Preventing PTSD with a 'video game' that trains soldiers to control their brains
Scientists have developed a neurofeedback system that can specifically target the amygdala
Post Traumatic Stress Disorder — or PTSD — can wreak havoc in the lives of those who suffer from this invisible illness. It's particularly prevalent in military veterans who've experienced trauma in the battlefield. Now according to a recent study published in the journal Nature Human Behaviour, scientists from the Tel Aviv University in Israel say they've developed a new brain training system, which they hope could one day prevent the onset of PTSD symptoms.
Chris Dupee of Newmarket, Ontario, who served as a corporal in the Royal Canadian Regiment in Afghanistan for about eight months and is the founder of an online network for military veterans who struggle with PTSD — Military Minds, said he's been suffering from PTSD since he returned about nine years ago.
"Personally, it led me away from my family. I lived in my truck for quite some time," said Dupee. "I pushed my loved ones away. And the closest ones, they take the brunt."
He said if there was a way he could have prevented the onset of his symptoms, he would have been open to it.
"Any advantage that I could have jumped on before I went overseas — absolutely, I would have [done it.]"
PTSD in the brain
Dupee said something happened to his mindset when he served in Afghanistan. At first, he was excited and scared when he ventured out into enemy territory, but then something shifted.
"If you were to fast forward now to my last patrol, and how I felt stepping out, I didn't have that same fear that I had before," said Dupee. "So something happened in between there — something that was born inside of me that helped me survive, that helped me look at death or just really anything that is abnormal, and laugh at it."
The amygdala is like like an alarm bell of the brain. So an alarm bell is something that is very important, but when it goes out of control it makes it very difficult for us to function.- Jackob Keynan, Tel Aviv University
Upon returning to Canada, he continued to bury his feelings, which led him to feel like an empty shell and that his mind now automatically often goes immediately to the worst-case scenario.
"And it's very powerful. That's one of the things I personally deal with - the anxiety, hypervigilance," added Dupee. "A lot of that it really comes out and is amplified."
Jackob Keynan, a researcher in cognitive neuroscience at Tel Aviv University's Sagol Brain Institute and lead author on the new study, said PTSD causes certain activities in the brain to become dysregulated, specifically the amygdala, an area deep within the brain.
"Its activity becomes heightened all the time. And the amygdala is like like an alarm bell of the brain. So an alarm bell is something that is very important, but when it goes out of control it makes it very difficult for us to function."
The idea behind their new training system involves a specialized form of neurofeedback, but one that specifically targets the amygdala. Neurofeedback is a way to train the brain whereby the person undergoing it monitors their brain function in real time to make adjustments in order to regulate it in a healthier way.
Keynan said that the goal of their neurofeedback system is to target the amygdala, so that before a person experiences trauma and it becomes dysregulated, that person could train their brain to dampen the alarm bell arising from the amygdala.
"We see that when people train to regulate their own amygdala — first of all, it's possible. People can learn to regulate their own amygdala," he said. "And more importantly, the amygdala becomes more connected to the prefrontal cortex, which is like the boss of the brain. And making these guys — the amygdala and the prefrontal cortex — talk better with each other, can protect us from the harmful effect of stress."
Neurofeedback targeting the amygdala
The challenge in creating a neurofeedback system that can target the amygdala is that fMRI, which can focus on specific areas in the brain, is not practical to use. It's expensive and not mobile. Whereas EEG systems, which pick up brain waves on the surface of the skull, is cheaper and more mobile, but lacks specificity.
You basically ask the computer, 'Please tell me — look at the EEG signal, look at the fMRI signal, and tell me what what goes together. What can I use in the EEG that will be indicative of amygdala activity.'- Jackob Keynan, Tel Aviv University
To come up with a system that's practical and specific, they simultaneously ran EEG and fMRI systems together, then employed machine learning techniques to the data.
"You basically ask the computer, 'Please tell me — look at the EEG signal, look at the fMRI signal, and tell me what what goes together. What can I use in the EEG that will be indicative of amygdala activity,'" said Keynan.
The signal they came up with is correlated with the amygdala, so they could create a game-like system to target that amygdala with enhanced EEG.
"In the training that we've developed, what happens is the participant is sitting in front of a laptop and he sees a virtual hospital waiting room," described Keynan. "And the hospital waiting room is very agitated. You see people shouting and congregating in the middle of the room. And we tell the participant that his goal is just to make people be more relaxed, calm down, and sit down quietly in their place. And what happens is when the computer identifies that amygdala activity is down regulating, it reflects on the room that people are quieting down and sitting down in the room."
Once the participant is able to calm the people in the virtual waiting room, then they know they've learned how to regulate their own amygdala.
Keynan and his colleagues tested their system on Israeli military recruits in the first few weeks of their military training, which he said can be a stressful time. He found that when they finished the training, 80 per cent of the soldiers managed to significantly reduce their amygdala activity. And beyond that, Keynan also found those who targeted their amygdala also reduced their stress responses compared to the controls.
The hope is not only soldiers would be able to use this neurofeedback system to increase their emotional resiliency and even prevent the onset of PTSD, but other populations that are also at risk of traumatic exposure, such as firefighters or paramedics.
"But beyond that, you know stress is harmful to our well-being and we know that stress can aggravate existing mental conditions and even harm our physical health under some conditions. So I think that trying to make this a mobile app that you can put on an easy electrode on your head and train to regulate your own brain at your own home. I think that can be very helpful to a general [population's] well-being and not only for PTSD," said Keynan.