Target audience
Neurobiologists, neurologists, radiologists, psychiatrists who are interested in the chemical deregulation of the human brain caused by exposure to blast and psychological trauma as a frontline defender.Outcome/Objectives
Capacity to distinguish between the conditions of Post Traumatic Stress Disorder (PTSD), blast exposure, traumatic brain injury (TBI) and the healthy brain.Purpose
Frontline defenders (Defence personnel, Police, and Paramedics etc.) have experienced a significant increased incidence of PTSD. The Australian and USA Department of Defence is looking for an “in life” means of evaluating the effects of PTSD and blast exposure for assistance with return to duty decisions and potential prophylactic and treatment options.Methods
Police and armed forces with either PTSD, blast exposure or mild traumatic brain inury (mTBI) are screened to ensure no other co-morbid neurological or psychological conditions are apparent. The volunteers undergo two-dimensional (2D) COrrelated SpectroscopY (COSY) (1-3) applied to the posterior cingulate gyrus (PCG) and 1D spectroscopy in other brain regions, to evaluate any chemical deregulation. The data is analysed by conventional methods and the MR spectroscopy biomarker discovery algorithms (MBDA) (4-6).Results
There are clear biochemical delineations of each of the above-mentioned conditions. These include changes to specific molecules that can be associated with structural damage, depression, pain and memory.Discussion
It is now possible to monitor each person’s type and level of deregulation and associate the chemical changes with established neuropsychological evaluation. Until now, there has been no objective test for PTSD or the affect of exposure to blast. Once the classifiers are available for each type of condition those with multiple causes of neuro deregulation will be able to be evaluated.
Conclusion
Given time, COSY technology will be available to provide a personalised approach to diagnose and monitor the effects of trauma on frontline defenders.1. Ramadan S, Andronesi OC, Stanwell P, Lin AP, Sorensen AG, Mountford CE. Use of in vivo two-dimensional MR spectroscopy to compare the biochemistry of the human brain to that of glioblastoma. Radiology. 2011;259(2):540-9.
2. Mountford C, Quadrelli S, Lin A, Ramadan S. Six fucose-alpha(1-2) sugars and alpha-fucose assigned in the human brain using in vivo two-dimensional MRS. NMR in biomedicine. 2015;28(3):291-6.
3. Quadrelli S, Mountford C, Ramadan S. Hitchhiker's Guide to Voxel Segmentation for Partial Volume Correction of In Vivo Magnetic Resonance Spectroscopy. Magnetic resonance insights. 2016;9:1-8.
4. Stanwell P, Siddall P, Keshava N, Cocuzzo D, Ramadan S, Lin A, et al. Neuro magnetic resonance spectroscopy using wavelet decomposition and statistical testing identifies biochemical changes in people with spinal cord injury and pain. Neuroimage. 2010;53(2):544-52.
5. Cocuzzo D, Lin A, Ramadan S, Mountford C, Keshava N. Algorithms for characterizing brain metabolites in two-dimensional in vivo MR correlation spectroscopy. Conference proceedings : Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual Conference. 2011;2011:4929-34.
6. Cocuzzo D, Lin A, Stanwell P, Mountford C, Keshava N. In Vivo Brain Magnetic Resonance Spectroscopy: A Measurement of Biomarker Sensitivity to Post-Processing Algorithms. IEEE Journal of Translational Engineering in Health and Medicine. 2014;2:1-17.