a message to our veterans traumatic brain injury · research to advance the care of traumatic brain...
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Research to Advance
the Care of
Traumatic Brain Injury
Investigators with the Department of Veterans Affairs
(VA) are conducting cutting-edge research aimed at
improving care for Veterans with traumatic brain injury.
T R A U M A T I C B R A I N
I N J U R Y
D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T
Joel Kupersmith, M.D.Chief Research and Development OfficerDepartment of Veterans Affairs
A Message to Our Veterans
VA Research and Development Program:Unraveling the Complexities of Traumatic Brain Injury
With improvements in body armor and battlefield medicine, many military menand women are surviving modern warfare in Afghanistan and Iraq with multiple,complex injuries that would have proved fatal in previous wars. One such injuryis traumatic brain injury (TBI), which can be caused without any visible woundswhen an explosion jars the brain. Estimated to affect at least 20 percent of ourtroops wounded in the current conflicts, TBI can involve symptoms ranging fromheadaches, irritability, and sleep disorders to memory problems, slower thinking,and depression. TBI is also a significant cause of disability outside of militarysettings—most often as the result of assaults, falls, automobile accidents, or sportsinjuries. In the civilian sector alone, TBI has been estimated to cost morethan $56 billion annually.
Because TBI can affect how a person thinks and acts, even mild brain injuries cansignificantly disrupt the lives of Veterans and their families. Current therapeuticstrategies can help patients with TBI regain some degree of function, but thereremains a compelling need for improved methods of care.
VA Research is leading the way in TBI investigation,conducting studies that cover the spectrum ofscreening, diagnosis, rehabilitation, and treatment.
This brochure highlights some of the groundbreakingresearch projects being undertaken by VA’s dedicatedinvestigators—studies that we hope will make animportant difference in understanding TBIand ultimately improve the care available to ourcourageous Veterans coping with this condition. 2009
For questions or additional copies contact:
R&D Communications (12)
103 South Gay Street, Ste. 517
Baltimore, MD 21202
(410) 962-1800 x223
D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T
Research to Advance
the Care of
Traumatic Brain Injury
Investigators with the Department of Veterans Affairs
(VA) are conducting cutting-edge research aimed at
improving care for Veterans with traumatic brain injury.
T R A U M A T I C B R A I N
I N J U R Y
D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T
Joel Kupersmith, M.D.Chief Research and Development OfficerDepartment of Veterans Affairs
A Message to Our Veterans
VA Research and Development Program:Unraveling the Complexities of Traumatic Brain Injury
With improvements in body armor and battlefield medicine, many military menand women are surviving modern warfare in Afghanistan and Iraq with multiple,complex injuries that would have proved fatal in previous wars. One such injuryis traumatic brain injury (TBI), which can be caused without any visible woundswhen an explosion jars the brain. Estimated to affect at least 20 percent of ourtroops wounded in the current conflicts, TBI can involve symptoms ranging fromheadaches, irritability, and sleep disorders to memory problems, slower thinking,and depression. TBI is also a significant cause of disability outside of militarysettings—most often as the result of assaults, falls, automobile accidents, or sportsinjuries. In the civilian sector alone, TBI has been estimated to cost morethan $56 billion annually.
Because TBI can affect how a person thinks and acts, even mild brain injuries cansignificantly disrupt the lives of Veterans and their families. Current therapeuticstrategies can help patients with TBI regain some degree of function, but thereremains a compelling need for improved methods of care.
VA Research is leading the way in TBI investigation,conducting studies that cover the spectrum ofscreening, diagnosis, rehabilitation, and treatment.
This brochure highlights some of the groundbreakingresearch projects being undertaken by VA’s dedicatedinvestigators—studies that we hope will make animportant difference in understanding TBIand ultimately improve the care available to ourcourageous Veterans coping with this condition. 2009
For questions or additional copies contact:
R&D Communications (12)
103 South Gay Street, Ste. 517
Baltimore, MD 21202
(410) 962-1800 x223
D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T
Recent Milestones in Traumatic Brain Injury Research and Care2005 2006 2007 2008
VA establishes thePolytrauma and Blast-Related InjuryQuality Enhancement ResearchInitiative (QUERI) to promote thesuccessful rehabilitationof Veterans with TBI and otherblast-related injuries.
VA, DoD, and other partnersinaugurate the Center for theImaging of NeurodegenerativeDiseases at the San FranciscoVAMC, where researchers studyTBI as well as conditions such asAlzheimer’s disease and Gulf WarVeterans’ illnesses.
VA initiates routine TBI screeningfor all Veterans who served inAfghanistan or Iraq.
VA establishes the Center ofExcellence for Research onReturning War Veterans, basedat the Central Texas VeteransHealthcare System, to study TBI,PTSD, and related conditions.
DoD establishes the Defense Centerof Excellence for PsychologicalHealth and TBI, which willincorporate the Defense andVeterans Brain Injury Center —a program begun by DoD and VAin 1992—and be fully operationalby late 2009.
VA holds a state-of-the-artconference on TBI to furtheradvance research and care.
Research to Advance
the Care of
Traumatic Brain Injury
• Regenerating Nerve CellsVA investigators are working to identifyways to repair the nervous system bysupporting regrowth of nerve cells.Strategies being explored include genetherapy, tissue engineering, and adult stemcell transplantation. Advances in this areahold promise not only for TBI, but alsofor conditions such as spinal cord injury,multiple sclerosis, and Alzheimer’s disease.In one example of recent research in thisarea, VA lab investigators demonstratedpromising methods for coaxing adult stemcells within the hippocampus—the brain’smemory and learning center—to developinto new brain cells.
• Using Medications for TBI Symptoms The Defense and Veterans Brain InjuryCenter, a collaboration between VAand the Department of Defense (DoD),is studying the effectiveness of variousdrugs for treating TBI symptoms such asheadaches, anxiety, and mood swings.
• Advancing Personalized MedicineBecause genetic factors may play a role inhow TBI develops after an injury and howpatients respond to treatment, a new VAregistry will allow for anonymous analysisof DNA samples from Veterans who servedin Afghanistan and Iraq. The goal is tolearn how to use individuals’ geneticinformation to optimize care andtreatment for TBI.
Important areas of VA research in TBI include:
• Characterizing Brain ChangesTBI can result in sometimes-subtle braindamage with changes in memory, attention,thinking, personality, and behavior that arecurrently difficult to diagnose and treat.VA researchers are refining ways to reliablydiagnose TBI and predict patients’outcomes and care needs.
In one example of this work, a VA researchteam is combining two new brain-scantechnologies to help in detection of subtlebrain injuries. One method recordsmagnetic signals that brain cells give off asthey communicate with each other. Thesecond method tracks the movement ofwater molecules through brain tissue.
At another site, VA researchers are studyingbrain cells that have been exposed toextreme pressure inside a lab device called abarochamber. The investigators are usingthe device, which simulates the effects ofexplosions, to help them understand how cellsin the brain respond. The study could supportthe development of therapies that troopswould receive while in a combat zone—eitherbefore they go out on patrol, as a preventivemeasure; or after a blast has occurred, to limitdamage to the brain.
Spotlight on VA ResearchVA’s research related totraumatic brain injury (TBI)is wide-ranging. Among its goals: shedding light on the brain changes
in TBI; improving screening methods andrefining tools for diagnosing the condition;developing drugs to treat brain injury or limitits severity when it first occurs; designingimproved methods for assessing treatmenteffectiveness; helping Veterans with TBI toreintegrate into their communities; andlearning the best ways to help family memberscope and provide support.
“As the stepping stone to advancements in care, research into the causes and treatmentof TBI is crucial to so many Veterans. Even mild to moderate TBI can have far-reaching effectson quality of life, though the outside world may see no telltale signs of the condition.”Michael Selzer, M.D., Ph.D. ,Neurologist and VA’s Director of Rehabilitation Research and Development
• Treating Blast-Related Sensory Loss VA Research is increasing its focus on thehearing and vision loss that often occurs aspart of TBI. For example, investigators atVA’s National Center for RehabilitativeAuditory Research are partnering withaudiologists at Walter Reed Army MedicalCenter to study central auditory processing—how the brain interprets incoming sounds—in service members who have been exposed to blasts.
Other teams of VA investigators are studyingthe prevalence and nature of vision problemsamong Veterans with TBI. Their findingspoint to the need for more comprehensiveevaluations that include, for example,binocular function tests, which may detectsubtle but distressing vision problems thatmay be missed in standard eye exams.
• Supporting ReintegrationVA investigators are examining ways tohelp Veterans with TBI achieve a smoothtransition back into daily life, includingfamily, school, and work roles. To restoreindependence to Veterans with TBI,investigators are looking at such innovativetechniques as robotic movement therapyand driving simulators for assessment andtraining. Researchers are also focusing onsupporting caregivers, by assessing theirneeds and the resources currently availableto them.
• Promoting Best PracticesVA’s Quality Enhancement ResearchInitiative (QUERI) focuses on rapidlytranslating research findings into patientcare. A Polytrauma and Blast-RelatedInjury QUERI coordinating centerhas been established to promote evidence-based “best practices” in care and therebysupport the rehabilitation, psychologicaladjustment, and community reintegrationof Veterans affected by TBI and otherinjuries.
Plans for Further ResearchIn an effort to maximize the benefits fromtraumatic brain injury research, VA’s Officeof Research and Development recently helda conference titled “Research to Improve theLives of Veterans: Approaches to TraumaticBrain Injury Screening, Treatment,Management, and Rehabilitation.”Recommendations from the conferenceincluded calls for enhanced access to TBIdata through a central database, increasedrecruitment of TBI researchers into theVA system, and additional support for TBI clinical trials. VA has already acted onrecommendations from the TBI conferenceand issued a request for new study proposalsreflecting priorities discussed.
Team Approach toTBI CareBecause TBI often occurs along with othersevere injuries, some patients with TBI receivecare through regional VA polytrauma teams.Polytrauma refers to multiple, complexinjuries, often including limb loss, spinal cordinjury, vision or hearing loss, burns, and relatedmedical complications. Those needing themost intensive care are treated at one of VA’sfour main polytrauma centers, in Minneapolis,Tampa, Richmond, and Palo Alto.
Initially established as TBI clinics in the early1990s, these sites now provide comprehensivecare for polytrauma. VA is building a fifthpolytrauma center in San Antonio.
(http://www.polytrauma.va.gov)
More InformationA recent issue of VA’sJournal of RehabilitationResearch and Development(Volume 44, Number 7,2007) is devoted entirely toscientific research on TBIand polytrauma. Among the articles isa discussion of recent studies linkingposttraumatic stress disorder (PTSD) andTBI.Other articles cover topics such as militaryand VA telemedicine systems for patients withTBI; a neuropsychiatric perspective on TBI;hearing, vision, awareness, and balanceproblems following TBI; and community-integrated rehabilitation for TBI. The articles are available online atwww.rehab.research.va.gov.
Recent Milestones in Traumatic Brain Injury Research and Care2005 2006 2007 2008
VA establishes thePolytrauma and Blast-Related InjuryQuality Enhancement ResearchInitiative (QUERI) to promote thesuccessful rehabilitationof Veterans with TBI and otherblast-related injuries.
VA, DoD, and other partnersinaugurate the Center for theImaging of NeurodegenerativeDiseases at the San FranciscoVAMC, where researchers studyTBI as well as conditions such asAlzheimer’s disease and Gulf WarVeterans’ illnesses.
VA initiates routine TBI screeningfor all Veterans who served inAfghanistan or Iraq.
VA establishes the Center ofExcellence for Research onReturning War Veterans, basedat the Central Texas VeteransHealthcare System, to study TBI,PTSD, and related conditions.
DoD establishes the Defense Centerof Excellence for PsychologicalHealth and TBI, which willincorporate the Defense andVeterans Brain Injury Center —a program begun by DoD and VAin 1992—and be fully operationalby late 2009.
VA holds a state-of-the-artconference on TBI to furtheradvance research and care.
Research to Advance
the Care of
Traumatic Brain Injury
• Regenerating Nerve CellsVA investigators are working to identifyways to repair the nervous system bysupporting regrowth of nerve cells.Strategies being explored include genetherapy, tissue engineering, and adult stemcell transplantation. Advances in this areahold promise not only for TBI, but alsofor conditions such as spinal cord injury,multiple sclerosis, and Alzheimer’s disease.In one example of recent research in thisarea, VA lab investigators demonstratedpromising methods for coaxing adult stemcells within the hippocampus—the brain’smemory and learning center—to developinto new brain cells.
• Using Medications for TBI Symptoms The Defense and Veterans Brain InjuryCenter, a collaboration between VAand the Department of Defense (DoD),is studying the effectiveness of variousdrugs for treating TBI symptoms such asheadaches, anxiety, and mood swings.
• Advancing Personalized MedicineBecause genetic factors may play a role inhow TBI develops after an injury and howpatients respond to treatment, a new VAregistry will allow for anonymous analysisof DNA samples from Veterans who servedin Afghanistan and Iraq. The goal is tolearn how to use individuals’ geneticinformation to optimize care andtreatment for TBI.
Important areas of VA research in TBI include:
• Characterizing Brain ChangesTBI can result in sometimes-subtle braindamage with changes in memory, attention,thinking, personality, and behavior that arecurrently difficult to diagnose and treat.VA researchers are refining ways to reliablydiagnose TBI and predict patients’outcomes and care needs.
In one example of this work, a VA researchteam is combining two new brain-scantechnologies to help in detection of subtlebrain injuries. One method recordsmagnetic signals that brain cells give off asthey communicate with each other. Thesecond method tracks the movement ofwater molecules through brain tissue.
At another site, VA researchers are studyingbrain cells that have been exposed toextreme pressure inside a lab device called abarochamber. The investigators are usingthe device, which simulates the effects ofexplosions, to help them understand how cellsin the brain respond. The study could supportthe development of therapies that troopswould receive while in a combat zone—eitherbefore they go out on patrol, as a preventivemeasure; or after a blast has occurred, to limitdamage to the brain.
Spotlight on VA ResearchVA’s research related totraumatic brain injury (TBI)is wide-ranging. Among its goals: shedding light on the brain changes
in TBI; improving screening methods andrefining tools for diagnosing the condition;developing drugs to treat brain injury or limitits severity when it first occurs; designingimproved methods for assessing treatmenteffectiveness; helping Veterans with TBI toreintegrate into their communities; andlearning the best ways to help family memberscope and provide support.
“As the stepping stone to advancements in care, research into the causes and treatmentof TBI is crucial to so many Veterans. Even mild to moderate TBI can have far-reaching effectson quality of life, though the outside world may see no telltale signs of the condition.”Michael Selzer, M.D., Ph.D. ,Neurologist and VA’s Director of Rehabilitation Research and Development
• Treating Blast-Related Sensory Loss VA Research is increasing its focus on thehearing and vision loss that often occurs aspart of TBI. For example, investigators atVA’s National Center for RehabilitativeAuditory Research are partnering withaudiologists at Walter Reed Army MedicalCenter to study central auditory processing—how the brain interprets incoming sounds—in service members who have been exposed to blasts.
Other teams of VA investigators are studyingthe prevalence and nature of vision problemsamong Veterans with TBI. Their findingspoint to the need for more comprehensiveevaluations that include, for example,binocular function tests, which may detectsubtle but distressing vision problems thatmay be missed in standard eye exams.
• Supporting ReintegrationVA investigators are examining ways tohelp Veterans with TBI achieve a smoothtransition back into daily life, includingfamily, school, and work roles. To restoreindependence to Veterans with TBI,investigators are looking at such innovativetechniques as robotic movement therapyand driving simulators for assessment andtraining. Researchers are also focusing onsupporting caregivers, by assessing theirneeds and the resources currently availableto them.
• Promoting Best PracticesVA’s Quality Enhancement ResearchInitiative (QUERI) focuses on rapidlytranslating research findings into patientcare. A Polytrauma and Blast-RelatedInjury QUERI coordinating centerhas been established to promote evidence-based “best practices” in care and therebysupport the rehabilitation, psychologicaladjustment, and community reintegrationof Veterans affected by TBI and otherinjuries.
Plans for Further ResearchIn an effort to maximize the benefits fromtraumatic brain injury research, VA’s Officeof Research and Development recently helda conference titled “Research to Improve theLives of Veterans: Approaches to TraumaticBrain Injury Screening, Treatment,Management, and Rehabilitation.”Recommendations from the conferenceincluded calls for enhanced access to TBIdata through a central database, increasedrecruitment of TBI researchers into theVA system, and additional support for TBI clinical trials. VA has already acted onrecommendations from the TBI conferenceand issued a request for new study proposalsreflecting priorities discussed.
Team Approach toTBI CareBecause TBI often occurs along with othersevere injuries, some patients with TBI receivecare through regional VA polytrauma teams.Polytrauma refers to multiple, complexinjuries, often including limb loss, spinal cordinjury, vision or hearing loss, burns, and relatedmedical complications. Those needing themost intensive care are treated at one of VA’sfour main polytrauma centers, in Minneapolis,Tampa, Richmond, and Palo Alto.
Initially established as TBI clinics in the early1990s, these sites now provide comprehensivecare for polytrauma. VA is building a fifthpolytrauma center in San Antonio.
(http://www.polytrauma.va.gov)
More InformationA recent issue of VA’sJournal of RehabilitationResearch and Development(Volume 44, Number 7,2007) is devoted entirely toscientific research on TBIand polytrauma. Among the articles isa discussion of recent studies linkingposttraumatic stress disorder (PTSD) andTBI.Other articles cover topics such as militaryand VA telemedicine systems for patients withTBI; a neuropsychiatric perspective on TBI;hearing, vision, awareness, and balanceproblems following TBI; and community-integrated rehabilitation for TBI. The articles are available online atwww.rehab.research.va.gov.
Recent Milestones in Traumatic Brain Injury Research and Care2005 2006 2007 2008
VA establishes thePolytrauma and Blast-Related InjuryQuality Enhancement ResearchInitiative (QUERI) to promote thesuccessful rehabilitationof Veterans with TBI and otherblast-related injuries.
VA, DoD, and other partnersinaugurate the Center for theImaging of NeurodegenerativeDiseases at the San FranciscoVAMC, where researchers studyTBI as well as conditions such asAlzheimer’s disease and Gulf WarVeterans’ illnesses.
VA initiates routine TBI screeningfor all Veterans who served inAfghanistan or Iraq.
VA establishes the Center ofExcellence for Research onReturning War Veterans, basedat the Central Texas VeteransHealthcare System, to study TBI,PTSD, and related conditions.
DoD establishes the Defense Centerof Excellence for PsychologicalHealth and TBI, which willincorporate the Defense andVeterans Brain Injury Center —a program begun by DoD and VAin 1992—and be fully operationalby late 2009.
VA holds a state-of-the-artconference on TBI to furtheradvance research and care.
Research to Advance
the Care of
Traumatic Brain Injury
• Regenerating Nerve CellsVA investigators are working to identifyways to repair the nervous system bysupporting regrowth of nerve cells.Strategies being explored include genetherapy, tissue engineering, and adult stemcell transplantation. Advances in this areahold promise not only for TBI, but alsofor conditions such as spinal cord injury,multiple sclerosis, and Alzheimer’s disease.In one example of recent research in thisarea, VA lab investigators demonstratedpromising methods for coaxing adult stemcells within the hippocampus—the brain’smemory and learning center—to developinto new brain cells.
• Using Medications for TBI Symptoms The Defense and Veterans Brain InjuryCenter, a collaboration between VAand the Department of Defense (DoD),is studying the effectiveness of variousdrugs for treating TBI symptoms such asheadaches, anxiety, and mood swings.
• Advancing Personalized MedicineBecause genetic factors may play a role inhow TBI develops after an injury and howpatients respond to treatment, a new VAregistry will allow for anonymous analysisof DNA samples from Veterans who servedin Afghanistan and Iraq. The goal is tolearn how to use individuals’ geneticinformation to optimize care andtreatment for TBI.
Important areas of VA research in TBI include:
• Characterizing Brain ChangesTBI can result in sometimes-subtle braindamage with changes in memory, attention,thinking, personality, and behavior that arecurrently difficult to diagnose and treat.VA researchers are refining ways to reliablydiagnose TBI and predict patients’outcomes and care needs.
In one example of this work, a VA researchteam is combining two new brain-scantechnologies to help in detection of subtlebrain injuries. One method recordsmagnetic signals that brain cells give off asthey communicate with each other. Thesecond method tracks the movement ofwater molecules through brain tissue.
At another site, VA researchers are studyingbrain cells that have been exposed toextreme pressure inside a lab device called abarochamber. The investigators are usingthe device, which simulates the effects ofexplosions, to help them understand how cellsin the brain respond. The study could supportthe development of therapies that troopswould receive while in a combat zone—eitherbefore they go out on patrol, as a preventivemeasure; or after a blast has occurred, to limitdamage to the brain.
Spotlight on VA ResearchVA’s research related totraumatic brain injury (TBI)is wide-ranging. Among its goals: shedding light on the brain changes
in TBI; improving screening methods andrefining tools for diagnosing the condition;developing drugs to treat brain injury or limitits severity when it first occurs; designingimproved methods for assessing treatmenteffectiveness; helping Veterans with TBI toreintegrate into their communities; andlearning the best ways to help family memberscope and provide support.
“As the stepping stone to advancements in care, research into the causes and treatmentof TBI is crucial to so many Veterans. Even mild to moderate TBI can have far-reaching effectson quality of life, though the outside world may see no telltale signs of the condition.”Michael Selzer, M.D., Ph.D. ,Neurologist and VA’s Director of Rehabilitation Research and Development
• Treating Blast-Related Sensory Loss VA Research is increasing its focus on thehearing and vision loss that often occurs aspart of TBI. For example, investigators atVA’s National Center for RehabilitativeAuditory Research are partnering withaudiologists at Walter Reed Army MedicalCenter to study central auditory processing—how the brain interprets incoming sounds—in service members who have been exposed to blasts.
Other teams of VA investigators are studyingthe prevalence and nature of vision problemsamong Veterans with TBI. Their findingspoint to the need for more comprehensiveevaluations that include, for example,binocular function tests, which may detectsubtle but distressing vision problems thatmay be missed in standard eye exams.
• Supporting ReintegrationVA investigators are examining ways tohelp Veterans with TBI achieve a smoothtransition back into daily life, includingfamily, school, and work roles. To restoreindependence to Veterans with TBI,investigators are looking at such innovativetechniques as robotic movement therapyand driving simulators for assessment andtraining. Researchers are also focusing onsupporting caregivers, by assessing theirneeds and the resources currently availableto them.
• Promoting Best PracticesVA’s Quality Enhancement ResearchInitiative (QUERI) focuses on rapidlytranslating research findings into patientcare. A Polytrauma and Blast-RelatedInjury QUERI coordinating centerhas been established to promote evidence-based “best practices” in care and therebysupport the rehabilitation, psychologicaladjustment, and community reintegrationof Veterans affected by TBI and otherinjuries.
Plans for Further ResearchIn an effort to maximize the benefits fromtraumatic brain injury research, VA’s Officeof Research and Development recently helda conference titled “Research to Improve theLives of Veterans: Approaches to TraumaticBrain Injury Screening, Treatment,Management, and Rehabilitation.”Recommendations from the conferenceincluded calls for enhanced access to TBIdata through a central database, increasedrecruitment of TBI researchers into theVA system, and additional support for TBI clinical trials. VA has already acted onrecommendations from the TBI conferenceand issued a request for new study proposalsreflecting priorities discussed.
Team Approach toTBI CareBecause TBI often occurs along with othersevere injuries, some patients with TBI receivecare through regional VA polytrauma teams.Polytrauma refers to multiple, complexinjuries, often including limb loss, spinal cordinjury, vision or hearing loss, burns, and relatedmedical complications. Those needing themost intensive care are treated at one of VA’sfour main polytrauma centers, in Minneapolis,Tampa, Richmond, and Palo Alto.
Initially established as TBI clinics in the early1990s, these sites now provide comprehensivecare for polytrauma. VA is building a fifthpolytrauma center in San Antonio.
(http://www.polytrauma.va.gov)
More InformationA recent issue of VA’sJournal of RehabilitationResearch and Development(Volume 44, Number 7,2007) is devoted entirely toscientific research on TBIand polytrauma. Among the articles isa discussion of recent studies linkingposttraumatic stress disorder (PTSD) andTBI.Other articles cover topics such as militaryand VA telemedicine systems for patients withTBI; a neuropsychiatric perspective on TBI;hearing, vision, awareness, and balanceproblems following TBI; and community-integrated rehabilitation for TBI. The articles are available online atwww.rehab.research.va.gov.
Research to Advance
the Care of
Traumatic Brain Injury
Investigators with the Department of Veterans Affairs
(VA) are conducting cutting-edge research aimed at
improving care for Veterans with traumatic brain injury.
T R A U M A T I C B R A I N
I N J U R Y
D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T
Joel Kupersmith, M.D.Chief Research and Development OfficerDepartment of Veterans Affairs
A Message to Our Veterans
VA Research and Development Program:Unraveling the Complexities of Traumatic Brain Injury
With improvements in body armor and battlefield medicine, many military menand women are surviving modern warfare in Afghanistan and Iraq with multiple,complex injuries that would have proved fatal in previous wars. One such injuryis traumatic brain injury (TBI), which can be caused without any visible woundswhen an explosion jars the brain. Estimated to affect at least 20 percent of ourtroops wounded in the current conflicts, TBI can involve symptoms ranging fromheadaches, irritability, and sleep disorders to memory problems, slower thinking,and depression. TBI is also a significant cause of disability outside of militarysettings—most often as the result of assaults, falls, automobile accidents, or sportsinjuries. In the civilian sector alone, TBI has been estimated to cost morethan $56 billion annually.
Because TBI can affect how a person thinks and acts, even mild brain injuries cansignificantly disrupt the lives of Veterans and their families. Current therapeuticstrategies can help patients with TBI regain some degree of function, but thereremains a compelling need for improved methods of care.
VA Research is leading the way in TBI investigation,conducting studies that cover the spectrum ofscreening, diagnosis, rehabilitation, and treatment.
This brochure highlights some of the groundbreakingresearch projects being undertaken by VA’s dedicatedinvestigators—studies that we hope will make animportant difference in understanding TBIand ultimately improve the care available to ourcourageous Veterans coping with this condition. 2009
For questions or additional copies contact:
R&D Communications (12)
103 South Gay Street, Ste. 517
Baltimore, MD 21202
(410) 962-1800 x223
D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T