While PTSD Research Has Accelerated, Much About the Disorder Remains a Mystery

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SAN FRANCISCO — Research into PTSD has accelerated exponentially over the last decade. Where once it was understood as little more than a loose collection of symptoms, now researchers are beginning to define the pathology of the disease as well as what effects it might have on other bodily systems. And, as patients with PTSD age, more is being understood about how PTSD will affect health the rest of their lives.

A number of studies have recently revealed that those diagnosed with PTSD are more likely to suffer from physical ailments as they grow older, including cardiovascular disease, stroke and dementia. Thanks to continuing work being done by VA researchers, including those at the San Francisco VA Medical Center, the reasons for the link between PTSD and those ailments is a mystery that soon could be solved.

What is still lacking, and a niche that researchers in San Francisco hope to fill, is in-depth research into different types of treatment that proves with scientific certainty which is more effective at treating PTSD.

Aging PTSD

The SFVAMC has a team of more than 20 investigators being funded by VA, DoD and NIH to do research into different facets of PTSD — psychiatrists, psychologists, internal medicine specialists, radiologists, laboratory medicine specialists and even a neurochemist and a biomedical engineer. All of them serve as principal investigators on a large portfolio of PTSD-related projects.

Much of that work focuses on aging veterans with PTSD and what the disease means for them as they grow older.

“We’re generally interested in the health effects of having PTSD, with a focus on the aging veteran,” said Thomas Neylan, MD, director of the PTSD program at SFVAMC. “As far back as 2009, we discovered that veterans with PTSD carry twice the risk of developing dementia later in life. We are keenly interested in what [other effects PTSD might have].”

That dementia discovery was made by Kristine Yaffe, MD, chief of geriatric psychiatry at SFVAMC. She and her team studied the records of 180,000 VA patients, most of whom were Vietnam or Korea-era veterans and found that patients with PTSD had a dementia rate of 10.6% compared to 6.6% for those without PTSD.

That finding pushed SFVAMC researchers to look for links between PTSD and brain functions. Brain imaging studies on PTSD patients done there and elsewhere in VA showed abnormalities in the hippocampus. “In particular, we found that PTSD is associated with a reduced volume in a region of the hippocampus that is associated with new neuronal growth in adults. That was the area that really seemed to be affected by PTSD,” Neylan said.

This reduced volume was found to also be associated with a decrease in sleep quality — a common symptom of PTSD. “This brings up the idea that sleep has a trophic or protective effect on the brain,” Neylan said.

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