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PTSD Researchers Win Nearly $7.4M Department of Defense Grant
Neuroscience Team To Conduct Multicenter Trial Combining Magnetic Stimulation, Behavioral Therapy
Aug. 30, 2018
A University of Texas at Dallas neuroscience research team led by Dr. John Hart Jr. has received a nearly $7.4 million grant from the U.S. Department of Defense for a multisite study on a novel treatment protocol for post-traumatic stress disorder (PTSD).
Dr. Michael Motes (left) and Dr. John Hart Jr.
The researchers are seeking up to 330 military veterans with combat-related PTSD for the study, which will include both repetitive transcranial magnetic stimulation (rTMS) and cognitive processing therapy (CPT). The funding comes four months after publication of the team’s Journal of Affective Disorders study, which indicated that CPT for PTSD is more effective when paired with rTMS.
“Dr. Hart’s efforts in addressing PTSD with state-of-the-art neurotechnology is an excellent example of the innovative, high-impact research conducted at UT Dallas, consistent with our Tier One status,” said Dr. Joseph J. Pancrazio, vice president for research and professor of bioengineering.
Hart, the Distinguished Chair in Neuroscience in the School of Behavioral and Brain Sciences, will work with co-investigator Dr. Michael Motes on the trial, which will be conducted at three sites. Two of those are in the Dallas-Fort Worth area — one at UT Dallas and the other at a Metrocare Mental Health Services facility — and one in Tampa, Florida. UT Southwestern Medical Center psychiatry professors Dr. John Burruss and Dr. Carol North will oversee the Metrocare cohort.
“We proposed a multicenter project because we want to show that this method would work for a variety of veteran populations at different therapeutic sites,” Hart said. “We have a Veterans Affairs hospital group; we have an uninsured, underserved group; and we have a community-dwelling group. We hope our results will provide more evidence that this treatment will be effective anywhere.”
“As in our prior study, we’ll be doing imaging to look at markers of change and to learn more about how PTSD works, the mechanisms behind it, and how it gets better.”
Repetitive transcranial magnetic stimulation is a technique long used to treat depression in which a magnetic coil modulates targeted brain areas — in this case, the prefrontal cortex.
Cognitive processing therapy is a version of cognitive behavioral therapy developed specifically for PTSD. This standardized therapy — uniformly administered from a set of rigorous guidelines — provides consistency across patients’ treatments, which is crucial for such a study.
“As in our prior study, we’ll be doing imaging to look at markers of change and to learn more about how PTSD works, the mechanisms behind it, and how it gets better,” Hart said.
Participants will be evaluated on PTSD symptoms and brain-imaging assessments at six and 12 months post-treatment. Within each population group, veterans will receive one of three treatment regimens. As in the previous study, there will be participants receiving rTMS followed by CPT, while others will receive only CPT. The new, third component will be a subset receiving only rTMS.
“We have published our initial study showing what rTMS does in combination with CPT compared to CPT alone, and we saw early benefits within five sessions,” Hart said. “Now we need to see what the combined therapy is doing compared to rTMS alone. It could be that we are seeing synergistic effects with the combined therapy, or that we are seeing separate effects of CPT and rTMS.”
Motes, a senior research scientist at UT Dallas and long-time collaborator with Hart, added that they have reason to be optimistic about sole usage of rTMS.
“The data from our previous trial indicated that, early within treatment, the people getting rTMS combined with CPT started getting better compared to those who received only CPT, and several preliminary studies have shown the potential benefits of rTMS alone,” Motes said. “Identifying the relative and combined contributions of rTMS and CPT to PTSD treatment will provide valuable information for veterans and clinicians to consider in developing treatment plans.”
Two UT Dallas graduate students demonstrate the usage of the equipment for repetitive transcranial magnetic stimulation, in which a magnetic coil modulates targeted brain areas.
Hart explained that conducting a large, diverse trial to see if earlier results can be replicated in different environments is a huge step in bringing a treatment method to the public.
“The different providers, patients and settings allow for a more definitive way of seeing how neuromodulation can be effective in treating neuropsychiatric disorders,” he said.
As with any PTSD therapy, or neuropsychiatric therapy in general, the goal is to give patients improvement in their quality of life.
“The goal should be to get to a point where PTSD does not disrupt your work, home and social life,” Hart said.
Hart believes this study is a great example of translational research — fundamental research that is “translated” into medical practice and yields meaningful health outcomes.
“We started out by developing models of normal memory here at UTD, studied disruptions in those memory systems in humans, and then devised the proposed investigations to examine treatment of these disruptions,” Hart said. “Through our work at UTD, we developed this model and have marched it all the way out to originate this large multisite clinical trial centralized at UTD.”
Media Contact: Office of Media Relations, UT Dallas, (972) 883-2155, [email protected].