MENDING THE MIND
medical leaders such as Dr. Robert J. Ursano, Chairman of the Department of Psychiatry at the Uniformed Services Uni- versity of the Health Sciences; U.S. Air Force Col Michael S. Jaffee, M.D., for- mer national director of the Defense and Veterans Brain Injury Center (DVBIC) who is currently on the faculty of the San Antonio Uniformed Services Health Education Consortium; and Dr. Don- ald Marion, Director of Clinical Affairs at DVBIC, discussed current solutions, ongoing research, and possible new research angles of attack. Highlights from the discussion follow.
Panelists noted that DoD took an impor- tant procedural step with a June 2010 directive to identify and treat early con- cussion in deployed service members
THE BENEFITS OF EXERCISE
PFC Jeremiah Mullins, a Military Policeman attached to the 1st Battalion, 26th Infantry Regiment, 3rd Brigade Combat Team, 1st Infantry Division, Task Force (TF) Duke, exercises as part of his rehabilitation from mild traumatic brain injury (mTBI) in March 2011. At right is SGT Jeremy Burch, the Noncommissioned Officer in Charge of the TF Duke mTBI reconditioning center. During this portion of mTBI recovery, Soldiers do simple physical activity in order to raise their heart rate and see if symptoms recur. Research has also shown that exercise benefits memory, learning, mood, and sleep, and may hold promise as a possible protective mechanism or a way to reduce the effects of traumatic exposure and mild brain injury. (Photo by SSG Ben Navratil.)
through mandatory medical evaluations and rest for those exposed to certain events. Because this approach does not rely on service members to report symp- toms, more are being screened for injury in theater.
Neurologists, as well as information from the field, suggest that the most useful device to identify concussion within one to two hours after injury may be a smart- phone application that would enable a medic to measure key physiological parameters such as balance, reaction time, and eye tracking, or a ruggedized, field- portable device, such as the Tempus Pro, optimized for military use by TATRC in collaboration with U.S. Army Spe- cial Forces. Tempus Pro, which provides medical data capture, telemonitoring, and
telemetry, recently received recognition by the Secretary of Defense as among the best capabilities in the FY10 Joint Capa- bility Technology Demonstration.
For cognitive assessment, the military currently uses paper-and-pencil tests as well as neuropsychological instru- ments, including the Army’s Automated Neuropsychological Assessment Metrics (ANAM) computerized test. Studies have shown that cognitive tests detect concus- sion effects in individuals even after they report themselves to be symptom-free. Dr. Robert Kane, Project Manager for the Neurocognitive Assessment Tool program at DVBIC, said that computerized tests seem to give more detail than traditional ones, thus illuminating a variety of cog- nitive effects stemming from different types of concussion. He and many others are also enthusiastic about the additional information that virtual reality (VR) might offer.
Dr. Thomas D. Parsons, Director of the NeuroSim Laboratory at the Univer- sity of Southern California’s Institute for Creative Technologies, an Army University-Affiliated Research Center, is developing and testing VR assessment tools for return-to-duty decisions after brain or psychological injury. With Soldiers’ input, his team has recreated multisensory environments and situa- tions from Iraq and Afghanistan.
“The beauty of VR is that it allows us to integrate standardized neuropsychological measures into interactive applications that approximate the real world of a military service member,” Parsons said. The team has worked with other partners, both mili- tary and civilian, to compare results from standardized paper-and-pencil tests as well as ANAM results. “My focus is on vali- dating this technique, working with both clinical and nonclinical populations, so it
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Army AL&T Magazine
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