Non Invasive Brain Stimulation for PTSD

Being involved in combat is a horrific experience that substantially increases the risk of
developing posttraumatic stress disorder (PTSD). Although several effective treatments have
been identified for PTSD a substantial number of patients (up to 50%) continue to experience
symptoms. The field of neuroscience has revealed that patients with PTSD demonstrate altered
functioning within, and interactions between, several brain regions; findings that are
consistent with animal models of chronic stress. Despite this evidence, existing treatments
are generally not designed using this neuroanatomical knowledge. The central premise of the
proposed study is that neuroscientifically-based information can be used to develop more
precise and effective treatments. Transcranial direct current stimulation (tDCS) will be used
in an attempt to "correct" the dysfunctional brain regions (and communication between these
regions), with the expectation that this modulation will result in symptom improvement.

The primary goals of the study are to verify the maladaptive brain networks and then
establish evidence that tDCS modulates these networks. Subsequent studies, performed during
the later study years, will examine dose-response relationships and synergistic effects of
tDCS and existing treatments. Outcome will be assessed using a multi-method approach that
includes functional connectivity using resting-state functional magnetic resonance imaging
data, neuropsychological tests, and self-report measures of emotional functioning. The
combined results will provide vital methodological, mechanistic, and practical information
necessary for a formal clinical trial of tDCS in PTSD.

Inclusion Criteria:

- Male

- Combat Veteran - both Veterans with and without PTSD will be included at different
points in this study

- Right-handed

- Between the ages 18-88

- Stable on medications for a minimum of 2 weeks

Exclusion Criteria:

1. a history of neurological disease (e.g., dementia, epilepsy, stroke, moderate - severe
traumatic brain injury)

2. "severe" Axis I diagnoses (e.g., bipolar disorder, schizophrenia)

3. presence of Axis II disorders

4. current alcohol or drug abuse/dependence (in the past 8 weeks)

5. participants will also be excluded if they are not MRI compatible (assessed using the
guidelines of the American College of Radiology)

6. Imminent risk of harm to self or others

7. history of HIV or sickle cell anemia, as these can cause neuropsychological issues .