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VA'S "BRAIN AT WAR" SYMPOSIUM HIGHLIGHTS OFTEN
SUBTLE, BUT COMMON TRAUMATIC BRAIN INJURY --
"We don't understand the biological mechanisms
very
well. We don't have great treatment for any of
this."
For more information about traumatic brain
injury, use the VA Watchdog search engine...click here...
http://www.yourvabenefits.org/sessearch.php?q=traumatic+brain&op=ph
Story here...
http://pub.ucsf.edu/today/cache/feature/200805191.html
Story below:
-------------------------
SFVAMC “Brain at War” Symposium Highlights Often
Subtle, but Common Traumatic Brain Injury
By Jeffrey Norris
Roadside bombs are a leading cause of injury and death among US soldiers
in Iraq, but few people may be aware that even when there is no direct hit
to the body, shock waves from explosives may damage the brain and impair
thinking and mood. This has occurred even among some veterans who, to the
casual observer, appear unaffected.
Common complaints include headaches, difficulty with memory and thinking,
blurry vision, fatigue, dizziness, irritability and depression. The damage
may be long-lasting and insidious in its cumulative effect on life
quality, according to physicians who have studied and treated veterans.
“Traumatic brain injury can have permanent and devastating consequences
functionally, socially and economically,” said Raymond Swanson, MD, chief
of neurology and rehabilitation services at the UCSF-affiliated San
Francisco Veterans Affairs Medical Center (SFVAMC).
On Friday, Swanson and other physician-scientists outlined challenges and
progress in identifying and treating blast-caused brain injury as part of
a “Brain at War” symposium at SFVAMC.
Speakers included researchers who use the most
powerful magnetic resonance imaging (MRI) technologies and techniques ever
developed to track brain abnormalities that do not show up in computed
tomography (CT) or positron emission tomography (PET) images — or even in
more conventional MR images.
The goal is to understand how specific injuries lead to specific brain
impairments, and to find ways to better treat these injuries to prevent or
lessen long-term damage.
Any medical advances in understanding and treating soldiers injured in war
may also benefit civilians who suffer traumatic brain injury.
Gary Abrams, MD, chief of rehabilitation at SFVAMC, noted that there are
about 1.5 million new cases of traumatic brain injury in the United States
each year due to automobile and other accidents. In many of these cases,
the brain injury is considered mild. Even among veterans, civilian auto
accidents are the most common cause of traumatic brain injury, eclipsing
wartime injury.
Connecting Brain Injury to Loss of Function
 Injury
to brain tissue may be observable through MRI as, for example, tiny sites
of bleeding or of sheared nerve fibers. But the link between brain injury
and loss of brain function is not well understood.
According to Michael Weiner, MD, director of the Center for Imaging of
Neurodegenerative Diseases at SFVAMC, “We don’t understand the biological
mechanisms very well.” Partly as a consequence, Weiner added, “We don’t
have great treatment for any of this.”
Weiner leads imaging studies on veterans with post-traumatic stress
disorder (PTSD), a focus of an afternoon session at Friday’s seminar — and
he and his fellow researchers have obtained preliminary evidence that
specific changes in the brain occur with PTSD. He now is looking at
specific forms of brain injury that can be observed with powerful MRI
techniques. Weiner is comparing PTSD patients with traumatic brain injury
patients, and with patients affected by both disorders. He aims to
identify similarities, differences, or combined effects in the patterns of
brain injury and impaired function.
Another concern of Weiner is the long-term consequences of traumatic brain
injury. Animal studies reveal that brain injury causes amyloid protein to
be deposited in the brain, similar to the amyloid deposition observed in
Alzheimer’s patients.
Through the VA, the Department of Defense and other agencies, the federal
government has boosted research funding for traumatic brain injury. Part
of the difficulty in identifying brain damage due to trauma is the lack of
baseline data on brain functioning for soldiers before they enter
conflict. Individuals vary widely in their performance on tests to measure
thinking and memory.
In many cases, symposium speakers said, soldiers may be reluctant to
complain about symptoms of brain injury, thinking that they will be
perceived as weak. In turn, in some cases, physicians historically have
been hesitant to evaluate patients neurologically or psychologically.
Medical research on traumatic brain injury had already been on the rise
before the Iraq war. Now there is hope that increased awareness of the
problem will reduce stigma.
Symposium speaker Colonel Karl Friedl, PhD, director of the Telemedicine
and Advanced Technology Research Center at the US Army Medical Research
and Materiel Command at Fort Detrick, MD, said that the Department of
Defense has begun collecting baseline neuropsychological data on members
of US armed forces before deployment, and expects to have a substantial
database within a few years.
Other speakers at the symposium session on traumatic brain injury included
Anthony Chen, MD, adjunct assistant professor of neurology at UCSF and
director of the Program in Rehabilitation Neuroscience, based at UC
Berkeley; Douglas Katz, MD, associate professor of neurology at Boston
University School of Medicine; Henry Lew, MD, PhD, clinical associate
professor at Stanford University School of Medicine; Pratik Mukherjee, MD,
PhD, assistant professor of radiology at UCSF; and S. Scott Panter, PhD, a
research chemist and UCSF adjunct assistant professor of neurological
surgery based at SFVAMC.
-------------------------
posted by Larry
Scott
Founder and Editor
VA Watchdog dot Org
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