A recent study conducted by researchers at the Stony Brook University’s World Trade Center Health and Wellness Program have found traces of dementia in first responders who worked at Ground Zero after the Sept. 11, 2001 terror attacks.
A test sample of 99 responders underwent MRI neuroimaging to determine whether they had the degenerative brain disease. For the purposes of this study, there were two different test groups.
“Half of them were cognitively unimpaired and half of them have cognitive impairment that looks like mild dementia,” said Sean Clouston, an associate professor and lead researcher on the project.
They also selected people who had chronic Post-Traumatic Stress Disorder (PTSD), which has been associated with risk of dementia. Symptomatically, dementia appeared in both groups. This includes visible memory impairments, such as forgetting lists of words. It was also discovered that patients with PTSD and dementia experience more severe physical and cognitive impairments.
Beyond visible symptoms, the researchers also viewed MRI imagery — 3D pictures of the inside of the brain — focusing on white matter health or the center region of the brain. They determined how healthy the brain is based on identification of atrophy. Researchers also used a method called connectometry to analyze the differences between test groups.
“We found that the connectome for these individuals with PTSD and cognitive impairment really looked quite different from the individuals that had cognitive impairment alone,” Clouston said. “We also found that both of those groups differed from people who were not cognitively impaired,” he continued.
Past studies have found that people with PTSD often show cognitive difficulties and that their brains show signs of neurodegeneration. Clouston said the results of dementia in World Trade Center first responders are nonspecific, meaning that they can’t currently classify their results as a specific type of dementia.
“Our [study] is the first to show that these individuals can have dementia that looks very different from other types,” he said. "And to show that those symptoms are not necessarily just a part of PTSD but may show a sign that long term PTSD is leading to something that is actually relatively new.”
While there aren’t many promising treatments for dementia, Clouston suggests that monitoring cardiovascular health can be important. The research team is running additional testing and trying to rule out larger diseases. This includes using a new way of diagnosing Alzheimer’s, the most common type of dementia. They will also be connecting with responders to further develop research on individual cases based on where they were and what they were doing at ground zero. Going forward, Clouston and his team plan to also investigate the immune system.
“We are going to take a broader approach with the immune system to isolate what is going wrong in hopes of maybe developing a therapy for this particular disease,” he said.
The U.S. Justice Department administers the September 11th Victim Compensation Fund, which provides funding for first responders to pay their medical bills, including treatments at the World Trade Center Health Program.
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