How does MEG (magnetoencephalography) differ from MRI and EEG?
-MEG has the spatial resolution of MRI and the temporal capabilities of EEG, allowing it to capture both the location and timing of brain activity in real time, which is not possible with MRI or EEG alone.
What were the four groups included in the research study?
-The four groups included soldiers diagnosed with PTSD, soldiers without PTSD but with similar combat experience, a civilian group with mild traumatic brain injury (MTBI), and a civilian control group without MTBI.
What brain activities were observed in soldiers with PTSD during the MEG tasks?
-Soldiers with PTSD showed hyperactivity in the high-frequency bands, particularly in networks involving frontal areas, hippocampal areas, and the temporal lobe, which are associated with memory and attention.
How did the soldiers with PTSD react to combat-related stimuli during the MEG tasks?
-The soldiers with PTSD showed a rapid double activation in the amygdala, which is associated with emotional processing, indicating a heightened emotional response to combat-related stimuli.
What was the significance of the findings in the study for the diagnosis and understanding of PTSD?
-The study provided an objective means to determine the presence and severity of PTSD. It also differentiated the effects of physical trauma (MTBI) from psychological trauma (PTSD) on the brain, offering a breakthrough in mental health diagnosis and the potential to reduce the stigma associated with PTSD.
What broader implications does the speaker suggest the study's approach could have for mental health?
-The speaker suggests that the approach used in the study could be applied to diagnose and understand other mental illnesses, potentially changing the current models of mental health diagnosis and treatment.
What is the speaker's final message to the audience regarding facing difficult questions?
-The speaker encourages the audience to not shy away from difficult questions, as doing so could lead to missed opportunities for breakthroughs and discoveries that can significantly impact lives.
Outlines
🔬 The Challenge of Diagnosing PTSD in Soldiers
Queenie Lee, a researcher at Sick Kids Hospital, discusses the unexpected request from Defense Canada to find a way to diagnose post-traumatic stress disorder (PTSD) in soldiers. Despite initial reluctance due to the complexity of the condition, which is often invisible and self-reported, Lee's team felt morally obligated to help. They utilized their expertise in brain imaging to explore the possibility of differentiating between soldiers with and without PTSD by examining brain function and structure.
🧠 Advanced Brain Imaging Techniques for PTSD Research
The team employed magnetoencephalography (MEG), a cutting-edge imaging technology that combines the spatial resolution of MRI with the temporal capabilities of EEG, to observe real-time brain activity. They conducted a study involving four groups, including soldiers with PTSD, soldiers without PTSD but with similar combat exposure, and civilian groups with and without mild traumatic brain injury (MTBI). The study revealed distinct brain patterns associated with PTSD, particularly in high-frequency bands and networks involving memory and attention, which correlated with the severity of psychiatric symptoms.
🏆 Breakthrough in PTSD Diagnosis and the Future of Mental Health
Through advanced analysis, including brain connectivity and complexity measures, the research distinguished between the effects of PTSD and MTBI on brain function. The findings not only provided an objective means to diagnose PTSD but also highlighted the different impacts of physical and psychological trauma on the brain. This breakthrough has significant implications for earlier diagnosis, reducing the illness duration, and lessening the stigma associated with PTSD. It also opens up new possibilities for diagnosing and understanding other mental health disorders.
Mindmap
Keywords
💡Sick Kids
💡Post-Traumatic Stress Disorder (PTSD)
💡MRI (Magnetic Resonance Imaging)
💡EEG (Electroencephalography)
💡MEG (Magnetoencephalography)
💡Cognitive Difficulties
💡Brain Connectivity
💡High-Frequency Bands
💡Amygdala
💡Mild Traumatic Brain Injury (MTBI)
💡Moral and Social Obligation
Highlights
Queenie Lee, a researcher at Sick Kids, was asked by Defense Canada to investigate the possibility of diagnosing PTSD in soldiers.
Lee's work primarily focuses on children with autism and pre-term infants, using specialized imaging to study brain structure and function.
The challenge of diagnosing PTSD lies in its invisibility and reliance on self-reporting, often accompanied by feelings of shame or anxiety in soldiers.
A definitive diagnostic test for PTSD could greatly assist the Armed Forces in detecting, helping, and monitoring the recovery of affected soldiers.
Despite initial reluctance, Lee and her team felt a moral and social obligation to help soldiers and agreed to explore the question of diagnosing PTSD.
The team utilized magnetoencephalography (MEG), a cutting-edge imaging technology that combines the spatial resolution of MRI with the temporal capabilities of EEG.
MEG allows for real-time observation of brain activity, with a precision not achievable with traditional MRI.
The research study included four groups: soldiers with PTSD, soldiers without PTSD, civilians with mild traumatic brain injury (MTBI), and civilians without MTBI.
Tasks performed by participants in the MEG measured abilities such as attention, memory, emotional processing, and mental flexibility, with stimuli from the Afghan war.
Soldiers with PTSD exhibited hyperactivity in high-frequency brain patterns, indicating overconnection in certain brain networks.
The study found that soldiers without PTSD reacted more strongly to combat-related stimuli, showing hyper-arousal similar to those with PTSD.
In contrast, soldiers with PTSD were already in a state of high arousal and could not escalate further, correlating with the severity of their symptoms.
The rapid double activation in the amygdala of soldiers with PTSD when shown combat-related pictures indicates a unique emotional processing challenge.
The study provided an objective means to determine the presence and severity of PTSD, differentiating it from MTBI and unaffected groups.
The research demonstrated that physical and psychological trauma have distinct effects on the brain, despite overlapping behavioral symptoms.
The ability to diagnose PTSD earlier could significantly reduce the duration of the illness and improve the lives of soldiers and their families.
The findings validate PTSD as a real injury, potentially reducing the stigma associated with it and opening new avenues for mental health diagnosis.
Lee encourages others to consider the difficult questions they might be avoiding, as they could lead to significant breakthroughs.
Transcripts
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