31 March 2009

Innovative Brain Therapies Offer Hope to Injured Troops

By Gerry J. Gilmore American Forces Press Service
Innovative therapies that have assisted previously comatose patients regain consciousness may be incorporated on a greater scale to treat troops diagnosed with traumatic brain injuries, a brain injury expert said Mar. 23.

Dr. Philip A. DeFina, chief executive and scientific officer at the not-for-profit International Brain Research Foundation Inc., in Edison, N.J., said that, over the past four years, electronic brain stimulation, oxygen-induction, drugs and other therapies were used to bring 43 people, including five injured soldiers, out of minimally-conscious or vegetative states. DeFina, an Army veteran, is also the chief consultant for the brain injury program at the Kessler Institute for Rehabilitation, a for-profit hospital in West Orange, N.J. He was one of several civilian and military guest speakers who attended March 23’s Reserve Officers Association-sponsored seminar in Washington, D.C., on mental health care. Brain injuries can occur because of blunt-force trauma to the head, explosions, and penetrative wounds, DeFina explained. Such injuries, he said, cause oxygen starvation in the brain, from which damage ensues. “There are a number of different types of (brain) injuries that we’ve been dealing with -- all of which have been responding to the protocols,” he said. “What we’re doing proactively, with our consortium of doctors and scientists,” he said, is “to electrically and chemically stimulate the brain.

” Other treatments employed, he said, include drugs and oxygen-inducing regimes, such as hyperbaric oxygen therapy, where the brain is inundated with oxygen. The goal, he said, is to balance the electrical and chemical activity in the brain. “Once we can stabilize electrical-chemical activity, we can optimize what the brain’s capability is at that point,” he said. Doctors can employ functional imagery techniques to examine the state of a person’s neural markers, which are the chemical and electrical patterns within the brain, he said. “We can then use that to guide us for treatment and to predict recovery,” he said. The prognosis for recovery for the five injured soldiers was “close to zero,” he said, before they underwent the treatments at the Kessler institute.

“The brain heals,” DeFina said, noting there are “different levels of improvement” among patients who’d formerly been minimally conscious and/or unresponsive. After treatment, some people “wake up and some people can communicate,” DeFina said. Other people, he said, may be able to perform simple tasks or return to work. “So, we have different levels of the ability to recover,” he said. And, applying such innovative therapies to patients with mild to moderate forms of traumatic brain injury, he said, produces “dramatic results.” Congress has set aside about $6.4 million in Fiscal Year 2009 appropriations funding, DeFina said, so that the foundation can conduct continued research and development of the new therapies in cooperation with military health care organizations. “We’re in the process of accessing those funds,” he said. The foundation has developed close relationships with several Defense Department healthcare components, DeFina said, including the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, headed by Army Brig. Gen. (Dr.) Loree K. Sutton. “Within the last year, we’ve had probably about 30 military doctors from the Army and Marines come visit Kessler to look at the program, including General Sutton,” DeFina said. “We’ve briefed them, we’ve given them formal presentations on all the science, and then showed them the patients that are there. “We’ve gotten a really good response from that,” he said. Many innovative therapies, DeFina said, have been used in a “stand-alone” manner to successfully treat patients with brain injuries. Yet, using those therapies in combination “is even more powerful,” he said.

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