Post-Traumatic Stress Disorder: Diagnosis & Therapy

4:00PM Traumatic Brain Injury Clinical Trials from the Past for the Future
Ross Zafonte, DO, Earle P. and Ida S. Charlton Chairman of the Department of Physical Medicine and Rehabilitation, Harvard Medical School; Visiting Professor, Harvard Medical School; Vice President Medical Affairs, Spaulding Rehabilitation Hospital; Chief of Physical Medicine and Rehabilitation, Massachusetts General Hospital, rzafonte@partners.org

Moderator: Steven Schachter, MD, Professor of Neurology, Harvard Medical School; Director of Research, Department of Neurology, Beth Israel Deaconess Medical Center; Associate Director, Clinical Research, Harvard Medical School Osher Institute; Member, Board of the Epilepsy Therapy Development Project; Founder & Editor-in–Chief, Epilepsy & Behavior; Editor-in-Chief of Epilepsy.com; CIMIT Program Leader, Neurotechnology; CIMIT Site Miner, BIDMC, sschacht@bidmc.harvard.edu

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5:00PM Neurological Soft Signs in Post-Traumatic Stress Disorder
Roger Pitman, MD, Professor of Psychiatry, Harvard Medical School and Psychiatrist, Massachusetts General Hospital, rpitman@partners.org

Moderator: Jordan Smoller, MD, ScD, Associate Professor of Psychiatry, Harvard Medical School; Director, Psychiatric Genetics Program in Mood and Anxiety Disorders and Co-Director, Genetics and Genomics Unit, Clinical Research Program, Massachusetts General Hospital, jsmoller@partners.org

Post-traumatic stress disorder (PTSD) is a psychiatric condition resulting from a psychologically traumatic event. We have found evidence of subtle neurological dysfunction, manifest in more neurological soft signs (NSSs), in adult females sexually abused as children and in male Vietnam combat veterans. However, the identical co-twins of combat veterans show comparable NSSs, suggesting that the subtle neurological compromise in not caused by the psychological trauma, but rather serves as a pre-existing, probably genetic, risk factor for developing PTSD upon traumatic exposure.

In contrast to PTSD, traumatic brain injury (TBI) is a neurological condition that results from a physical trauma to the brain. However, mild TBI shares several symptoms with PTSD, e.g., detachment, difficulty concentrating.  Some have suggested that many cases of mild TBI are really somatoform (or “psychosomatic” in layman’s terms) in nature, rather than based upon real brain pathology. Physical aids are needed to make this differential diagnosis.  We hypothesize that if mild cases of TBI in returning veterans are truly of neurological origin, these veterans should have more NSSs than the “baseline” level of NSSs found in PTSD veterans.  Dr. Roger Pitman will help us study this question.

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