Art therapy and underlying fMRI brain patterns in military TBI: A case series

ABSTRACT

TBI and PTSD are global issues and are often referred to as signature wounds of the Iraq and Afghanistan wars. Art therapy can provide unique insights into military service members’ injuries and states of mind via externalisation within an art product; however, interpretation of results is complex and subjective. Advance neuroimaging tools such as resting state fMRI can be employed to demonstrate objective measures of brain structure and activity. This case series highlights two distinct patient profiles, suggesting a relationship between resting state connectivity maps and dynamic thalamic connectivity (as well as PCL-C and NSI scores and brain scars) and the corresponding visual elements of masks made during art therapy treatment. Ultimately, this study indicates a need for future research examining potential neurological changes pre- and post-art therapy treatment.

KEYWORDS:

• Art therapy
• military
• TBI
• PTSD
• fMRI
• neuroimaging

Acknowledgements

We would like to thank Arnold Fisher and the Intrepid Fallen Heroes Fund for founding the National Intrepid Center of Excellence. The authors would also like to thank the National Endowment for the Arts for their support.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Melissa S. Walker is the Healing Arts Program Coordinator and an art therapist at the National Intrepid Center of Excellence, a directorate of the Walter Reed National Military Medical Center, and Lead Art Therapist for Creative Forces: NEA Military Healing Arts Network. Melissa works with active duty service members suffering from traumatic brain injury and psychological health conditions. Dedicated to helping recovering military service members safely express their deep thoughts and emotions in a creative environment, Melissa has helped develop the Healing Arts Program at the National Intrepid Center of Excellence since 2010. There, she and her team engage patients in creative arts therapies, powerful treatments for helping them express their invisible wounds. Masks made by service members as part of the NICoE art therapy program were highlighted in a 2015 edition of the National Geographic magazine, and the program is also highlighted in Melissa's 2016 TED talk. Melissa received her Master's Degree in Art Therapy from New York University.

Adrienne M. Stamper, MA, is a Virginia native and earned her dual-Master's degree in Art Therapy and Counseling from George Washington University. She has clinical experience working with various populations, including inpatient-psychiatric, forensic, children suffering from emotional disorders, pediatric oncology, and our military. Adrienne is a dual American/Irish citizen, and has lived and studied abroad in both Rome and India. In 2016, she officially joined The Creative Forces: NEA Military Healing Arts Network, and treats active-duty service members who have been diagnosed with traumatic brain injury (TBI) and underlying psychological health conditions. She is passionate about healing the wounds of war and is particularly interested in exploring the neuroscience behind art therapy and trauma.

Dr. Dominic E. Nathan earned his Ph.D. in biomedical engineering from Marquette University under the guidance of Drs. Robert W. Prost, Ph.D. and Dean C. Jeutter, Ph.D. His dissertation focused on modeling cognitive processes of upper extremity motor control using artificial neural networks. Dr. Nathan is a contractor at the National Intrepid Center of Excellence, Walter Reed National Military Medical Center serving as a Computer Scientist in the department of Neuroradiology. His research interests span the areas of machine learning and nonlinear dynamics for modeling physiological signals and multi-modal data for traumatic brain injury clinical biomarker development.

Gerard Riedy, MD, PhD, is a board-certified neuroradiologist and PhD biochemist with training from Johns Hopkins and MIT. With $15 million in research grants he has directed the NICOE advanced neuroimaging laboratory since its inception in 2010. This laboratory focuses on the implementation and analysis of advanced neuroimaging techniques for the evaluation of military TBI and PTSD.

Additional information

Funding

This work was supported by the Congressionally Directed Medical Research Programs (grant number DM130132).