Ending the War at Home for TBI Troops - Support & Resources

The Ongoing Battle for Returning Service Members

The period of active conflict has concluded, and our military personnel are returning home after years of dedicated service, often involving multiple deployments. Their service now transitions to new roles – supporting families as parents and caregivers, and contributing to communities through education or employment.

The Prevalence of Traumatic Brain Injury

However, for a significant number, the challenges persist. Traumatic brain injuries (TBIs), frequently termed the defining injury of the Iraq and Afghanistan conflicts, have impacted over 430,000 U.S. service members. The most commonly diagnosed TBI is the “mild” TBI (mTBI), or concussion, accounting for over 82% of all TBI cases among service members.

While many individuals recover from these injuries, thousands continue to experience lasting cognitive difficulties impacting areas like processing speed, attention, and memory – even years following the initial injury. This significantly hinders their ability to reintegrate into work, academic pursuits, and family life. A history of TBI also elevates the risk of developing pre-dementia and dementia later in life.

A National Burden

This presents a considerable hardship for both service members and their families. Furthermore, it represents a loss for the nation, as the skills and experience of these individuals are not being fully utilized.

The Search for Effective Treatments

Over a decade ago, the Department of Defense acknowledged this critical issue and initiated a call for research into novel treatments tailored to these unique war-related injuries. Numerous research teams responded to this challenge.

At Posit Science, we assembled a team of leading clinicians from military hospitals and VA centers nationwide to evaluate a new approach: computerized brain training. Our goal was to rigorously test its effectiveness.

Addressing Two Key Challenges

We identified two primary hurdles to overcome in assisting service members with TBI.

Firstly, the brain training program itself had to demonstrate efficacy. We leveraged our existing BrainHQ program, which had previously shown improvements in cognitive function among older adults in studies funded by the National Institutes of Health. The focus was on adapting this program for the specific needs of younger service members.

BrainHQ’s exercises differ from traditional cognitive training by targeting the fundamental processes of information processing within the brain, utilizing brain plasticity – the brain’s remarkable capacity to reorganize itself through learning and experience.

Secondly, the program needed to be accessible. Many active duty personnel and veterans lack the ability to attend frequent in-person clinic visits due to deployment schedules, educational commitments, or geographical limitations. Computerized brain training offers a solution by delivering interventions remotely, allowing individuals to participate on their own time and in their own homes.

Promising Research Results

The BRAVE Study, published in the journal Brain, involved 83 patients from five U.S. military and veterans hospitals diagnosed with cognitive impairment and mTBI. The study employed a double-blind, randomized controlled trial design.

Participants had, on average, experienced persistent cognitive issues for over seven years prior to the intervention. The study compared BrainHQ’s plasticity-based exercises to attention-demanding video games as an active control.

Researchers observed significant improvements in overall cognition among those utilizing BrainHQ compared to the video game group. The average gain equated to approximately 24 percentile points – a shift from the 50^th to the 74^th percentile. This represents the first scalable intervention to demonstrate significant gains in a rigorous mTBI study.

A subsequent study conducted at NYU, published in NeuroRehabilitation, confirmed and expanded upon these findings. This study included 48 civilians with varying degrees of TBI severity. The results indicated a significant improvement in an objective measure of overall cognition for those using BrainHQ.

Furthermore, participants reported a noticeable improvement in their own cognitive health through self-assessment.

Other Successful Approaches

Other research groups have also achieved success using cognitive compensation techniques delivered in person by trained clinicians, including SMART training (UT Dallas) and CogSMART training (UCSD/VA San Diego).

Bridging the Gap Between Research and Practice

Despite these advancements, much of this valuable research remains underutilized. Congress and the Department of Defense have invested substantial funds in TBI research, yet many military hospitals and VA centers lack the necessary resources – staff, space, technology – to implement these proven interventions.

A coordinated effort from the Department of Defense and the Veterans Affairs Administration is crucial to translate this scientific knowledge into practical application, providing much-needed support to those who have served.

A Continuing Obligation

As military engagements conclude, we must uphold our commitment to ensuring that our nation’s warriors benefit from the research conducted on their behalf. Unlocking the potential of these discoveries will not only empower them but also enrich our entire nation with their contributions.