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Thursday, February 11, 2016

An Objective Diagnostic Capability for PTSD

Draper solution could help ensure patients receive proper care

CAMBRIDGE, MA – Nearly one in three U.S. veterans who fought in Iraq suffers from post-traumatic stress disorder (PTSD), which affects approximately seven percent of the civilian population as well. Those suffering from the condition may struggle in the workplace due to panic attacks, memory problems, and difficulty interacting with coworkers. However, arriving at an accurate diagnosis to ensure they receive proper treatment for the condition can be problematic. Many patients meet with primary care physicians who may lack the time and expertise to conduct the 60-90-minute clinical interview typically used to diagnose PTSD. Those interviews also use subjective criteria that can make it difficult to distinguish PTSD from conditions with similar symptoms, like clinical depression. Clinicians need tools and techniques to offer more personalized and effective treatment solutions for patients with PTSD and other mental health conditions.  

Draper is addressing these diagnostic and mental health treatment challenges by developing a new capability that combines virtual reality data with psychophysiological sensors to precisely distinguish between PTSD and other conditions. Sensors monitor biomarkers, including the patients’ heart rate, sweat, and pupil diameter, while test subjects experience different types of audio and visual stimuli. Software then analyzes the data from the sensors to develop an objective diagnostic decision. This approach provides a new research-based diagnostic capability that, with additional studies to validate effectiveness, could be used by practicing clinicians to enable more-effective and more-efficient patient care.  

Draper successfully demonstrated this approach with recent studies focused on diagnosing PTSD and major depressive disorder and published the results in the current issue of IEEE Pulse. Prior papers detailing this work have been published in Brain and Behavior and the International Journal of Psychophysiology.

Previous research has demonstrated that stimuli customized to an individual patient’s (idiographic) personal traumatic experience generates robust psychophysiological responses. However, tailoring stimuli takes time and results in an approach that is not ideal for a point-of-care setting in which the time to assess a patient is limited. Instead, Draper’s solution employs generalized (nonidiographic) stimuli that results in an accurate assessment more quickly.  

“We’re engineering a data-collection and analysis solution that can be used in point-of-care settings to assist clinicians in diagnosis, treatment selection and treatment monitoring,” said Andrea Webb, a psychophysiologist and chief scientist for the work at Draper.

Follow-on studies are needed to address larger samples spread over a wide geographic area as well as patients suffering from multiple mental health conditions and other chronic diseases. Additional studies also could inform how to apply this “precision medicine” approach to personalize and tailor medication choices and other forms of therapy for each patient, said Dr. Philip Parks, a program manager and practicing clinician who oversees Draper’s neurotechnology portfolio.

“Once diagnosed with a particular disorder, such as depression, most mental health patients get relatively the same treatment even though their symptoms and response to treatment choices may be quite different,” Parks said. “We hope that one day these technologies will help clinicians ensure that patients get the best possible medication and other treatments at the right time.”

Capabilities Used
Human-Centered Solutions

Draper has continued to advance the understanding and application of human-centered engineering to optimize the interaction and capabilities of the human’s ability to better understand, assimilate and convey information for critical decisions and tasks. Through its Human-Centered Solutions capability, Draper enables accomplishment of users’ most critical missions by seamlessly integrating technology into a user’s workflow. This work leverages human-computer interaction through emerging findings in applied psychophysiology and cognitive neuroscience. Draper has deep skills in the design, development, and deployment of systems to support cognition – for users seated at desks, on the move with mobile devices or maneuvering in the cockpit of vehicles – and collaboration across human-human and human-autonomous teams.

Image & Data Analytics

Draper combines specific domain expertise and knowledge of how to apply the latest analytics techniques to extract meaningful information from raw data to better understand complex, dynamic processes. Our system design approach encompasses effective organization and processing of large data sets, automated analysis using algorithms and exploitation of results. To facilitate user interaction with these processed data sets, Draper applies advanced techniques to automate understanding and correlation of patterns in the data. Draper’s expertise encompasses machine learning (including deep learning), information fusion from diverse and heterogeneous data sources, optimized coupling of data acquisition and analysis and novel methods for analysis of imagery and video data.

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