An article featured on The U.S. Department of Defense website reads “Since Sept. 11, 2001, more than 2.5 million service members have deployed to Iraq and Afghanistan in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn. The Armed Forces Health Surveillance Center data indicates there have been more than 250,000 cases of TBI [traumatic brain injury] in the military between 2000 and 2012.”
While we have made huge advancements in understanding the brain, soldiers are still experiencing traumatic brain injuries that are debilitating or significantly hindering their daily lives. Oftentimes traumatic brain injury is misdiagnosed as alcohol or drug abuse.
In a blog on Huffington Post, Margaret Stone, President of Veterans Healing Initiative writes “Undiagnosed and untreated PTSD and TBI are in many cases accompanied by depressive disorders, which can be as crippling as the physical wounds a veteran may bear. Depression, moodiness, lethargy and sleeplessness all play a part in these conditions. Without treatment, many veterans self-medicate to seek the mental peace and quiet they find so elusive.”
The good news is that because we are gaining grounds in understanding the brain, we are starting to recognize under- or misdiagnoses.
“The government and VA have begun to address these complex issues. Under General Peter W. Chiarelli, the Army has made significant strides in preventive measures, programs and support for our troops and how best to address brain injuries. A recent study, ‘Army 2020: Generating Health and Discipline in the Force Ahead of the Strategic Reset Report 2012,’ lays out a comprehensive analysis of the behavioral and physical health needs of our troops” says Stone.
According to the Brain Trauma Foundation “Brain injuries are a signature issue of the Iraq and Afghanistan conflicts, and tests to detect them are limited, leading to many troops’ conditions being misdiagnosed or undiagnosed as they return home from combat. Yet there is hopeful news on the horizon.”
While we once thought that chronic brain injuries were typically irreversible, science is showing that cognitive training can significantly enhance the brain’s ability to recover. According to an article featured on University of California’s website, “In a study led by researchers at the San Francisco VA Medical Center and the University of California, San Francisco, a new cognitive training method significantly improved the ability of patients with chronic brain injury to maintain attention on goals and execute tasks – skills that these patients often lack as a result of their injuries.”
A study which has become known as The Vietnam Head Injury Study has allowed for countless improvements and breakthroughs in research, particularly around the human brain’s ability to recover and the cognitive architecture of the brain.
William F. Caveness, a neurologist and veteran of the Korean War documented post-traumatic epilepsy in soldiers injured during the Korean War and became determined to understand more about the brain and the effects of head injuries. In 1967 he began building a registry of living soldiers who had suffered head trauma in Vietnam and by 1970 he had collected information from approximately two thousand servicemen who had experienced traumatic brain injuries.
Information from this study produced immediate improvements in head protection leading the military to redesign helmets before the war had ended. Since data collection was finalized in 1970, it has continued to produce to the medical community greater understanding of the brain. Just this year Dr. Grafman, who took over The Vietnam Head and Injury Study since the founding researcher of the study, Dr. William F. Caveness passed away, has “…published papers on the neural basis of social problem-solving, pathological aggression after brain damage, and the relationship between caregiver style and cognitive decline—all based on Caveness’s research. The study has yielded more than one hundred scientific papers so far and is likely to yield many more.” – The New Yorker.
This study has provided us with life-altering information regarding head injuries, but it has also has provided us with an even greater understanding of how a healthy brain works. When soldiers are injured through shrapnel (pieces of a bomb, shell, bullets or other objects projected out through explosion), typically damage to the brain occurs in one contained area. Being able to study the brain when only specific regions are damaged has proven monumental in understanding how the brain works and has given us research on which regions of the brain affect our cognitive, behavioral and emotional abilities. Emily Anthes of The New Yorker writes “One series of studies revealed that Vietnam veterans with damage to a particular area of the frontal lobe—a region known as the ventromedial prefrontal cortex (vmPFC)—were more aggressive, had reduced emotional intelligence, and demonstrated more stereotypical attitudes about gender than control subjects or veterans with lesions in other areas, providing evidence that the vmPFC is involved in social cognition and conduct. By cataloguing the areas of brain damage in the veterans, and cross-referencing that information with data on their deficits and difficulties, Barbey, Grafman, and their colleagues have been able to map out the neural circuits involved in general intelligence, emotional intelligence, and social problem-solving. They recently discovered that many of the same brain areas—a network of structures in the frontal lobe and parietal cortex—underlie all three of these abilities.”
The Vietnam Head Injury study has also shown us how resilient the human brain is. Grafman says “If you just look at the CT scans and saw the amount of brain tissue missing, you’d say, ‘Oh my god, they’ll have to be in nursing homes.’” But according to The New Yorker, “Many [of the veterans suffering from brain injury] went on to have relatively normal lives. They got married and started families. Most went back to work. Some even stayed in the military. ‘They had their own impairments and deficits, but through a combination of motivation and will, and the care of their family and friends, the majority of them managed to reënter society,’ Grafman said.”
Click here to read the entire article, “Vietnam’s Neuroscience Legacy” by Emily Anthes.