Improving Sleep for Veterans with Traumatic Brain Injury

The recent conflicts in Iraq and Afghanistan have brought much needed attention to Traumatic Brain injury (TBI), which occurs in about 19.5% of deployed service members. For many Veterans, mild traumatic brain injury (mTBI) can be associated with many symptoms that persist after injury such as depression, headaches, dizziness, tinnitus, fatigue, trouble with concentration, mood shifts, behavioral changes, seizures, and especially sleep disturbances.

Understanding TBI through Blood-Based Biomarkers

More than 360,000 armed service members sustained a traumatic brain injury (TBI) during combat and training between 2000 and 2016. Veterans with TBI often require healthcare for years after the initial injury. Therefore, having a way to aid in the diagnosis, prognosis, and treatment of TBI is very important. There are blood tests that can detect whether TBI has occurred, but these tests cannot provide details about TBI symptoms. CESAMH Associate Director of Neuroscience, Dr. Victoria Risbrough, and her collaborator Dr. Robert Rissman were awarded a $1.4 million VA Merit Grant to investigate new biomarkers from blood samples that may provide helpful information about TBI symptoms. They will study “exosomes,” which are vesicles (pouches containing proteins and genetic material, such as RNA) that are released from most types of cells, including brain cells. Exosomes can be used to understand the health of brain cells. Exosomes are readily detectable in blood and are promising tools for aiding diagnosis of disorders associated with nerve cell damage. Results of this study may help improve the detection and treatment for deployment-related TBI.

A Different Approach to Treating Combat-Related Conditions

Combat stress can lead to a number of impactful emotional and cognitive conditions, such as Posttraumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD) and mild Traumatic Brain Injury (mTBI). Because symptoms of these disorders tend to overlap, they are often managed with similar medications. The most commonly prescribed medication for these conditions is Sertraline, but it has not been fully successful. To help improve treatment response, CESAMH investigators are exploring a different approach to understanding and treating the symptoms of combat-related conditions.

Instead of using a diagnosis to determine treatment, CESAMH researchers are looking to identify the brain areas involved in producing symptoms associated with PTSD, MDD and mTBI. Their approach is to identify individuals with similar patterns in brain activity. They theorize that understanding the brain areas involved may provide more useful information about successful treatments than using traditional clinical diagnoses. This study is one of the first to link clinical research and clinical practice to best benefit our Veterans.

Gene Variant May Increase Psychiatric Risk After TBI

A variant of the APOE gene may be linked to worse psychiatric symptoms in people who have had a traumatic brain injury, found a VA San Diego Healthcare System study. Study participants with both the gene variant and at least one TBI had more severe symptoms of PTSD, anxiety, and depression than comparison participants.

Treating TBI and PTSD together

Researchers are combining an evidence-based PTSD treatment called cognitive processing therapy (CPT) with a relatively new approach to mTBI called Cognitive Symptom Management and Rehabilitation Therapy, or CogSMART for short.

Seeking New Coping Tools for Veterans with TBI

One of the most effective tools to manage a mild traumatic brain injury (mTBI), is a smartphone calendar app, say VA researchers. Considered the signature injury of the Iraq and Afghanistan wars, mTBI can result in memory loss, mood disturbances and other potentially disabling symptoms. For some, the injury can prove life-altering.