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Military sharpens new tools for brain injuries

Jun. 24, 2013 - 03:55PM   |  
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Blood tests revealing hidden brain injuries. Drugs that stem the damage. Differences in men and women who suffer head blows. Even a new app to help people determine whether they’ve suffered a concussion.

These are among advances from scientists responding to a wave of traumatic brain injury among troops who fought in Iraq and Afghanistan.

In addition, the Pentagon is poised to launch about $100 million worth of research this year exploring long-term effects of brain injuries and seeking better understanding of psychological illnesses, according to Army Col. Dallas Hack, who coordinates military trauma research.

The new funding is in addition to $700 million spent since 2007 on research into traumatic brain injury, Army Secretary John McHugh said.

Hack was among more than 50 leading experts in the field of neural science gathered at a Pentagon symposium earlier this month to discuss the state of science on brain injury — a wound suffered by nearly 275,000 troops since 2000. Many expressed concern about the pace of progress.

“You are in a universe that is still rather significantly unexplored and not well understood,” Defense Secretary Chuck Hagel told the group.

“A huge issue is the disconnect in the general public — that we know a hell of a lot more about this than we really do,” said retired Gen. Peter Chiarelli, a former Army vice chief of staff.

Chiarelli, chief executive of One Mind, a nonprofit organization devoted to funding new brain-injury research, cited major knowledge gaps, such as predicting long-term effects of even a mild brain injury.

“There’s a whole lot that we don’t know that we need to know,” he told scientists.

In many cases, findings have raised more questions than answers.

A study of more than 900 veterans treated at Department of Veterans Affairs facilities in Palo Alto, Calif., from 2009 to 2011 found differences between women and men who suffered traumatic brain injury. Scientists have no explanation for the differences.

Among veterans who served in Iraq and Afghanistan, a smaller percentage of women than men were diagnosed with TBI. But those women with the injury were much more likely to suffer depression, post-traumatic stress disorder, chronic pain, substance abuse, joblessness or be homeless, according to data presented by Odette Harris, associate professor of neurosurgery at the Stanford University School of Medicine.

An estimated 12-20 percent of troops who returned from Iraq and Afghanistan suffered brain injuries, most of them mild and many from exposure to blasts. The Centers for Disease Control and Prevention estimates that 1.7 million Americans have brain injuries each year.

Other research advances presented at the symposium:

■ Results from two recent studies — one with 215 patients, another with more than 1,200 — confirming that a blood test for locating one or more proteins released into the blood stream after a brain injury was strong evidence for diagnosing these invisible wounds. The first study was by Geoffrey Manley, chief of neurosurgery at San Francisco General Hospital, and the second by Jeff Bazarian, of the University of Rochester Medical Center. Currently, there is no means of diagnosing concussions other than symptoms reported by patients.

■ Among drugs that have shown significant benefits in treating severe head injuries is progesterone, a hormone replacement commonly provided to women going through menopause. Studies show it reduces swelling in the brain and cuts deaths in severe cases by more than half, said researcher David Wright, associate professor of emergency medicine at the Emory University School of Medicine.

■ A new mobile phone app to help people assess whether they have concussion symptoms. Called the Concussion Coach, it was developed in a collaboration with the Department of Veterans Affairs.

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