Summary: As with other mental health disorders, the diagnosis of PTSD is mainly clinical. That means it rests on a doctor’s judgment. No reliable objective test can measure how severe it is. In a new study, researchers used fMRI brain scans of people with PTSD. They found that activity in the hippocampus, a memory center, is turned down in people with PTSD.
These findings may lead to a better way to diagnose PTSD and track treatment in the future. PTSD is a fairly common problem. But some people are at greater risk because of their genes. PTSD is about past experiences haunting you all the time. People with PTSD struggle to shake bad memories, and their emotional reactions change. Long-lasting PTSD may also raise the risk of other mental health problems. As with other mental health problems, doctors diagnose it by taking your history and weighing your signs and symptoms. But diagnosing most mental health problems, including PTSD, is still hard because there are no objective tests.
So doctors have a hard time judging how severe the condition is. They also struggle to track whether treatment is working. To treat PTSD and other mental health disorders better, we need better ways to diagnose and understand them. In recent years, researchers have made slow progress in the right direction. Some tests, like fMRI, can now measure activity in different brain centers. That lets researchers see their patients more clearly, which will also help them treat them better.
A new study along these lines shows changed hippocampal activity in people living with PTSD. The hippocampus is a brain region that plays a key role in memory and in finding your way around. It sits in the medial temporal lobe and is part of the limbic system, the brain’s emotion network. The hippocampus makes new memories. It also turns short-term memories into long-term ones. Damage to the hippocampus can cause memory loss. Research has shown it is also involved in certain mental and nerve disorders, such as PTSD and Alzheimer’s disease.
In the new study, researchers looked at hippocampal activity in people who went to the emergency room after a car accident. During the test, they asked them questions and tracked their answers, and at the same time, researchers measured their hippocampal activity using fMRI. In those with more severe PTSD, hippocampal activity was lower. They found no such change in people who could more easily get past their fears and bad experiences. The study shows that people prone to PTSD have changed hippocampal activity. Of course, these are still early days. But it is a step in the right direction. Judging how severe PTSD is only from a patient’s answers or signs and symptoms is not a very accurate way to diagnose it.
Next, researchers plan to build more precise diagnostic algorithms, step-by-step rules for making a diagnosis. This will help make diagnosis more accurate. It will change not only how PTSD is diagnosed but also how it is treated, since it will give a reliable way to track treatment. Such an objective test will also help run clinical studies. It is quite likely that this may even help catch the condition early. Such tests may, in the future, help spot people at greater risk of PTSD and more.
Frequently asked questions
What part of the brain is affected by PTSD?
The hippocampus is one of the key regions. It sits in the medial temporal lobe as part of the limbic system. It makes new memories and turns short-term memories into long-term ones. In the fMRI study of people seen in the emergency room after a car accident, those with more severe PTSD had lower hippocampal activity. People who more easily got past their fears and bad experiences showed no such change.
Can a brain scan diagnose PTSD?
Not yet. PTSD is still diagnosed clinically. A doctor takes your history and weighs your signs and symptoms, because no reliable objective test exists. That makes it hard to judge how severe the condition is or whether treatment is working. fMRI can now measure activity in specific brain centers. Researchers plan to build more precise diagnostic algorithms from findings like these. But this work is at an early stage.
How hard is it to live with PTSD?
PTSD means past experiences haunting you all the time. People with it struggle to shake bad memories, and their emotional reactions change. When PTSD lasts a long time, it can raise the risk of other mental health problems. Some people are more likely to develop it because of their genes. Better objective tests could one day help doctors spot people at higher risk earlier and track how well treatment is working.
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