The war on terror has left thousands of U.S. soldiers both physically and mentally injured, changing their lives forever.
A team of researchers led by Kerry Z. Donnelly, an adjunct assistant professor in the Department of Counseling, has been studying the clinical profiles of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans suffering from traumatic brain injuries (TBI) to design treatments to better the return to civilian life.
The study of brain injuries has evolved along with the history of warfare and combat medicine, but the current medical understanding of TBI has only developed since WWII, Donnelly explained.
"TBI is injury to the brain caused by some kind of insult to the head, such as from a vehicular accident, a fall, firearm injury, assault or even a sports injury," Donnelly said. "It can be caused by penetration, such as from a bullet that pierces the skull or by a blow against the head which causes a closed head injury."
TBI is the leading cause of death and disability in the US, with over 1 million cases of TBI per year, according to Donnelly.
Since the war in Afghanistan began in 2001, about 15 percent of U.S. forces have sustained at least mild TBIs (mTBI), Donnelly said.
There are no known prescription drugs to mask the effects of TBI directly, but prescription drugs can be used to treat associated mood symptoms, according to Donnelly. Drugs used for ADHD (Attention Deficit Hyperactivity Disorder) are helpful for cognitive symptoms, and referrals to a therapist for cognitive rehabilitation are also prescribed.
Donnelly did not originally plan to set up a large-scale study of patients with TBI.
"Our original goal was to develop a standard of clinical care across our network [in upstate New York]. That evolved into a plan to scientifically study our clinical work," Donnelly said. "In subsequent revisions of the research proposal, we added the pieces on health care utilization, quality of life, and psychometric study of the [Veterans Affairs] TBI screening tool."
The clinical profile consists of a composite of personal and combat characteristics, TBI status, cognitive abilities, emotional symptoms, and substance use patterns, according to Donnelly.
The Veterans Affairs (VA) TBI screening tool was mandated by Congress to screen all returning veterans for TBI upon their entry into the VA system, Donnelly explained.
"We will see each veteran four times, six months apart, so we can track how his or her symptoms change over time," Donnelly said.
The study will include 500 veterans across upstate New York with at least 200 of them enrolled in the Buffalo area.
The researchers discovered many of the veterans in the current study have something known as mTBIs.
"In mTBI, there is either a relatively brief loss of consciousness or a period of disorientation or confusion following the event. Headache and dizziness are common, as are sensitivity to light and sound, nausea, irritability and sleep disturbance," Donnelly said. "Some people who sustain mTBI complain of problems with thinking or remembering afterward, and they might not remember the injuring event at all."
Moderate to severe TBIs are different, in that a person experiences an extended loss of consciousness, Donnelly explained. Symptoms last longer than an mTBI, and all of the long-term implications of blast-related mTBI are still not fully understood.
"The magnitude of the effects are related to the severity of the injury, the support system available and complications such as trauma at the time of injury," Donnelly said.
Often in mTBI, post-concussion syndrome, post-traumatic stress disorder and substance abuse are common, Donnelly explained.
Donnelly feels honored and grateful to work on this project with co-investigators James P. Donnelly, UB clinical associate professor in the Department of Counseling, and Kathy Smythe, director of the OEF/OIF program, to improve the quality of life for U.S. veterans.
"It is very meaningful to me to help describe and explain the phenomena of what our troops have endured-and are continuing to endure," Donnelly said.
Photo: Courtesy of Laron Fomby
