The Other Lasting Trauma

p3140356hdr.jpgThe next frontier in mental-health studies of veterans is the relationship between PTSD and traumatic brain injury, or TBI, signaled by $100 million in research funding set aside for that subject by Veterans Affairs and the Department of Defense in September.

Researchers call TBI the “signature injury” of the conflicts in Iraq and Afghanistan. A neurodegenerative disease, it can result from abrupt and/or repeated blows to the head, such as those caused by improvised explosive devices, which were used often in both wars.

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A recent study at the Boston VA indicates that more than 75 percent of patients with TBI have co-occurring PTSD. Because of the somewhat confusing overlap in causes and symptoms between the two diseases, medical and psychiatric doctors caring for veterans have to communicate in new ways.

“Psychiatrists who are seeing military patients with PTSD need to be on the lookout for TBI, because it’s going to affect not only a patient’s life in general, but it may affect what we do to treat them,” says Dylan Wint of Las Vegas’ Cleveland Clinic Lou Ruvo Center for Brain Health. “And the same with the medical doctor who’s seeing someone who’s had brain trauma. You want to be proactive and ask them about PTSD symptoms and make sure they get help for those.”

The Ruvo Center specializes in integrating care of multiple issues for single patients, and it plans to bring this skill to bear on the problem of PTSD and TBI. The center has already been studying TBI in athletes, says director Jeffrey Cummings, and is now discussing the possibility of extending that work to veterans.

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