Researchers seek treatments for veterans combating chronic injury

David Tate

David Tate, associate research professor for the Missouri Institute of Mental Health at UMSL, studies traumatic brain injuries in military veterans to better diagnose and treat their condition.

Mild traumatic brain injury, an underreported risk of military service, can lead to chronic pain and changes in mood. The latest special issue of “Brain Imaging and Behavior” collects recent research on such injuries with a specific focus on military personnel and the veteran population.

“The numbers we’re seeing so far, gathered by the Defense and Veterans Brain Injury Center, show that nearly 20 percent of all service members deployed from 2000 to 2012 suffered some form of TBI (traumatic brain injury),” said David Tate, University of Missouri–St. Louis associate professor of research and director of the Brain Imaging and Behavior Laboratory at the Missouri Institute of Mental Health. “Eighty percent of those were MTBIs.”

Of the more than 300,000 TBIs reported, 85 percent of those were incurred in a non-deployment setting.

“We’re seeing that a lot of this is happening, for example, in garrison, during training, in vehicle accidents,” Tate said.

Even with the high prevalence rate of mild traumatic brain injury found in the most recent reports, some researchers believe the numbers could be higher. One of the most difficult aspects of research and treatment is the lack of a consistent diagnostic framework for discerning a traumatic brain injury from a number of other similar and co-occurring conditions, including post-traumatic stress disorder.

“The trauma of war is unique and something that sets it apart from similar injuries in sports. The Venn diagram of PTSD and MTBI is, essentially, overlapping,” Tate said, placing one hand over the other. “There are unique features to each, but things like short-term memory and attention problems, fatigue, energy dysfunction, these are the hallmarks of both conditions.

“This is very complicated and our current approaches to treatment may not be adequate,” he added. “You have one group here doing this, another group over there doing that. We’re a little disjointed.”

The complexities of the conditions are cause for disparity in accurate diagnosis. Because traumatic brain injuries can impact any area of the brain – and each injury is unique to the person who sustained it and the event that caused it general – patterns have been difficult to analyze, Tate said. This does not discourage him and other researches from studying this health issue, as they believe each discovery and insight is another step toward a potential universal plan of diagnosis and care.

“One of the studies in the journal uses cluster analysis to show the different expressions of mTBI and its comorbidities,” Tate noted. “It shows that there are seven distinct groupings of patients, each with their own unique constellation and comorbidities. It’s an exciting discovery. From there we can develop treatments specific to each cluster.”

The issue features over 12 new research articles and 4 review papers edited by Tate, Baylor’s Elisabeth Wilde and Stephen McCauley, and Harvard Medical School’s Dr. Sylvain Bouix. It can be accessed at: http://link.springer.com/article/10.1007/s11682-015-9445-x. Though the articles are behind a paywall, the issue’s introduction, written by Tate and Wilde, is available for free at the link above. The print version of the issue is now available for purchase as well.


This story was written by Daniel Musgrave, who is pursuing an MFA in Creative Writing at UMSL.

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