News | December 05, 2014

PET/CT Shows Pituitary Abnormalities in Veterans with PTSD

HPA axis suspected of playing crucial role in PTSD

Nuclear imaging, PET/CT, Clinical Trial/Study, RSNA 2014

PET/CT on the left and an MRI on the right demonstrating the relative locations of both the Hypothalamus and the Pituitary.

December 5, 2014 — Hybrid imaging with positron emission tomography and computed tomography (PET/CT) in the pituitary region of the brain is a promising tool for differentiating military veterans with post-traumatic stress disorder (PTSD) from those with mild traumatic brain injury (MTBI), according to a new study presented at RSNA 2014.

The findings also lend support to the theory that many veterans diagnosed with PTSD may actually have hormonal irregularities due to pituitary gland damage from blast injury.

MTBI involves damage to the brain from an external force, while PTSD is generally defined as a mental health condition that can develop after someone has experienced a traumatic event. Research has shown that up to 44 percent of returning veterans with MTBI and loss of consciousness also meet the criteria for PTSD. Differentiating PTSD from MTBI can be challenging for clinicians due to symptom overlap and, in many cases, normal structural neuroimaging results.

Researchers recently used PET/CT to study the hypothalamus and pituitary glands of veterans who had suffered blast-related MTBI. The pituitary gland is a pea-sized structure that sits in the bony enclosure located at the base of the skull and is connected to a part of the brain called the hypothalamus. Together with the adrenal glands above each kidney, the hypothalamus and pituitary gland form the HPA axis, an important regulator of many body processes, including stress response, mood and energy expenditure.

The researchers focused on 18F-fluorodeoxyglucose (18F-FDG) PET/CT, which provides a picture of metabolism by measuring uptake of the radiopharmaceutical FDG. A review of 159 brain 18F-FDG PET/CT exam records showed that FDG uptake in the hypothalamus was significantly lower in the MTBI-only group compared with normal controls. FDG uptake in the pituitary gland was significantly higher in the MTBI and PTSD group compared with the MTBI-only group.

The finding of higher FDG uptake in the pituitary glands of PTSD sufferers supports the theory that many veterans diagnosed with PTSD may actually have hypopituitarism, a condition in which the pituitary gland does not produce normal amounts of one or more of its hormones.

"This raises the possibility that some PTSD cases are actually hypopituitarism masking itself as PTSD," Malone said. "If that's the case, then we might be able to help those patients by screening for hormone irregularities and treating those irregularities on an individual basis."

Malone said the increased FDG uptake in the pituitary glands of veterans with MTBI and PTSD may be due to the gland working harder to produce hormones.

The results suggest that PET/CT may provide an effective way to diagnose and differentiate PTSD from MTBI and offer more insight into the biological manifestations of the disorder.

Malone comments: "Currently, treatment for PTSD is typically limited to psychological therapy, antidepressants and anxiety medications. Our findings reinforce the theory that there is something physically and biologically different in veterans who have MTBI and PTSD compared to those who just have MTBI."

Co-authors on the study include Osama A. Raslan, M.D., M.B., B.Ch.; Diane M. Whitson, M.P.H.; Razi Muzaffar, D.O., P.T. Roskos, Ph.D.; Patrick V. Kelly, Ph.D.; Richard R. Buchholz, M.D. and Medhat M. Osman, M.D.

For more information: www.rsna.org

 

Related Content

Transpara Deep Learning Software Matches Experienced Radiologists in Mammogram Reading
News | Computer-Aided Detection Software | January 12, 2018
Deep learning and artificial intelligence improves the efficiency and accuracy of reading mammograms, according to...
Smartphone Addiction Creates Imbalance in Brain
News | Mobile Devices | January 11, 2018
Researchers have found an imbalance in the brain chemistry of young people addicted to smartphones and the internet,...
Fat Distribution in Women and Men Provides Clues to Heart Attack Risk
News | Women's Health | January 11, 2018
January 11, 2018 – It’s not the amount of fat in your body but where it is stored that may increase your risk for hea
Minimally Invasive Treatment Provides Relief from Back Pain

Lumbar spine MRI showing disc herniation and nerve root at baseline and one month after treatment

News | Interventional Radiology | January 11, 2018
The majority of patients were pain free after receiving a new image-guided pulsed radiofrequency treatment for low back...
Emergency Radiologists See Inner Toll of Opioid Use Disorders

Rates of Imaging Positivity for IV-SUDs Complications. Image courtesy of Efren J. Flores, M.D.

News | Clinical Study | January 11, 2018
January 11, 2018 – Emergency radiologists are seeing a high prevalence of patients with complications related to opio
CT Shows Enlarged Aortas in Former Pro Football Players

3-D rendering from a cardiac CT dataset demonstrating mild dilation of the ascending aorta.

News | Computed Tomography (CT) | January 11, 2018
Former National Football League (NFL) players are more likely to have enlarged aortas, a condition that may put them at...
Study Finds No Evidence that Gadolinium Causes Neurologic Harm

MR images through, A, C, E, basal ganglia and, B, D, F, posterior fossa at level of dentate nucleus. Images are shown for, A, B, control group patient 4, and the, C, D, first and, E, F, last examinations performed in contrast group patient 13. Regions of interest used in quantification of signal intensity are shown as dashed lines for globus pallidus (green), thalamus (blue), dentate nucleus (yellow), and pons (red).

News | Contrast Media | January 11, 2018
January 11, 2018 — There is no evidence that accumulation in the brain of the element gadolinium speeds cognitive dec

Size comparison between 3-D printed prosthesis implant and a penny.

News | 3-D Printing | January 11, 2018
January 11, 2018 — Researchers using...
RSNA 2017 technical exhibits, expo floor, showing new radiology technology advances.
Feature | RSNA 2017 | January 11, 2018
January 11, 2018 — Here is a list of some of the key clinical study presentations, articles on trends and videos from
Hip Steroid Injections Associated with Bone Changes

58-year-old woman with left hip pain. X-ray from one month prior to the steroid/anesthetic injection demonstrates moderate joint space narrowing (arrows) and bony proliferation (arrowheads).

News | Orthopedic Imaging | January 11, 2018
January 11, 2018 – Osteoarthritis patients who received a steroid injection in the hip had a significantly greater in
Overlay Init