A new partnership to combat PTSD

Thursday, March 16, 2017

The UW Prevention Neuroscience Lab is partnering with Parkwood Hospital Research Institute to improve the mental health of Canadian military personnel suffering from Post-traumatic Stress Disorder (PTSD). Clinical psychologist and AHS faculty member, Dr. Peter Hall and neuropsychiatrist, Dr. Amer Burhan of Parkwood Institute-Mental Health Therapeutic Brain Stimulation Program, are leading the study in collaboration with Veterans Affairs Operational Stress Injury Clinics in Waterloo and London, Ontario.

The study will test the effects of using brain enhancement strategies to amplify the effects of cognitive therapy in a way that has not been previously attempted.

"The idea is to leverage neurobiological systems to open the gates for a cognitive therapy" says Hall.

The type of cognitive therapy being employed is currently the front line-treatment for PTSD in North America, an approach called Cognitive Processing Therapy (CPT).  CPT involves encouraging PTSD sufferers to develop new ways to think about and respond to trauma-related stimuli. It has been proven more effective than any other intervention, and yet not everyone is able to fully benefit from it. 

The challenge, according to Hall, is that CPT requires the ability to self-reflect, change entrenched thinking patterns and keep negative emotions in check, even when they are triggered in the therapeutic session; all of these are processes are adversely affected by the condition itself. That is, CPT asks patients to do exactly what they have largely had trouble doing up to this point, sometimes leading to treatment drop-out, non-adherence or only partial treatment response.

“We know that the capacity to engage in meta-cognition—or thinking about thinking—and our ability to suspend default thinking patterns and emotional reactions is dependent partially on the brain’s executive control network,” says Hall, “We also know of two very good techniques for optimizing the executive control system: aerobic exercise and repetitive transcranial magnetic stimulation (rTMS).”

Both exercise and rTMS have been shown to enhance brain networks that support self-reflection and self-control, with may serve to amplify the effects of CPT. “The potential for synergy between brain-optimization and CPT is substantial, and this is exactly what we will be testing.”

A major focus of the study will also be to test what military personnel’s attitudes are toward each treatment package. “We think that there may be some systematic preferences for one treatment package over the other, but we don’t for sure know which way it will go. Ultimately, it is an empirical question; that is, it is a question that we can answer by collecting data, rather than relying on our own best guesses.”

The question of preferences may be an important one if the treatment packages turn out to be roughly equivalent in effectiveness.

“Collaboration between Parkwood Institute-Mental Health Brain Stimulation Program and the UW Prevention Neuroscience Lab is a great opportunity to combine two different but likely synergistic interventions (cognitive processing therapy and brain optimization) to address a significant and complex issue” says Burhan, “we are very excited about this collaboration.”

Those interested in participating in or hearing more about the study should contact Dr. Peter Hall (phone: 519.888.4567 x38110; email: pahall@uwaterloo.ca).

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