According to the U.S. Department of Veterans Affairs, 31 percent of Vietnam veterans, 10 percent of Gulf War/Desert Storm veterans and 11 percent of Afghanistan veterans have experienced post-traumatic stress disorder. Their symptoms can include insomnia, poor concentration, sadness, re-experiencing traumatic events, irritability or hyper-alertness, as well as diminished cardiovascular condition.

Medications to treat these conditions have been available for decades, and they provide relief for many of those experiencing PTSD. But some servicemen and women would prefer not to take medication. They don't like the way it makes them feel. Side effects like fatigue, an inability to think clearly and others are common.

A recent report by the Wake Forest School of Medicine is showing promise for those who suffer from PTSD. The school concluded a pilot study using sound to help military veterans heal without the use of medication. It's been used in the past for concussion patients as well.

In this single-site study, 18 service members or recent veterans who experienced symptoms over one to 25 years, received an average of 19 ½ sessions over 12 days. Symptom data were collected before and after the study sessions, and follow-up online interviews were conducted at intervals of one, three and six months.

Dr. Charles Tegeler is the study's principal investigator. He spoke with WFDD's David Ford about the technology called high-resolution, relational, resonance-based, electroencephalic mirroring, known by the acronym, HIRREM.

Dr. Charles Tegeler is a professor of neurology at Wake Forest School of Medicine. (Photo courtesy of Wake Forest Baptist Medical Center)

Interview Highlights

How does HIRREM work?

The process involves having sensors on different parts of the scalp that are continuously monitoring brainwaves. The software analyzes that very quickly, identifies specific frequencies, and translates those into audible tones in real time. Those are then played back by ear buds in very short order. And the brain constantly changes, so what the individual receiving it hears is a series of tones, in essence providing an opportunity in one sense to listen to the song that the brain is playing—or at least to listen to itself—and, figuratively speaking, because of that rapid updating about information regarding its own pattern, to look at itself in an electronic or acoustic mirror.

How does allowing the brain to look at itself in this way help reduce PTSD symptoms?

Somehow that rapid updating about its own pattern really does support the brain to make self-adjustments toward improved balance or reduced hyperarousal to sort of reset stress response patterns that had become rewired or kind of stuck because of repetitive or chronic traumatic events.

Is the brain resetting process where the mystery lies for researchers?

Yes. The exact mechanism remains to be fully understood, but it appears that resonance between the acoustic stimulation and the oscillating networks in the brain play some role, potentially like a musical instrument tuning itself. But, when we see the brain have an opportunity to do that, we observe that in most folks the brain pattern will shift towards improved balance and reduced hyperarousal. And the correlative of that is that now they typically begin to report reduced symptoms.

What has been the most promising feedback you've received from the 18 service members involved in the pilot study, and what have been the most encouraging results to you professionally?

That so many of them had struggled for so many years with symptoms and had tried so many things, and so for them it was wonderful that they were able to observe benefits, reduced symptoms and things they'd struggled with for a long time. And from our perspective, seeing benefits in the autonomic nervous system function. One of the gratifying things with that specific project was that it seemed to be very well tolerated—we had no one drop out of that project—and we also saw durability. We did follow-up up to six months online after they left us to check symptoms, and we saw durability in those symptom reductions up to six months.

On plans for HIRREM research.

Ultimately, our vision for the future could be that we could use this to focus on improved wellness, wellbeing, prevention. Wouldn't it be wonderful to help mitigate the effects of that chronic stress—turn the spigot off before it becomes a raging torrent causing symptoms and diseases? So, looking to try to apply this in other ways before it gets to the stage of severity that many of these initial groups we worked with had reached.


An online version of the study results is in the December 22 edition of the journal Military Medical Research.




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