Health Rounds: New procedure dramatically improves combat-related PTSD

By Nancy Lapid

April 7 (Reuters) - Hello Health Rounds readers! Today we focus on the brain with two very different studies. One tested a new type of brain stimulation that greatly improved quality of life in those with post-traumatic stress disorder from combat. The other found differences in how Alzheimer's affects men and women that could lead to changes in how the disease is monitored and treated.

New treatment eases combat-related PTSD

An advanced version of a procedure that uses magnetic fields to stimulate brain nerve cells appears to be extremely effective for combat-related post-traumatic stress disorder, according to a study of active military and veterans.

That procedure in combination with psychotherapy successfully treated 85% of participants with PTSD who received it in the trial, they reported.

Overall, 119 soldiers and former soldiers with severe combat-related PTSD were randomly assigned to receive psychotherapy with or without an MRI-guided, robot-controlled form of transcranial magnetic stimulation, called “navigated TMS,” during a 30-day residential program at Laurel Ridge Treatment Center in San Antonio.

Navigated TMS guides placement of the magnetic device to the exact spot that should be targeted based on the patient’s unique anatomy and brain structure, according to a report of the study published in JAMA Network Open.

After one month, 85% of those who received the navigated TMS treatment had clinically significant symptom reductions, enough to greatly improve their quality of life. That compared with 59% of those who received a “sham” TMS procedure as a control, the researchers reported.

Soldiers and veterans receiving the TMS add-on were more likely to maintain their treatment gains over time, the researchers also found.

“These are exciting findings for the hundreds of thousands of U.S. service members and veterans suffering from combat-related PTSD,” study leader Dr. Peter Fox of UT Health San Antonio said in a statement.

Brain changes in Alzheimer’s disease differ by sex

Scientists trying to understand the brain changes of Alzheimer’s disease may need to interpret standard monitoring tools differently in women and men, researchers say.

In particular, scores on the 30-point Mini-Mental State Examination, or MMSE, might not fully reflect underlying brain changes in women with mild cognitive impairment, their study found.

“A woman who scores well on the MMSE... may still (have) underlying brain changes that are not fully captured by that score alone,” study leader Mukesh Dhamala of Georgia State University said in a statement.

The researchers analyzed brain scans and MMSE tests from 332 people at different stages of the disease.

In men, gray matter in the brain showed more shrinkage early in the disease, with some degree of stabilization afterward. In women, shrinkage of gray matter was slow early in the disease, becoming steeper and more widespread in later stages of cognitive decline.

The findings of normal MMSE scores in women with early gray matter shrinkage suggest their brains may be compensating in ways that help maintain cognitive performance earlier in the disease.

“These patterns likely reflect distinct biological mechanisms, including hormonal influences, genetic susceptibility and sex-specific neural compensation,” the researchers wrote in Brain Communications.

“Overall, the findings establish sex as a key determinant of Alzheimer’s disease pathology, influencing both the spatial distribution and temporal dynamics of brain atrophy,” they added.

“Recognizing and modeling these differences are crucial... to improve personalized care and clinical outcomes in Alzheimer’s disease.”