Showing posts with label TRAUMATIC BRAIN INJURY. Show all posts
Showing posts with label TRAUMATIC BRAIN INJURY. Show all posts

Monday, April 13, 2015

Saturday, September 14, 2013

'INVISIBLE WOUNDS' TREATMENT

FROM:  U.S. DEFENSE DEPARTMENT 
Director Discusses Innovations in 'Invisible Wounds' Treatment
By Terri Moon Cronk
American Forces Press Service

WASHINGTON, Sept. 13, 2013 - The Military Health System acknowledges that U.S. troops in previous conflicts haven't been subjected to the circumstances that surround 12 years of war in Iraq and Afghanistan, a senior Defense Department physician said here yesterday during a panel discussion at a warrior-family symposium.

Dr. James Kelly, director of the Defense Department's National Intrepid Center of Excellence, talked about his center's advancements in post-traumatic stress disorder and traumatic brain injury – signature wounds from the wars - in a panel discussion titled, "Innovative Mental Health Solutions – Today and Tomorrow."

The annual symposium is sponsored by the Military Officers Association of America and the National Defense Industrial Association.

Kelly cited problems that stem from the pattern of repeated deployments and training between deployments, combined with an all-volunteer force composed of members put themselves in harm's way time and time again. "It is not the pattern we've previously had in our military," he said.

The idea that the younger generation is somehow softer or in some ways more vulnerable doesn't hold water, Kelly said. "These people are tough as nails," he said to a round of applause from hundreds of audience members.

"What we need to do is innovate, look more in depth, and understand them as people and individuals that have been engaged in ways [for which] we simply have no good track record to point to and say, 'Here's what this is about, and here's what to do about it,'" he said.

Kelly said he and his staff learn as they go at the center, conducting research and treating service members in an intensive four-week program.

In a previous interview with American Forces Press Service, Kelly explained that when service members with severe traumatic brain injury do not respond to conventional medical treatment, they can be referred to the National Intrepid Center of Excellence, but they must also have a co-existing psychological health issue, such as post-traumatic stress disorder, depression or anxiety.

Kelly became NICoE's director five years ago. The center got underway when Defense Department officials invited him -- a former neurology consultant for the Chicago Bears football team -- to join a group of doctors to examine how to treat service members who were exposed to blast injuries and other head trauma.

He and the other doctors were "willing volunteers" drawn to military health care and working with service members coming back from both wars because of blast-related injuries and a variety of other causes of concussions, Kelly said.

The need for innovation in research and in treating service members led to a concept of using "virtual reality war," with service members are immersed in a setting with a vision of what happens when they're inside a Humvee going down a road. The seat begins to vibrate as a bomb goes off, and the smell of burning rubber wafts into the vehicle. The hope, Kelly explained, is that while the service members are in a safe clinic setting, the experience can help them get past the traumatic events they brought back from deployments.

This use of virtual reality shows quantifiable metabolic changes deep inside the brain when it's dealing with stress, Kelly said.

"That's just one of the examples of the kinds of things that we're engaged in that is really novel, innovative," he added. "[It] bridges into areas of the mind ... in ways that traditional medicine -- certainly traditional neurology -- hadn't previously."

Thursday, August 15, 2013

MULTI-INSTITUTIONAL CONSORTIA ESTABLISHED TO RESEARCH PTSD AND TBI

FROM:  U.S. DEPARTMENT OF DEFENSE 

DoD, VA Establish Two Multi-Institutional Consortia to Research PTSD and TBI

           In response to President Obama's Executive Order, the Departments of Defense (DoD) and Veterans Affairs (VA) highlighted today the establishment of two joint research consortia, at a combined investment of $107 million to research the diagnosis and treatment of post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) over a five-year period.

           "VA is proud to join with its partners in the federal government and the academic community to support the President's vision and invest in research that could lead to innovative, new treatments for TBI and PTSD," said Secretary of Veterans Affairs Eric K. Shinseki. "We must do all we can to deliver the high-quality care our Service members and Veterans have earned and deserve."

           The Consortium to Alleviate PTSD (CAP), a collaborative effort between the University of Texas Health Science Center – San Antonio, San Antonio Military Medical Center, and the Boston VA Medical Center will attempt to develop the most effective diagnostic, prognostic, novel treatment, and rehabilitative strategies to treat acute PTSD and prevent chronic PTSD.

           The Chronic Effects of Neurotrauma Consortium (CENC), a collaborative effort between Virginia Commonwealth University, the Uniformed Services University of the Health Sciences, and the Richmond VA Medical Center will examine the factors which influence the chronic effects of mTBI and common comorbidities in order to improve diagnostic and treatment options.  A key point will be to further the understanding of the relationship between mTBI and neurodegenerative disease.

           Since Sep. 11, 2001, more than 2.5 million American service members have been deployed to Iraq and Afghanistan. Military service exposes service members to a variety of stressors, including risk to life, exposure to death, injury, sustained threat of injury, and the day-to-day family stress inherent in all phases of the military life cycle.

           To improve prevention, diagnosis, and treatment of mental health conditions, the President released an Executive Order directing the Federal agencies to develop a coordinated National Research Action Plan. The Department of Defense (DoD), Department of Veterans Affairs (VA), the Department of Health and Human Services (HHS), and the Department of Education (ED) came forward with a wide-reaching plan to improve scientific understanding, effective treatment,  and reduce occurrences of Post-Traumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI), co-occurring conditions, and suicide.

Friday, June 21, 2013

DOD CREATES TISSUE BANK FOR STUDY OF TBI

FROM: U.S. DEPARTMENT OF DEFENSE
DOD Establishes Tissue Bank to Study Brain Injuries

American Forces Press Service

WASHINGTON, June 14, 2013 - The Defense Department has established the world's first brain tissue repository to help researchers understand the underlying mechanisms of traumatic brain injury in service members, Pentagon officials announced yesterday.


The announcement follows a symposium that Defense Secretary Chuck Hagel convened, in which a group of senior defense officials and experts in the medical field and from outside organizations discussed advancements and areas of collaboration regarding traumatic brain injury.

"We have been at war for more than a decade, and our men and women have sacrificed," said Dr. Jonathan Woodson, assistant secretary of defense for health affairs. "The military health care system is bringing all the resources it can to better understand how to prevent, diagnose and treat traumatic brain injuries and to ensure that service members have productive and long, quality lives.

"Our research efforts and treatment protocols are all geared toward improving care for these victims," Woodson continued. "And that will have benefits to the American public at large."

The Center for Neuroscience and Regenerative Medicine Brain Tissue Repository for Traumatic Brain Injury was established at the Uniformed Services University of the Health Sciences in Bethesda, Md., with a multiyear grant from the U.S. Army Medical Research and Materiel Command to advance the understanding and treatment of TBI in service members.

"Little is known about the long-term effects of traumatic brain injury on military service members," said Dr. Daniel Perl, a neuropathologist and director of the brain tissue repository. "By studying these tissues, along with access to clinical information associated with them, we hope to more rapidly address the biologic mechanisms by which head trauma leads to chronic traumatic encephalopathy."

CTE is a neurodegenerative disorder that involves the progressive accumulation of the protein tau in nerve cells within certain regions of the brain. As the tau protein accumulates, it disturbs function and appears to lead to symptoms seen in affected patients such as boxers and, more recently, football players with multiple head trauma.

Defense Department researchers will look at the brain tissue samples to characterize the neuropathologic features of TBI in service members. Important questions to be addressed include "What does blast exposure do to the brain?" and "Do the different forms of brain injury experienced in the military lead to CTE?"

Service members exposed to blasts "are coming home with troubling, persistent problems and we don't know the nature of this, whether it's related to psychiatric responses from engagement in warfare or related to actual damage to the brain, as seen in football players," Perl said. "We hope to address these findings and develop approaches to detecting accumulated tau in the living individual as a means of diagnosing CTE during life -- and, ultimately, create better therapies or ways to prevent the injury in the first place."

"We are learning though the process of discovery the effects of repetitive mild traumatic brain injury, and also how to prevent this issue of chronic traumatic encephalopathy," Woodson said. "The brain tissue repository will enable us to learn even more about how we can treat injuries and prevent future calamity for service members."

Monday, March 18, 2013

CDC DISCUSSES TRAUMATIC BRAIN INJURY


Credit:  Wikimedia Commons.
FROM: CENTERS FOR DISEASE CONTROL
TBI: What You Should Know

Traumatic brain injury (TBI) is a serious public health issue for Americans. Each year, TBI contributes to a substantial number of deaths and permanent disability. A TBI is caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain. The severity of a TBI may range from "mild" to "severe".

According to research from CDC, approximately 3.5 million persons have a TBI in the United States. Of these individuals:
2.1 million received care in emergency departments,
300,000 were hospitalized,
84,000 were seen in outpatient departments,
1.1 million received care from office-based physicians, and
53,000 died.

Previously referred to as the "Silent Epidemic," individuals with this injury may not have any visible scars, and symptoms may not show up or be noticed until hours or days later. Still, a TBI can cause short or long-term problems se¬riously affecting thinking, learning, memory, and/or emotions. A TBI can affect all aspects of an individual’s life, as well as that of their loved ones. This may include relationships with family and friends, as well as their ability to work or be employed, do household tasks, or drive a car.

The most common causes of TBI are from falls and car crashes. While there is no one-size-fits all solution, there are many ways to reduce the chances of a TBI, including:
Wearing a seat belt every time you drive or ride in a motor vehicle.
Never driving while under the influence of alcohol or drugs.
Avoiding activities that can distract you while you drive, such as using a cell phone, texting, and eating.
Wearing a helmet and making sure your children wear helmets while riding a bike.
Helping prevent falls by:
Encouraging older adults to improve their balance and coordination by exercising.
Using safety gates at the top and bottom of stairs to prevent young children from falling.

This March, in recognition of Brain Injury Awareness Month, CDC encourages you to learn more about TBI prevention.

Thursday, September 20, 2012

PTSD AND TBI STUDY TO RECEIVE $100 MILLION

Photo:  Veteran Affairs Secretary Eric K. Shinseki
FROM: U.S. VETERANS AFFAIRS DEPARTMENT
VA, DOD to Fund $100 Million PTSD and TBI Study
From a Department of Veterans Affairs News Release

WASHINGTON, Sept. 19, 2012 - The Department of Veterans Affairs and the Department of Defense today announced they are investing more than $100 million in research to improve diagnosis and treatment of mild Traumatic Brain Injury and Post-traumatic Stress Disorder.

"At VA, ensuring that our veterans receive quality care is our highest priority," Veteran Affairs Secretary Eric K. Shinseki said. "Investing in innovative research that will lead to treatments for PTSD and TBI is critical to providing the care our veterans have earned and deserve."

The two groups, The Consortium to Alleviate PTSD and the Chronic Effects of Neurotrauma Consortium will be jointly managed by VA, and by the Congressionally Directed Medical Research Programs, on behalf of the DOD.

More than 15 percent of service members and veterans suffer impaired functioning as a result of PTSD. CAP will study potential indicators of the trauma, as well as prevention strategies, possible interventions, and improved treatments. Biomarker-based research will be a key factor for CAP's studies.

A primary goal of CENC is to establish an understanding of the after-effects of an mTBI. Potential comorbidities also will be studied; that is, conditions associated with and worsen because of a neurotrauma.

"PTSD and mTBI are two of the most-prevalent injuries suffered by our warfighters in Iraq and Afghanistan, and identifying better treatments for those impacted is critical," Assistant Secretary of Defense for Health Affairs Dr. Jonathan Woodson said. "These consortia will bring together leading scientists and researchers devoted to the health and welfare of our nation's service members and veterans."

On Aug. 31, President Barack Obama signed an executive order to improve access to mental health services for veterans, service members and military families. As part of that executive order, Obama directed DOD, the VA, the Department of Health and Human Services and the Department of Education to develop a National Research Action Plan that will include strategies to improve early diagnosis and treatment effectiveness for TBI and PTSD. He further directed DOD and HHS to conduct a comprehensive mental health study, with an emphasis on PTSD, TBI, and related injuries to develop better prevention, diagnosis, and treatment options.

VA, which has the largest integrated health care system in the country, also has one of the largest medical research programs.

This year, approximately 3,400 researchers will work on more than 2,300 projects with nearly $1.9 billion in funding. Specific information on the consortia, including the full description of each award, eligibility, and submission deadlines, and general application instructions, are posted on the Grants.gov and CDMRP websites.

Sunday, September 2, 2012

ARMY AND NFL WORK TO IMPROVE AWARENESS OF TRAUMATIC BRAIN INJURY

FROM: U.S. DEPARTMENT OF DEFENSE
Army, NFL Team Up to Fight Brain Injuries

By David Vergun
Army News Service


WEST POINT, N.Y., Aug. 31, 2012 - The Army and the National Football League are working together to improve awareness of traumatic brain injury and increase research into its causes, prevention and treatment.

The top leaders of both organizations -- Army Chief of Staff Gen. Ray Odierno and NFL Commissioner Roger Goodell -- met at the U.S. Military Academy Aug. 30 to discuss the issue and sign a letter of agreement to continue sharing resources to combat TBI.

They were joined by a panel of soldiers and retired NFL players who have had concussions while serving on the battlefield and the playing field. About 200 cadets also attended, as well as representatives from Army medicine.

Odierno explained how some of the best traits in soldiers can sometimes prevent them from seeking help following concussions.

"Mental and physical toughness, discipline, team over self and stressing the importance of resilience are fundamental to the cultures of both the NFL and the Army," Odierno said. "We have the Warrior Ethos, reinforced by the Soldier's Creed."

These selfless traits, he said, make it "particularly difficult for individuals to come forward and identify physical and mental issues, especially mental.".

"We are seeking to educate both players and soldiers about TBI, to empower them to seek treatment both on the battlefield and playing field," Odierno said.

The Army and NFL are continuing their dialogue and sharing of research on TBI, said Odierno, citing examples of joint efforts at monitoring TBI, including placing special sensors in the helmets of soldiers and NFL players that can detect a possible concussion following trauma to the head.

NFL players and soldiers are now coordinating strategies and using special types of tests to determine if a concussion has occurred, added Dr. Richard Ellenbogen, chair, Department of Neurological Surgery, University of Washington. He expects research to continue to reduce TBI.

The NFL commissioner then addressed the cadets. "You are the future leaders of Army," Goodell said. "Together, we can make a big difference, sharing medical research, and helping players and fighters and bringing a greater awareness to society as well. I believe we can change our cultures, with athletes and soldiers sharing their experiences."

The cultural shift to which Goodell referred is the reluctance of many football players and soldiers to ask for help after receiving concussions.

"A frank conversation needs to take place at the lowest levels, with the people most powerful in soldiers' lives -- not me, but their platoon sergeants and first sergeants," Odierno said. "Soldiers must be made to realize that there will not be retribution of any kind for asking for help."

"Sometimes the NCOs must make the decision for the soldiers and not penalize them," said Army Staff Sgt. Shawn Hibbard, addressing the reluctance of many soldiers to seek help on their own. "When I got blown up I felt like, 'Hey, I'm mentally still in the fight.' That NCO must check those injured and remove them from the fight so they can get better." Hibbard said he suffered concussions himself during recent combat operations, but was reluctant to seek help.

Maj. Christopher Molino, who also suffered a concussion during recent combat operations, agreed that small unit leaders must step in and take charge. "Removing yourself is counterintuitive to soldiers' instincts. That's why good leadership is important."

Former NFL player Troy Vincent said he had a concussion on the football field so severe, that he was unconscious and didn't recall the event. No one got him to seek help, he explained. "They protected me with some play calls and didn't expose my weakness at the time," he said.

"The coach told me that 70 percent of you is better than 100 percent of the second string [players]," meaning that despite losing 30 percent of his ability to play due to concussion, he was still better than many of the uninjured players. Vincent was a cornerback for the Miami Dolphins, Philadelphia Eagles, Buffalo Bills and Washington Redskins.

Bart Oates, who also suffered a concussion on the playing field, agreed that the mindset is hard to change. He played center for the New York Giants and San Francisco 49ers.

Goodell said that old school mentality of not asking for help will no longer be tolerated. He stressed the importance of accountability. "Myself, the coaches and other members of this organization have a responsibility to make the lives of players better, both on and off the field," he said, adding that he hopes those in other sports -- especially young athletes -- get the message and provide proper leadership and supervision.

"We need to learn to rely on the players to do the right thing; to raise their hand if they need help or ask others to seek assistance," he said. "Someone needs to say 'Hey, you're not feeling too well,' and allow medical personnel to make the call whether to stay in the game. The coaches or players should not make that call. You can play smart as well as tough. Seeking help is playing smart."

The commissioner said he's not satisfied that enough progress has been made. "We're not going to stop; we're going to continue, we're going to make a difference."

Odierno agreed that more has to be done, despite recent policies and directives designed to protect the health of soldiers.

Army Directive-Type Memorandum 09-033, for instance, stipulates that soldiers have a minimum of 24 hours of downtime and get a medical clearance before returning to duty following a blast or vehicle incident.

Maj. Sarah Goldman, program director of Army Traumatic Brain Injury at the Office of the Surgeon General, Rehabilitation and Reintegration Division, emphasized that seeking help more often than not does not take a soldier "out of the fight." She said more than 13,000 service members sustained some form of concussion since 2010 and 95 percent were returned to duty.

Odierno, who played high school football, admitted that he likely would not have sought medical attention for a concussion. "I wouldn't have taken myself out. Someone else would have had to." He added that kind of thinking is wrong.

"I worry about our leaders more than anyone else. They're the ones who feel the burden of leadership and responsibility. They're the ones who won't take themselves out of the fight. I'm asking that leaders look after leaders," he implored. "First sergeants looking after NCOs, sergeants major looking after commanders, senior commanders looking out for junior commanders. We've got to have a bond to take care of each other."

The Army and the NFL have had a close working relationship over the last few years. "It was my honor to visit soldiers in Iraq and Afghanistan," said Goodell. "Our cultures are similar in so many ways. We owe it to our players and soldiers [to remove the stigma of seeking help]."

"Having played football and been the senior commander in Iraq for almost five years, I've personally seen the impact of traumatic brain injury," Odierno said. "Roger and I got together on several occasions. He's passionate about taking care of his players. Our organizations make a really good match. I'm excited."

Odierno said he hopes the initiative helps both soldiers and football players.

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