Ingeborg van Teeseling

We’re Closer to Understanding PTSD and Dementia

Amazingly, researchers have found brand new ways to understand PTSD and dementia.

 

As you know, I’m a sucker for good news. Especially now, when we’ve got the leaders we apparently deserve. One who thinks that preventing a war means attacking a country, and another whose fate in God is so large that he believes that the best thing to do in a crisis is to do nothing.

Anyway, enough whinging. There are two developments on the medical front I want you to know about, on two conditions that are both scaring me (and a lot of other people) to bits.

So, I thought it would be a good idea to start this new year and a new decade with a bit of a pick-me-up.

First of all, Alzheimer’s disease. With this illness rapidly claiming more and more people around me, I am desperate for something, anything to shine some light in the darkness. And it seems that a research firm in San Francisco called Cortexyme is getting closer to both an answer to the question of what causes Alzheimer’s and a possible cure.

So far, the medical world has been convinced that one of the main problems of Alzheimer’s is a protein called beta-amyloid that goes crazy and starts messing up the brain. If you’re close to somebody with the illness, you know the dreaded word: “plaque.”

And that word is interesting, because Cortexyme’s new thinking is that a kind of plaque is certainly connected with Alzheimer’s, but of a completely different kind. They point the finger at Porphyromonas Gingivalis, a bacterium mostly found in the oral cavity that causes periodontal disease.

The idea is that the toxins that are released by this bacterium, called gingipains, also cause the brain damage that results in Alzheimer’s. Cortexyme, that specializes in Alzheimer’s research, has now developed an experimental drug called COR388, that should block the gingipains.

To see if that works, they are enrolling 570 people with mild or moderate Alzheimer’s into trials in centers across the United States and Europe. They are also looking at the link between gingipains and a protein by the name of ApoE, one that controls immune responses in the brain.

The interesting thing with this protein is that it seems to be a marker for Alzheimer’s: the higher your number, the more chance of getting the illness. So, people with ApoE2 have a low risk, those with ApoE4 the highest. Now Cortexyme is seeing if it is possible to use COR388 to bring those numbers down and therefore either prevent Alzheimer’s or at least improve symptoms.

Finally, they say, dentistry is being included in general medical research. With hopefully encouraging results.

 

At that time, PTSD was an illness without a solution. People either went into long-term therapy or were prescribed serious drugs, and often both.

 

The other fabulous development I would like to tell you about has to do with PTSD, Post Traumatic Stress Disorder.

Of course, we have known for a few decades that a treatment called EMDR (Eye Movement Desensitization and Reprocessing) can be startlingly successful.

I remember coming across it for the first time in the late 1980s, when I was interviewing most of the Western hostages kept in Lebanon by Hezbollah, most of them for years in dark basements, chained to the wall.

A fair few of them had also been tortured and, when they came out, they were not in a good state.

At that time, PTSD was an illness without a solution. People either went into long-term therapy or were prescribed serious drugs, and often both. The therapy, mostly cognitive behavioral therapy, needed an average of forty sessions.

A lot of people quit halfway through and, out of the rest, only roughly half recovered. There were a lot of suicides, divorces, and other malaise as a consequence, and the medical world was a bit stumped on what to do.

Then a Stanford University psychologist named Francine Shapiro came up with a method that looked ridiculous on paper: sit a person in front of a therapist. While they tell the story of their horrible experience, the therapist makes rapid hand movements from left to right, asking the patient to follow those movements with their eyes.

I remember thinking at the time that she must have lost the plot, so I called her and spoke to her at length. Her theory went like this: the working memory of the brain is great, but its capacity is limited. Basically, it can only do one thing at a time.

So, when you ask somebody to do two things at the same time (tell the story and follow the movements), the memory of the story becomes fainter and less emotional. The more you put weight on the working memory, as it were, the faster you can diminish the memory of the trauma. Because that is the aim, of course: to neutralize the memory, take the sting out of it.

Once you’ve done that, it can take its normal place in our brain, amongst everything else we sort-of remember. Especially in Europe and the United States, EMDR was quickly tried out by the medical profession, who were amazed that most trauma only took one or two sessions to neutralize.

Now, scientific research has proven not only that EMDR works, but on MRI scans and taped therapy sessions, researchers can also see it in action. The World Health Organization has endorsed it and the initial skepticism has disappeared and made way for the joy of possibilities for people who had been given up on before Shapiro came onto the scene. In fact, EMDR now solves problems for 70% of patients.

20% have fewer symptoms and only in 10% does it have no effect. And all of that for a therapy that is non-invasive, non-pharmaceutical, and mercifully brief. That is why a lot of therapists around the world have now developed EMDR 2.0: let patients do as many things as possible at the same time, like walk, calculate, tell the story, spell words, and follow the hand movements.

As a consequence, some traumatic memories don’t even last ten minutes. As one therapist said, “They crack under the pressure of the overload.” It is not that they disappear altogether, it is just that there is no more emotion attached to them. And that lasts.

In June, Francine Shapiro died at age 71. The amount of people she has saved is immeasurable. We owe her an enormous debt of gratitude.

 

Ingeborg van Teeseling

After migrating to Australia from Holland ten years ago and being warned by the Immigration Department against doing her job as a journalist, Ingeborg van Teeseling became a historian instead. She is writing a book and runs Lifebooks, telling people's life stories.

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