Tuesday, January 13, 2015

Vets get zapped to ease PTSD, and no one really knows why it works


NEWPORT BEACH, CALIF. — The headquarters of Oakley, a maker of recreational and military gear, looks as if it belongs in a war zone. It's a massive bunker with exposed-steel pipes, girders and blast walls. Even the dais in the auditorium is armored.


But on a recent afternoon, the talk inside the building, set atop an arid, inland hillside in Orange County, Calif., was not about fighting wars but about caring for warriors. Doctors, scientists and veterans approached the podium at a conference to present some of the latest tools to help vets recover from wounds both mental and physical: bionics, virtual reality, magnetic waves.


A session called "Healing the Warrior Brain" featureed a trim, bleach-blond former Army staff sergeant named Jonathan Warren, who recounted on video his struggle with post-traumatic stress disorder after combat in Iraq. His flashbacks, panic attacks and booze benders were well chronicled: For a year, the Los Angeles Times tracked Warren's efforts to find peace, including via Veterans Administration therapy.


It didn't work, he said. But now a different Jon Warren is here to say that he is finally free of symptoms, one year after that 2013 story ran. No longer does his worst memory of the Iraq War — failing to rescue his best friend, who nearly burned to death after their Humvee hit a roadside bomb in 2006 — grasps his psyche and inflict guilt.


That's because of a revolutionary new treatment that retuned his brain, he said, and set "my frequencies right." Now he's able to proudly embrace his military service, "to keep the memory, to be able to go there," Warren told the audience, "and not be controlled by it."


The 32-year-old veteran, who also suffered traumatic brain injury in the blast, credits his recovery to something called magnetic resonance therapy, or MRT — a procedure that pulses energy from magnetic coils into his cortex. He and scores of other combat vets have been drawn by word of mouth to a private clinic here for what some of them call "brain zapping."


The unproven procedure is offered at the Brain Treatment Center, located in an unremarkable office park, free of charge to former servicemembers. The veterans exit telling of a miracle cure, a transformation to tranquillity that they, their buddies and families can hardly believe.


"It saved my life," they say, one after another. "I got my husband back," their wives say.


Glowing testimonials also flow from the parents of autistic children treated here, who say they've seen breakthroughs beyond all expectation: children who are truly communicating for the first time, learning normally, behaving like other youngsters instead of dwelling in unknowable private worlds.


Is this a product of science? A matter of faith? Or simply a mystery?


Yes, yes and yes.


Miracles sometimes require all three.


Positive responses


As doctors take on stubborn, baffling neurological disorders such as PTSD, autism and Alzheimer's disease, they are turning to esoteric treatments that require journeys to unexplored frontiers.


"As humans, we can identify galaxies light-years away, we can study particles smaller than an atom. But we still haven't unlocked the mystery of the three pounds of matter that sits between our ears," President Barack Obama said in launching an initiative to understand and map the brain.


The goal of the brain initiative is to harness private, academic and federal research along the lines of the Human Genome Project, this time using experts in physics and medicine to focus on the brain's nearly 100 billion neurons and 100 trillion connections — the circuitry that governs thought, learning and behavior.


Some doctors think the plan is too focused on mapping and not enough on exploring potential cures. One of them is Yi Jin, the Brain Treatment Center's medical director. The affable, Taiwan-born psychiatrist has plowed ahead with MRT for PTSD, autism and other disorders despite limited evidence that it works.


"We are not claiming efficacy, but we are seeing clinical responses that are positive," the doctor said cautiously in an interview, offsetting some bolder testimonials of swift, remarkable improvement in quality of life.


In 2008, the Food and Drug Administration approved the magnetic procedure — applied through what is called transcranial magnetic stimulation — for drug-resistant major depression. Published studies in recent years — one with 20 PTSD patients, another with 30 — reported significant reduction in symptoms in patients receiving this TMS care. The procedure has been shown to be safe and is offered for depression at medical centers including Johns Hopkins in Baltimore.


Jin uses the treatment off-label, customizing it, he said, to realign and synchronize the firing of neurons in each patient's brain depending on the condition: People with Alzheimer's, anxiety, sleep and eating disorders, addiction and tinnitus (ringing in the ears) have gone under the coils that emit the magnetic fields.


He calls it "noninvasive neuromodulation." In May, the clinic became a research affiliate of the University of Southern California's Center for Neurorestoration, whose director touts MRT's potential as "a real game-changer for the treatment of neurological diseases."


More than 100 vets have been through treatment since Jin started offering it in 2013. Many say they had given up on Veterans Administration PTSD approaches — which include behavior therapy, medication and virtual re-exposure to trauma — before finding their way to the clinic.


"One hundred percent responded with very visible change," Jin said.


In June, a National Institutes of Health advisory group on the president's brain initiative listed magnetic treatment as among those that "need to be better elucidated" as regards the potency, scale and duration of their effects. But parents of autistic children often are desperate for a cure and willing to pay Jin's clinic $11,500 and up for a month of daily treatments, usually lasting 30 minutes each and not covered by insurance.


Since opening the Newport Beach center four years ago, Jin estimated, he has used the procedure on about 1,000 people, the large majority of them being treated for autism.


Evidence supporting the therapy's value for autistic patients comes from trials conducted at the University of Louisville with more than 200 higher-functioning autistic children. About 90 percent of them showed improvement, said Manuel Casanova, the psychiatrist and neuroscientist who carried out the federally funded studies.


"You can actually make a difference," he said. But how much of a difference and for how long? Casanova is forthright: "I do not have good answers." A more expansive trial, involving more research centers, is needed.


'It's like gold dust on the belly'


In the spring, Jin and others with the center made the rounds in Washington, D.C., briefing officials at the Pentagon and Veterans Administration and Sen. Lindsey Graham, R-S.C., on their PTSD findings. They urged a pilot program to give veterans immediate access to the treatment, which they said could be simply implemented with a couple of MRT machines, which cost about $50,000 each.


But the VA needs controlled clinical trials. So, striving to gain credibility, the center launched a double-blind trial in October for 48 vets who reported PTSD symptoms, and it expects to launch one for 400 autistic patients early this year — both at the University of California at San Diego.


"Right now it's like we're selling snake oil," acknowledges Kevin Murphy, a pediatric radiologist and oncologist running the PTSD and autism trials. "It's hard to believe, and if I hadn't had my own son treated, I wouldn't have believed it."


Murphy said that after three to four months of magnetic therapy, his 10-year-old, who has Asperger's syndrome, showed major improvement, to the point of no longer needing a constant one-on-one school aide, reading at a high school level and acing spelling tests when before he could barely write.


"I have colleagues saying, 'What's the mechanism?' " Murphy says after his talk at the Oakley conference. "I say I don't know. I'm not at the point where I can say I understand these things."


It's like magic, then?


Yes, he said, then mentions a medieval cure. "It's like gold dust on the belly."


Getting the treatment


On a recent day at the Brain Treatment Center, a former Marine helicopter crew chief reclines in a medical suite, eyes closed, while a bearded ex-Army squad leader holds a paddle-shaped wand over the forehead of his fellow Iraq combat veteran.


Click-click-click.


For six seconds, a staccato beat ensues from the device. Then 54 seconds of silence before the clicking resumes.


"It's almost like a magnetic massage, a little tickle," said Ryan Wood, the man with the wand, who swears by the PTSD treatment he received here himself. Jin has hired 10 veterans, including Wood, 30, who is the center's operations coordinator, and Jon Warren, 32, who does outreach to fellow veterans.


"It's like waking up from a good nap," said Joseph Hummel, 37, the former Marine, who witnessed four comrades die in a fiery helicopter crash at the start of the Iraq war in 2003. "It's like taking a 10-minute snoozer at 2 o'clock, and you feel like you've slept 16 hours."


Hummel, an insurance agent, said his PTSD manifested in chronic insomnia, explosive anger and excessive drinking; he said he was able to sleep normally for the first time in years after his first treatment in March and awoke a far calmer man.


He decided if it worked so immediately for him, it might help his 15-year-old stepson, Andrew, who is autistic.


Andrew used to communicate mainly by reciting random lines from movies, his parents say. Andrew may have thought he was connecting with people — but in fact, his parents say, he never really engaged in two-way conversations, and never started them. He separated himself from the family.


Now the teenager's mother, Joleen Hummel, is sitting in the center's waiting room while Andrew undergoes treatment just a few hours after her husband did. She's recalling what happened after her son's first appointment last year.


"He walked out of the treatment door — he was cracking up and laughing, and he just doesn't do that," she said. "Right away there was something."


That night, she had an actual conversation with her son.


"He was like my child for the first time, talking to me about his future, asking questions about autism, asking me about heaven, what happens when you die. It was like having a conversation with a 14-year-old child I'd never met.


"We talked until we couldn't talk anymore."


Her face, framed by long brown hair, reflects a profound joy.


"I'll never forget that."


Was it possible something else caused this change besides magnetic resonance therapy?


"Oh, no," she said decisively, leaning in for emphasis. "I don't have an explanation for it, other than this. Nothing was out of the ordinary except for coming here and getting the treatment."


Here comes a thin teenager with a skateboard-logo shirt and close-cropped haircut. It's Andrew, finished with treatment. We talk for about 15 minutes. He starts out a bit nervous but becomes engaged; he asks questions; he describes some of his favorite superheroes and movies and school courses.


"I love science," he said, locking eyes with his questioner. "Science is more important than anything."


But faith and love are important, too, the boy said.


"That, and dreams."


'You can't prove it one way or another'


On several occasions, Jin has met with Peter Chiarelli, a blunt-spoken retired general who once led efforts to reduce the Army's alarming suicide rate. Now he is chief executive of One Mind, a nonprofit dedicated in part to finding ways to treat what Chiarelli calls post-traumatic stress. (To avoid the stigma attached to mental illness, the group does not use the word "disorder" in referring to PTSD.)


He and Jin say the condition, to be better treated, must be better diagnosed. They are highly critical of the Department of Veterans Affairs' current self-reporting method, a 20-item questionnaire that asks veterans to recount, for example, how much were they bothered — on a scale of 1 to 5 — in the past month by "repeated, disturbing, and unwanted memories of the stressful experience."


"You can't prove it one way or another," said Chiarelli, who was a top commander in Iraq. "I'm here to tell you that 50 percent who say they have PTS — or some percentage of people — do not have PTS."


As disability certifications for PTSD have become easier to obtain in recent years — VA eased documentation requirements in 2010 — and the number of claimants has soared, the agency has been grappling with false benefit claims. While the total number of vets who suffer from the disorder is uncertain — many avoid reporting it — PTSD has clearly climbed in the aftermath of the wars in Iraq and Afghanistan.


The disorder is the third-most-common service-connected disability in the past 13 years, VA says. Nearly 250,000 recent veterans have received a disability designation of that sort.


Jin thinks he has found the route to solid diagnoses in the electroencephalography readings of veterans, taken before the magnetic treatment and then at regular intervals afterward to measure how neurons are behaving. It's right there: You can monitor the patient's progress, according to Jin.


The retired general agreeed that "we need to understand the biology" of the condition — but, again, where is Jin's evidence of success?


What about all those vets at his clinic who tell of marriages saved, suicides averted, careers restored — all by painless half-hours under the coils. To a man they say ...


"I know, I know," Chiarelli interjected.


"I can go and find you the same group of men that will tell you hyperbaric oxygen is the answer. I can find you a group of men that will convince you that riding horses is the answer. I can go find you a group of men who will tell you that floating on a river and catching fish is the answer."


Maybe they all are answers. Every veteran is different. In the clinic hallway awaiting treatment stands Scott Ralston, 6-foot-6, a former Marine sergeant who survived service in Fallujah. But this warrior will tell you that he could not defeat the uncontrollable anger, the terrible isolation and sense of failure that followed in civilian life. That he spent days of the week prepared to kill himself — until he found the doctor who turned his life around, Jin.


Ralston, 33, has received more than 80 treatments since the end of May. Just being around other veterans has helped, sure, Ralston said, but he is certain the zapping does, too.


"I felt so extinguished, but now I feel a spark in there that wasn't there," Ralston said. "It's a new life for me."


A miracle? You take them where you find them.



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