Cranial Scan & Neuro-Imaging of PTSD

Emotional traumas and stress influencers are scientifically aligned with anxiety, depression, behavioral disorders, drug/alcohol abuse and a wide list of physiological health issues. These symptoms are typically diagnosed by mental health professionals through observational science and behavioral analysis. But within the past 15 years, global advancements in transcranial imaging pioneered the ability to detect trauma-related issues in the brain through neurological imaging. Now, neurological stress can be identified clinically by monitoring chronic imbalance and changes in the neurochemical structure (or circuitry). The shift in memory performance - specifically the hippocampus and the medial prefrontal cortex is one indicator of this imbalance whereby a stressful event can show images with signs of neuronal dysfunction.

Neuro-imaging measures brain thought activity which has known chemical tissue changes by observing the alterations in capillary blood vessels in the retina located in close proximity to the main emotional center of the anterior brain. Functional MRI (fMRI) is currently used to show brain chemical changes with cognitive commands such as “death vs freedom.” Most recognizable patterns with suicide occur in the anterior cingulate cortex of the brain which lies directly behind the globe and is vascularized by orbital branches of the anterior cerebral artery. Functional near infrared imaging (fNIR) devices show changes in brain oxygenation linked to suicide.

Another imaging innovation is the TRANSCRANIAL DOPPLER (TCD) - a type of sonogram that is a non‐invasive, non‐ionizing, inexpensive, portable and safe technique that uses a pulsed Doppler transducer for assessment of the blood flow in the anterior cerebral arterial circulation. This technology has been used to evaluate intracranial steno‐occlusive disease, subarachnoid hemorrhage, and extracranial diseases (including carotid artery disease and subclavian steal syndrome), detection of microembolic signals and acute strokes. The Transcranial Doppler has been used to examine the mean speed of blood circulation of patients to validate and monitor treatment efficacy by tracking cranial blood vessels and vertebrobasilar flow vasospasm. (See complete Abstract report from Military Medicine)


Psychoanalysis and Optical Brain Imaging in vivo

Another device used by imaging specialists to detect mental distress is through an EYE SONOGRAM or Real Time Sonofluoroscopy of the orbital soft tissues of the eyes. This process is performed in multiple scan planes with varying transducer configurations and frequencies. Power and color Doppler use angle 0 degrees and PRF at 0.9 at the optic nerve head. 3D imaging of optic nerve and carotid, central retinal arteries and superficial posterior ciliary arteries performed in erect position before & after verbal communication and orbital muscle tissue contractions may be observed as a precursor to visual changes in facial expression. Retinal arterial directional flow is also measured with peak systolic and diastolic values. Bulging of the optic nerve head is checked as increased intracranial pressure may be demonstrable in this condition. Other innovations such as the TRANSORBITAL DOPPLER, 3D/4D VESSEL DENSITY HISTOGRAM and the RETINAL OCT (optical coherence tomography) are also being explored in the pursuit of studying brain performance through the eyes. An expanded review on these solutions will be available in part 2 of this report.


Brain Imaging makes an invisible mental injury VISIBLE"
Today's digital imaging technology has mobilized the NON-INVASIVE movement in clinical diagnostics to capture the vital information from significant depths below the skin. "By mapping out some of the different brain changes... it's helped us have a much better understanding of - how to approach treatment", states Dr. Ruth Lanius. Her interview in this video presents the advancement in subdermal scanning to support diagnostics and monitoring of the brain-- where psychiatrists and neurologists are able to access and validate neurological issues through progression imaging reports. (Link: See video)

Video by London Free Press, a division of Postmedia Network Inc.

Brain Mapping used to investigate PTSD
Excerpt from source: Springer Nature Scientific Reports [Link: https://www.nature.com/articles/srep27131] Abstract by: Ting Wang, Jia Liu, Junran Zhang, Wang Zhan, Lei Li, Min Wu, Hua Huang, Hongyan Zhu, Graham J. Kemp & Qiyong Gong
- under Creative Commons licensse:  http://creativecommons.org/licenses/by/4.0/

Post traumatic stress disorder (PTSD) is a psychiatric illness caused by traumatic events, characterized by traumatic event re-experiencing (e.g. flashbacks), avoidance of trauma-related events, hyperarousal (e.g. hypervigilance), and negative cognitions and mood. This implicates a variety of brain regions including the amygdala, prefrontal cortex, temporal cortex, insula, thalamus, anterior cingulate cortex (ACC) and hippocampus. Neurocircuitry linking the increased activity of limbic regions such as amygdala and insula and the decreased medial prefrontal activation may also contribute to the anxiety and emotional dysregulation in PTSD.


The areas of increased (red) and decreased (blue) resting-state brain activity in the meta-analyses of studies in PTSD patients compared with NTC (A) and TEC (B). R, right; L, left; (B), bilateral; mPFC, medial prefrontal cortex; SMG, supramarginal gyrus; STG, superior temporal gyrus; HG, Heschl’s gyrus; LG, lingual gyrus; CFC, calcarine fissure cortex; PTSD, posttraumatic stress disorder; NTC, non-traumatized controls; TEC, trauma-exposed controls.

Multiple neuroimaging modalities such as functional magnetic resonance imaging (fMRI), single-photon emission computed tomography (SPECT), and positron emission tomography (PET) have been employed to investigate the aforementioned altered brain activities in PTSD. In general terms, fMRI makes use of the blood oxygen level-dependent (BOLD) signal to show patterns of activity in the brain, either in response to specific tasks or in the so-called resting state; two analysis methods, amplitude of low-frequency (0.01–0.08 Hz) fluctuation (ALFF) and regional homogeneity (ReHo), have been used to quantify patterns of fMRI resting-state activity. In addition, both regional cerebral blood flow (rCBF) /PET /SPECT and glucose metabolism (rCMglu)/PET can be used to visualize the activity of specific brain regions, and these have proved useful in studying PTSD. The four different techniques of ALFF, ReHo, rCBF, and rCMglu have generally been considered to reflect regional spontaneous neuronal activity in a similar manner, lending themselves to similar quantitative interpretation in terms of brain physiology; it therefore makes sense to combine them to explore the neural activity patterns of PTSD.

Findings in the pooled meta-analysis | Findings in the subgroup meta-analysis | Findings in the meta-regression analyses

Wang, T. et al. Altered resting-state functional activity in posttraumatic stress disorder: A quantitative meta-analysis. Sci. Rep. 6, 27131; doi: 10.1038/srep27131 (2016).


RESEARCH ANNOUNCEMENT: The AngioFoundation is seeking partnerships with clinical facilities or mental health professionals who are actively treating patients with PTSD to partner in exclusive Treatment Validation Tracking, Diagnostic Testing or Screening programs (min. 5 active patients). For more information, click this LINK or contact our Primary Investigator at nycralliance@gmail.com.

Occupational Hazard of Post Traumatic Recall
By: JESSICA A. GLYNN, LMSW, CPC, CEC

High risk professions like law enforcement, military service, healthcare and emergency response are known to have exposure to some of the most extreme levels of trauma - both physically and psychologically. They range in effects from manageable symptoms to crippling disorders. Over time, most people overcome disturbing or traumatic experiences and continue to work and live their lives. But others who get affected by traumatic experiences may trigger a reaction that can last for months or even years. This is called Post-traumatic Stress Disorder, or PTSD. Proportionately, studies have shown a lower percentage of retirees from such challenging careers acquire PTSD (from 15-20%) while an estimated 30-40% who suffer from PTSD associated symptoms go undetected or do not register as full cases. A larger percentage ‘on the job’ might be able to maintain the expected work standards throughout their career and even make it to retirement without visible signs. But “POST traumatic recall” leading to fully blown PTSD occurs when repeated exposure to trauma compounds on the tolerance capacity that eventually, one’s coping ability collapses. The individual may feel stages of grief, depression, anxiety, guilt or anger from uncontrollable issues like recurring flashbacks and nightmares.

Enduring trauma is different and unique for everyone. Some cases are event-specific (having intense auditory impact or visual intensity of a terrifying event) while other cases are contingent upon the tolerance of an individual. There are people who are more emotionally expressive than others- and that might help with if they talk about the trauma that they've been through. A latent emotional disorder like PTSD symptoms can come out over time just like anything that is suppressed or repressed. It could take some time for somebody who came back from combat or a first responder who has been in a traumatic event to show signs of disturbance. They could be holding it in and repeatedly thinking about it privately (or ruminating over it) allowing the disturbing memories to get more intense by the day. This can often be a coping mechanism- protecting themselves from dark or negative feelings for a while, but eventually it builds up and can become symptomatic like flashbacks and anxiety, then leading to an eventual explosion. Meanwhile, some people just have flashbacks right after the experience because of the way that everybody's brain processes differently. Others obsess over thoughts that keep popping up over and over again. It really just depends on the person.

 

Suicide and PTSD

Considerable research has reported a strong connection between significant forms of trauma and suicides or similar behaviors. Moreover, additional claims indicate an elevated number of cases from individuals with mental illness. With military Veterans, for example, combat-related traumas have been closely monitored to indicate a heavy preoccupation to self-inflict injury as a means of engaging recurrent nightmares, relenting negativity, high emotions of high anxiety, anger or guilt acquired from times of active duty. These cases are often scalated by clinical depression, substance abuse and suppressed or hidden emotions that result in uncontrollable reactions. [1]

Suicide rates have been rising in nearly every state, according to the latest Vital Signs report by the Centers for Disease Control and Prevention (CDC). In 2016, nearly 45,000 Americans age 10 or older died by suicide. Suicide is the 10th leading cause of death and is one of just three leading causes that are on the rise. [2]. Approximately 23% of people who had experienced a physical assault had also attempted suicide at some point in their life. These rates of suicide attempts increased considerably among people who had experienced multiple incidents of sexual (42.9%) or physical assault (73.5%). [3] Further, some cognitive styles of coping such as using suppression to deal with stress may be additionally predictive of suicide risk in individuals with PTSD. [4]

1) The Major Occupational Hazard of Post Traumatic Recall - Journal of Modern Healing
2) Suicide rates rising across the U.S.- CDC.gov
3) The Connection Between PTSD & Suicide: VeryWellMind.com
4) US Dept. of Veterans Affairs: National Center for PTSD: How Common is Suicide


Study: Police Officers and Firefighters Are More Likely to Die by Suicide than in Line of Duty - from the Ruderman Family Foundation

A white paper commissioned by the Foundation has revealed that first responders (policemen and firefighters) are more likely to die by suicide than in the line of duty. In 2017, there were at least 103 firefighter suicides and 140 police officer suicides. In contrast, 93 firefighters and 129 police officers died in the line of duty. Suicide is a result of mental illness, including depression and PTSD, which stems from constant exposure to death and destruction.

The white paper study, the Ruderman White Paper on Mental Health and Suicide of First Responders, examines a number of factors contributing to mental health issues among first responders and what leads to their elevated rate of suicide. One study included in the white paper found that on average, police officers witness 188 ‘critical incidents’ during their careers. This exposure to trauma can lead to several forms of mental illness. For example, PTSD and depression rates among firefighters and police officers have been found to be as much as 5 times higher than the rates within the civilian population, which causes these first responders to commit suicide at a considerably higher rate (firefighters: 18/100,000; police officers: 17/100,000; general population 13/100,000). Even when suicide does not occur, untreated mental illness can lead to poor physical health and impaired decision-making. In addition, the Firefighter Behavioral Health Alliance (FBHA) estimates that approximately 40% of firefighter suicides are reported. If these estimates are accurate, the actual number of 2017 suicides would be approximately equal to 257, which is more than twice the number of firefighters who died in the line of duty. (see complete article at rudermanfoundation.org - Heyman, Dill, & Douglas, 2018)


RESEARCH ANNOUNCEMENT: The AngioFoundation is seeking partnerships with clinical facilities or mental health professionals who are actively treating patients with PTSD to partner in exclusive Treatment Validation Tracking, Diagnostic Testing or Screening programs (min. 5 active patients). For more information, click this LINK or contact our Primary Investigator at nycralliance@gmail.com.

Contributing to the evolution of SCIENCE

The study of medicine is an ongoing stream of new discoveries that continue to shape the very way we approach PROBLEM SOLVING. The Biofoundation for Angiogenesis Research and Development also known as The ANGIOFOUNDATION (501c3) funds and supports specialized clinical research projects that underscore the future of how physicians and scientists identify disorders and the resources that pave new heights in efficiency and performance with the least possible risk.

Since its official launch in Dec., 2001, the AngioFoundation was committed to conducting various disciplines of clinical research to support the advancement of technologies, treatment protocols and diagnostic science. Founder Dr. Robert L. Bard's research concept was establishing the exploratory study of minimally invasive modalities to treat cancer and inflammatory arthritis by analyzing "angiogenesis" or new blood vessel (angio) formation (genesis). Major international congresses* showed tumor blood vessel formation revealed by sonogram Doppler imaging was the best predictor of cancer aggression. Treatment success is validated when abnormal arteries decrease in number after therapy. Treatment failure may be demonstrated earlier with this test allowing alternate therapies to be applied. The AngioFoundation has also expanded its research work through collaboration with global technology developers or modern laser innovations, MRI's & ultrasound technologies to detect and treat prostate, breast, thyroid and skin cancers non-invasively. The AngioFoundation's public mission is to advance image guided diagnostic and therapeutic technologies worldwide and supports teaching programs for physicians on new modalities to diagnose and deliver therapies for cancer and allied diseases including inflammatory arthritis.

 

* (AIUM2019 ICIS2018, ASLMS2019 and RSNA2018)

 


 

Research & Educational PROGRAMS
The AngioFoundation has been recognized worldwide by official medical organizations and peer reviews for its work in FIVE MAIN focal topics and class divisions. We continually maintain and update research works in these categories to support the advancement of these disciplines as part of The AngioFoundation's commitment to the scientific community.

Advanced use of Doppler Sonographic Imaging technology to identify malignant cancers and monitor their behavior through blood flow parameters- (Breast, Lung, Bladder, Prostate, Melanoma, etc) which correlates with comparative studies with other current technologies such as MRI, CT etc. (See cancerscan.com) Research / assessment of musculoskeletal disorders (arthritis, inflammation, trauma) and dermatological issues through the advanced use of 3D/4D ULTRASOUND innovations. Trauma Diagnostics) TECH REVIEWER: Beta-testing, industry-wide comparative feature review/evaluation program. Drafting of FDA application / compliance documentation of digital imaging technologies (models, brands and generations) including sub-dermal and musculoskeletal treatment devices Internal study of all cancer issues and health disorders of victims associated with 9/11 and other disaster-related environmental toxic exposures. Collaboration with geological labs & environmental statistics. (See First Responders Cancer Resource) Function review / performance evaluation program of all laser-based medical equipment including devices specializing in sub-dermal musculatory treatment of chronic disorders.


Major Research PROJECTS

• Efficacy of Injected Hyaluronidase Filler Reduction Dept Dermatology Mt Sinai
Marmur E  HS#14-00291 | Icahn School of Medicine 2015

• Photoacoustic and Optical Imaging
Bard R, Krueger L, Rasmussen S Rockefeller University 2013-2014

• Doppler Evaluation of Radiation Treatment Response
Bard R, Kaplan A 2013-2014 NY Medical College

• 3D Doppler Sonography of Malignant Melanoma 
Bard R, Lefkovitz A In conjunction with Mt Sinai Medical Center New York, NY 2013-2014

• 3D Imaging of Psoriasis
Bard R, Lebwohl M, Wortsman X In conjunction with Mt. Sinai Med Ctr New York, NY 2012

• Doppler Vessel Density in Melanoma
Morton D, Bard R in conjunction with John Wayne Cancer Institute Santa Monica 2009-2010

•  Prostatic Volume Reduction Implementing Radiotherapy Treatment Application
Rotman M, Bard R.  Applications in Prostate Cancer Patients 2006-2008
In conjunction with Downstate Medical Center Brooklyn, NY

• Ultrasonography of the Spine in Rheumatoid Arthritis
Smith M, Bard R | Dept Rheumatology St. Vincents Hospital New York 2000-2001
in conjunction with New York Medical College Valhalla, NY

• Ultrasound Evaluation of the Patient with Rheumatoid Arthritis
Smith M, Prashad R, Bard R et al | Dept Rheumatology St. Vincents Hospital New York 1997-1998 in conjunction with New York Medical College Valhalla, NY

Click HERE at pgs 19-21 for a complete list of AngioFoundation Research Projects

See RESEARCH PROTOTYPES

 

Scientific PUBLICATIONS
A significant asset to the medical community is publishing our research studies for complete academic access through medical journals and through full-text distribution with Springer Publishing Inc. Publishing all findings of our research reports maintains the tradition of supporting the growth of current and future generations of clinicians and for the expansion of the vast majority of relevant audiences who benefit from our discoveries. Under the authorship of Dr. Robert Bard, we have amassed over 18 combined years of research and generated countless articles, over 22 scientific textbooks with various topics and hundreds of presentations to the medical community worldwide.

(see Pg. 6-19 books published & international presentations)

 


Research Support and Fundraising EVENTS

May 10, 2018- NYC; The LOTOS CLUB hosted the 2018 speaker series with Dr. Robert Bard's opening presentation on Early Detection & Prevention by NYCRA (New York Cancer Resource Alliance) and endorsed Dr. Bard to launch this theme because of his expanded knowledge in today's modern diagnostic technologies and non-invasive applications including the 4D Doppler ultrasound technology - much of which has been driven by European medical influence for the cancer treatment community. Dr. Bard is an internationally recognized leading expert in the use of this process for the screening, scanning and pre/post procedural monitoring of Breast, Prostate & Skin Cancers. He is also known for his public mission to replace surgical analysis of tumors with his coined "digital biopsies". Dr. Bard gave the standing-room only audience at the LOTOS CLUB an astounding look at the effectiveness of his imaging process to the surgical chain. He shared images of actual patient cases including the study of blood flow in tumors, behaviors of cysts, foreign bodies in trauma cases, fracture analysis and proven ways that cancers can be safely detected, studied and even treated with the use of non-surgical means. The high accuracy of 3D-4D Histogram analysis allows cancer treatment to be implemented without invasive biopsies that may spread tumor cells. (full article)

 

Research results in APPLIED SCIENCE

IMAGING ASSISTS SURGICAL PLANNING OF INDICATED BIOPSIES

In my extensive career as the medical director of an advanced imaging diagnostics practice, I have provided great assistance to many surgeons with my work using advanced Doppler Scanning of Tumors and Cosmetic Disorders. I have uncovered countless dermal and subcutaneous issues that would have otherwise gone undetected with less effective technologies, leading to potential complications in the surgical procedure and patient recovery. The advancement in this innovation empowers upcoming surgical procedures with remarkable confidence of a safer end result. Where biopsies are becoming a thing of the past, our non-invasive 4D Digital imaging replaces weeks of lab work and radiologic tests and often provides more useful information. (see complete article)

DIGITAL BIOPSY CASES: WHAT ARE YOU ABOUT TO BIOPSY? WHAT HAPPENS AFTER THE NEEDLE INSERTS? Here we have 2 subdermal masses which are non tender and firm with no history of trauma. Case A: The oval mass (dark echoes=suspicious) with irregular vessels (red) was referred as a probable cyst or lipoma. The tumor is highly vascular and connected from the aorta by way of the subclavian feeding artery. Liposuction could result in massive hemorrhage and spread of tumor cells into the circulation.

 

Case B: The ovoid white region (bright echoes=benign) is ossified as confirmed by the CT scan of the coccyx. The sonogram allows you to reassure the patient it is NOT CANCER. It prompts one to avoid a standard needle that could bend, crack or dislodge into the soft tissues requiring further exploration to locate/retrieve the broken metal fragment.


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