National PTSD consortium to improve diagnosis, treatment
Woodruff Health Sciences Center | Aug. 14, 2012
Half of patients suffering from post traumatic stress disorder (PTSD) are not identified, and treatment for those who are diagnosed is only partially effective, leading Draper Laboratory to form a consortium of nationally-recognized experts on PTSD to improve diagnostic tools and treatment outcomes.
PTSD has been diagnosed in more than 200,000 troops returning from combat in Iraq and Afghanistan, but it is also commonly found in civilians who have been involved in an accident or assault, or have suffered the unexpected loss of a loved one. Approximately 8% of the U.S. population will suffer from PTSD at some point in their lives, which can lead to panic attacks, substance abuse, depression, suicide, and a host of serious medical complications, most notably, cardiovascular disorders.
The current state of the art in PTSD diagnosis is based on clinical interviews, so doctors have to rely on patients’ subjective reports. Although the clinical history is a good start, PTSD diagnoses would be better informed if reliable biomarkers of the condition were available, as is the case in many other areas of medicine.
"Although some biological characteristics that point to a PTSD diagnosis have already been identified, more comprehensive study is critical to examine the integrated roles of multiple potential biological factors of the condition," according to Dr. Roger Pitman, director of the PTSD Research Laboratory at Massachusetts General Hospital and Professor of Psychiatry at Harvard Medical School. "This will help clinicians develop personalized treatment plans to improve outcomes, rather than relying on ‘one-size-fits-all’ approaches."
Reducing inconclusive diagnoses and avoiding ineffective treatments, in turn, will help significantly reduce costs, both for patients as well as society, Pitman said.
The technology platform underlying the proposed solutions to PTSD diagnosis and treatment will be derived from those Draper has developed for a variety of systems for NASA and the Department of Defense. These systems synthesize data from multiple sources to create actionable information. One example is Draper’s Timeliner™ system, which currently collects data from hundreds of sources to automate operations and diagnose points of failure in real time aboard the International Space Station and in power plants.
"We have the most advanced data fusion technology in critical decision making available to apply to PTSD diagnosis and personalized treatment care," said Dr. Len Polizzotto, Draper’s vice president in charge of the program.
Bringing together a national team of leading PTSD experts from a variety of disciplines and institutions offers several advantages over pursuing the problem as a single organization, including the ability to look at the full spectrum of factors from neuroimaging to gene expression, and conduct human and animal studies in parallel, thus accelerating knowledge and development of solutions.
"No one of us could do this alone, but collaboratively, we will be able to create a solution to one of the most expensive healthcare problems our nation is facing in both cost and human toll," said Dr. David Diamond, Psychology Professor at the University of South Florida.
Current members of the PTSD consortium include: Dr. Roger Pitman, Dr. Mohammed Milad, and Dr. Scott Orr of Massachusetts General Hospital and Harvard Medical School; Dr. Martha Elizabeth Shenton of Brigham and Women’s Hospital; Dr. David Diamond of University of South Florida and the James A. Haley VA Hospital in Tampa, FL; Dr. Ann Rasmusson and Dr. Jennifer Vasterling of the National Center for PTSD, Boston University School of Medicine, and VA Boston Healthcare System; Dr. Paula Schnurr and Dr. Matthew Friedman of the National Center for PTSD and Dartmouth College; Dr. Israel Liberzon of the VA Ann Arbor Healthcare System and University of Michigan; Dr. Tom Neylan of the San Francisco VA Medical Center and University of California-San Francisco; Dr. Kerry Ressler of Emory University and the Yerkes National Primate Research Center; Dr. Tania Roth of University of Delaware; Dr. Lisa Shin of Tufts University; Dr. Rachel Yehuda of Mt. Sinai Hospital in New York City and the James J. Peters VA Medical Center in the Bronx, NY; Dr. Karestan Koenen of Columbia University’s Mailman School of Public Health; and Dr. Len Polizzotto, Dr. Nirmal Keshava and Dr. Andrea Webb of Draper Laboratory.
The team plans to develop solutions based on objective, clinical decision making by using sophisticated algorithms to integrate data from a spectrum of biomarkers including neuroimaging, psychophysiology, chemical assays, and gene expression. The resulting diagnostic and treatment protocols will be more objective and personalized, complementing today’s primarily subjective means of evaluation and treatment selection.