Researchers can now collectively deposit information on the impact of PTSD on the brain.
By Evan Bleier
Alzheimer’s disease has had a brain bank since 1984.
Research on Parkinson’s disease dates back to the 1800s. ALS, CTE, and autism have all had brain banks that provide analysis.
The National PTSD Brain Bank (NPBB) opened in 2014; there had never been a brain bank dedicated to PTSD, and it was sorely needed—the disorder affects a half-million veterans in the United States.
The brain bank is a six-pronged consortium. It includes sites at Veterans Affairs medical centers in Boston; Durham, N.C.; Miami; West Haven, Conn.; and White River Junction, Vermont. There is another location at the Uniformed Services University of Health Sciences in Bethesda, Maryland.
Supported by the National Center for PTSD, the NPBB researches the causes, progression, and treatment of PTSD using brain tissue that has been donated by both veterans and civilians, some healthy, some not. The NPBB has hundreds of tissue samples from men and women, a third of which are favorable for PTSD, a third of which are positive for depression, and a third of which are healthy controls.
“If we can understand what’s different about how the brain of a person with PTSD is reacting, whether it’s to a dangerous situation or everyday stress, then we can design drugs that will target those abnormalities and hopefully correct them,” says Dr. Matthew Friedman.
The NPBB is responsible for tissue acquisition, processing, and diagnostic assessment. It also maintains a confidential data biorepository and gives out research specimens for scientific study to other facilities. It has many organizational tasks and operates cooperatively with established brain banks that focus on Alzheimer’s, ALS, CTE, and other neurological disorders. The arrangement allows the NPBB and the other banks to share laboratories, swap personnel, and compare tissue samples to further their understanding. However, even though it does work in tandem with those banks, the focus at the NPBB remains squarely on PTSD.
One of the main reasons for that is the hard work and dedication of Friedman, the Department of Veterans Affairs National Center senior advisor and NPBB founder. According to Friedman, having the brain tissue on hand is incredibly important to develop medication and methods that can treat PTSD and is essential because even with modern advances, there is little information brain imaging provides.
“There’s no substitute for looking at the brain tissue itself,” Friedman says. “We’ve known for 20 years that there are abnormalities of the brain associated with PTSD.” The first studies done by the National Center on both veterans and civilians with PTSD showed that the hippocampus is smaller in people with the condition. Later, some studies showed that not only are their structural differences but also that the brains of people with PTSD process information—particularly potentially dangerous information—differently than the minds of people without the disorder.
Work by NPBB researchers has already determined there is a specific gene expressed in PTSD not represented in non-PTSD patients. Friedman said there seems to be a difference in the “synaptic density,” primarily how neurons in the brain communicate with other neurons. With that knowledge, researchers will be examining if people with PTSD also express their DNA differently. “DNA is like a piano. If you press different keys, you are going to get different chords,” Friedman said. “We know that certain genes are turned on, and certain genes are turned off. That’s how one identical twin might have PTSD, and the other might not. They have the same DNA, but are they expressing that differently.”
In addition to that project, NPBB researchers have run another major study in conjunction with the Lieber Institute for Brain Development. Researchers examine the RNA sequencing in the brain — what the DNA tells the brain to do — in 12 fundamental structures that seem to be different in people with PTSD. Friedman is cautiously optimistic all these projects examining brain tissue will lead to a better understanding of what’s different about PTSD patients. He believes this research will make it possible to develop a breakthrough medication to treat PTSD in 15 to 20 years.
“That said, there are a number of different ways the brain develops PTSD, so the medication that works for one person might not work for another,” Friedman says. “That’s why understanding these mechanisms at a fundamental level is so important.”
Even though it’s still in its infancy, the establishment of the NPBB was a critically important step, as well.