Department of Veterans AffairsRehabilitation Research & Development Service

Translational Research Center for Traumatic Brain Injury and Stress

Disorders[TRACTS]A Rehabilitation Research and

Development Center of ExcellenceVA Boston Healthcare System

Melissa Amick, InvestigatorRegina McGlinchey, PhD, DirectorWilliam Milberg, PhD, Co-Director

• 1.4 million TBI’s in the United States per year

• 80% mild, 10% moderate, 10% severe

• 50,000 fatalities annually

• 5.3 million Americans - 2% of the US population - live with disabilities resulting from TBI

Prevalence and Incidence of TBI

• Improved armor has made combatants more likely to survive injuries that would have been fatal in previous wars.

• Improved field treatment and rapid transport to state-of-the-art medical facilities.

• 90% survival of wounded who have been transported to these facilities.

• Weapons have changed: IED are the primary weapon. DOD reports that 73% of all military casualties are caused by explosive weaponry.

• Blasts can cause concussion or mild TBI.

Why is there an epidemic of TBI in OEF/OIF?

TBI

SPECIFIC BRAIN TRAUMA EVENT(S)BLAST

COMBAT

PTSD

Vasterling et al. 2010

PTSD mTBI

•Re-experiencing•Shame•Guilt

•Headache•Sensitivity

to Light•Memory Deficit

•Dizziness

++

•Depression/ Anxiety•Insomnia•Irritability/Anger•Trouble Concentrating•Fatigue•Hyperarousal•Avoidance

Stein & McAllister (2009)

Overlapping mTBI & PTSD Symptoms

The mission of the Boston Translational Research Center for TBI and Stress Disorders

(TRACTS) is to understand the modifying impact of traumatic brain injury on the effects of stress-related emotional disorders on brain

structure and function so that we may maximize cognitive and behavioral recovery

through the development of informed therapeutic techniques.

Mission Statement

Translational Research Center for TBI and Stress Disorders Organizational Chart

Project 1: Associative Learning

& Cognition

Core A:Administrative Core

Project 2:Cognitive Behavioral

Therapy

Project 3:Structural and

FunctionalNeuroimaging

Core B:Human Characterization

Core

Core C:Database Management

& Informatics Core

Year 1Cognitive

Rehabilitation of Attention

Year 2Experimental

Treatment of Memory and Executive

Function Impairment

Year 3fMRI Predictors of

CPT-COutcomes

Year 4Integrated

Treatment for Veterans with

Comorbid Pain, PTSD, and PPCS

Year 5To be determined

Neuro-ImagingPersonality

NeuropsychologyMedical

BioinformaticsStatistics

Preliminary Findings

TRACTS Participants Have Complex TBI Histories

Multiple Blast Exposure is common in the TRACTS Sample

Uncomplicated mTBI Rare in the TRACTS Sample

Thanks to:

Regina McGlinchey, DirectorWilliam Milberg, Co-Director

Melissa AmickMike Esterman

Catherine FortierAlex Kenna

Elizabeth LertizJohn Otis

Ann RasmussonDavid Salat

Jennifer VasterlingMieke Verfaellie

Marge AhlquistColleen BarberRachael Dayton

Vitaly DobomyslinPatrick KilduffLindsay MorraWally MustoJon Venne

David Zade

TRACTS Scientists and Professional Staff

The Department of Veterans AffairsRehabilitation Research & Development Service