Researcher explains why PTSD is more like a physical illness than an ‘invisible injury’

Post-traumatic stress disorder is associated with physical changes to the brain, according to neuroimaging research published in the journal BMC Neuroscience.

The study used magnetic resonance imaging technology to compare the brains of 24 soldiers with PTSD and 23 soldiers without PTSD. The researchers uncovered that soldiers with PTSD had reduced cortical thickness, primarily in the frontal and temporal lobes, while also having enlargement in several areas in the cerebellum.

PsyPost interviewed the study’s corresponding author, B. T. Dunkley of The Hospital for Sick Children in Toronto. Read his responses below:

PsyPost: Why were you interested in this topic?

Dunkley: We were interested in this topic because PTSD is still very much seen as an ‘invisible injury’ and a huge burden on the sufferer and military healthcare system (as well, of course, all healthcare systems). By ‘invisible injury’, I mean that there is often no overt sign that someone has this disorder, and many people with the illness suffer in silence, and feel like they are to blame for their symptoms and some of the problems that come with them. We wanted to show that the disorder has a physical, biological basis, much like any other physical illness we might think of. There has been a lot of work in this area over the past 10-15 years, and we wanted to contribute to that area of research.

What should the average person take away from your study?

That this disorder has an underlying basis in the brain, and that this is perhaps one of the reasons why PTSD can develop after suffering a traumatic event or being under constant stress in a hostile environment (in this case, a war zone). We hope to shine a light on the illness, and show that someone who suffers from PTSD isn’t responsible for the illness or their symptoms, but that a difference in brain structure is partly (along with other factors) to blame.

Are there any major caveats? What questions still need to be addressed?

Caveats that should be understood are related to ‘cause or consequence’ – with this type of study, we are unable to say whether these brain structure differences made it more likely for someone to develop PTSD after suffering a traumatic event, or whether the trauma induced the brain to change following the event. All we can say if that after the fact, there are observable differences in the physical structure of the brain that we can image using this type of technology.

In the future, we hope to run a pre-post study, and categorically say whether or not these markers exist before someone could potentially develop PTSD after trauma – thinking further ahead, this could hold promise in the diagnoses of the disorder, as well as predict the likely outcome of treatment, potentially expediting recovering and saving the healthcare system time and money.

In addition to Dunkley, the study “Neuroanatomical features in soldiers with post‑traumatic stress disorder” was co-authored by D. Sussman, E. W. Pang, R. Jetly and M. J. Taylor.