Walter Reed National Military Medical Center
Walter Reed-Bethesda, the largest DVBIC site, is less than five miles from DVBIC headquarters. Service members who are air-evacuated from Landstuhl Regional Medical Center in Germany come directly to Walter Reed-Bethesda. A service member’s stay may be brief before continuing to another CONUS destination, or it may be extended if a service member becomes attached to the Warrior Transition Brigade.
Walter Reed-Bethesda’s TBI clinic treats service members with the full spectrum of TBI by providing multidisciplinary evaluation, carefully coordinated treatment plans and patient-centered follow-up care. DVBIC provides integral support to this program. DVBIC’s clinical care coordination and educational programs increase the capacity and overall scope of TBI services in the hospital.
Regional Education Outreach
DVBIC regional education coordinators provide service members, family members, Walter Reed-Bethesda staff and community members with the latest information about TBI. Numerous outreach and education efforts include distributing DVBIC materials, hosting informational booths, delivering basic TBI and symptom-specific classes and coordinating the monthly TBI Staff Lecture Series. The TBI Lecture Series disseminates TBI information to military and civilian providers of all specialties. Video teleconferencing capabilities enable staff to participate from across the country via 15 sites.
Because of its unique accessibility to Landstuhl, Walter Reed-Bethesda reserves the ability to recruit research subjects early on in the TBI treatment process. DVBIC is actively recruiting for 10 IRB-approved protocols:
- Exploring the Natural History of Traumatic Brain Injury within a Military Cohort – A Longitudinal Database and Blood Banking Study aims to improve our understanding of TBI in a military cohort by developing a data repository that contains pertinent TBI-related information, including neurobehavioral, neurocognitive, neuroimaging, blood specimen, and sensory/motor data. It documents long term patient outcomes over 15 years.
- Traumatic Brain Injury and Substance Use Disorders Among Injured Soldiers evaluates the extent and timing of relationship between recent TBI and substance misuse among injured soldiers. It aims to identify risk factors for development or exacerbation of substance misuse.
- A Randomized Exploratory Study to Evaluate Two Acupuncture Methods for the Treatment of Headaches Associated with TBI aims to determine if standardized auricular acupuncture or semi-standardized traditional Chinese acupuncture (TCA) alleviates headaches more effectively than usual care alone in a cohort of active duty military service members with mild to moderate TBI.
- Military Blast-related TBI: A Study of Neuroanatomical and Neurobehavioral Sequelae and Low Cost Clinical Intervention provides data for policymakers on the consequences and treatment of blast-related TBI in the military population. It determines the neuroanatomical effects of blast-related TBI via neuroimaging techniques (MRI, DTI, and PET) and develops prevalence estimates for neuroanatomical and neurobehavioral sequelae of blast-related TBI and tests the efficacy of a low-cost telephonic clinical intervention.
- Brain Indices of Risk for Posttraumatic Stress Disorder (PTSD) after Mild Traumatic Brain Injury aims to improve the ability to predict PTSD in service members with mild TBI. It evaluates the associations between baseline indices of brain structure and function (measured within days of injury) and the development of PTSD symptoms measured at baseline and 3 and 6 months later. It compares brain changes following impact vs. blast mild TBI.
- A Demonstration Program to Test the Efficacy of Peer Visitation for Caregivers of Veterans of OIF/OEF with Polytrauma/Blast-related Injury establishes and evaluates a Caregiver Peer Visitor (CPV) program at WRNMMC to support the family members of servicemen and women who are admitted to WRNMMC with OIF/OEF polytrauma injuries. Core Evaluation Protocol conducts descriptive study designed to integrate clinical outcomes research into the treatment of TBI patients. It ensures that military and veteran TBI patients receive TBI-specific evaluation and follow-up while collecting standardized outcome data that will allow us to evaluate the relative efficacy and cost of various TBI treatment and rehabilitation strategies and defines impact of injury and optimal care for victims of TBI.
- Prospective Traumatic Brain Injury Tracking Protocol (CTF) collects clinical data that is obtained during standard TBI screening to create a master database. It analyzes this data in a descriptive, observational study. The data collected includes type and severity of injury, measures of neurological function, measures of cognitive function, symptomatology, concomitant injuries, PTSD assessment and neurobehavioral symptomatology.
- An fMRI Study of TBI Associated with Blast Injury uses fMRI to investigate the linkage of brain activation to performance of cognitive control and working memory tasks during scanning in service personnel at 3 to 42 months following TBI associated with blast injury compared to non-blast extracranial injury. Using fMRI, it investigates other linkages such as cognitive reserve, executive function, neuropsychiatric co-morbidities, and overall outcome in service personnel imaged at 3 to 42 months post-TBI compared to non-blast extracranial injury.
- A Randomized Controlled Pilot Study of the Effectiveness and Feasibility of Novel Rehabilitation approaches for OIF and OEF Patients with Persistent Complaints of Cognitive Dysfunction Following TBI is a pilot study to determine the feasibility of a novel computer-based program to meet post-discharge needs for subjects complaining of deployment-related cognitive deficits. Feasibility will be demonstrated in terms of improvement in subjective complaints, performance on neuropsychological tests, and compliance and satisfaction with the computer program.
Current Research projects can be viewed at Current DVBIC Studies, Walter Reed NMMC, MD.