Military study aims to aid troops with mild TBI

A team of experts at San Antonio Military Medical Center has launched a military study aimed at improving outcomes for service members suffering from a signature wound of today's wars: traumatic brain injury.

The Study of Cognitive Rehabilitation Effectiveness, dubbed the SCORE trial, is examining cognitive rehabilitation therapy's value as a treatment for service members with mild TBI.

The Defense and Veterans Affairs departments teamed up on this study to determine the best treatment for combat troops who are experiencing mild TBI symptoms -- such as difficulties with attention, concentration, memory and judgment -- three to 24 months post-injury, explained Douglas B. Cooper, the study's lead and a clinical neuropsychologist for the center's Traumatic Brain Injury Service.

We have a lot of great interventions to help in the first few days after concussion, he said in an interview with American Forces Press Service. We can pull them out, get them rest and get them better.

However, We don't have as many good interventions later on six months, 12 months or two years post-injury, acknowledged Cooper, who also serves as the director of the Military Brain Injury Rehabilitation Research Consortium.

The trial's aim is to determine if cognitive rehabilitation therapy improves chronic mild TBI symptoms and, if so, which interventions work best, on whom and why.

Cognitive rehabilitation, Cooper explained, involves a variety of interventions that help patients with brain injuries reduce, manage or cope with cognitive deficits. It's commonly used to treat patients with brain injuries, whether from concussions, penetrating brain injuries or strokes.

With vast experience in the field, Cooper said, he and his colleagues knew anecdotally that the therapy works, meaning it helps to improve memory and focus in patients. However, he added, experts have cited a lack of evidence-based research tying cognitive rehabilitation to successful treatment of brain injuries.

With a lack of in-hand research, insurance companies began to balk on covering it as a stand-alone treatment. For example, TRICARE, the military's health care plan, won't cover cognitive rehabilitation programs that haven't been proven as effective stand-alone therapy for TBI, according to a TRICARE fact sheet.

Rather than step away from the therapy, Congress directed a series of studies to explore cognitive rehabilitation and its effectiveness among troops, Cooper said.

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Military study aims to aid troops with mild TBI