The U.S. Department of Defense has awarded the UCSD School of Medicine the leadership role in a 10-site, five-year clinical consortium that will focus on gaining a greater understanding of post-traumatic stress disorder and traumatic brain injuries — disorders that have been appearing with alarming frequency lately, especially in military personnel who have participated in the current conflicts in Iraq and Afghanistan.
The consortium has been alotted $60 million out of $300 million set aside by Congress to address the issue of PTSD and TBI, as well as any possible links between the two.
The 10 research sites throughout the United States that comprise the consortium, including one located at the UCSD Medical Center, will work together to research ways in which to possibly prevent, mitigate and treat the symptoms displayed by victims.
“We are lucky in that we actually got two pieces of the whole pie,” said Raul Coimbra, who will be leading the San Diego TBI/PTSD clinical research center. “We are both overseeing the 10 sites involved in the consortium, as well as running a clinical research center right here in San Diego.”
While in the past, blast injuries received during military conflicts frequently resulted in fatalities, the advancement of both medical and military technology has increased survival rates and led to the new problem of how to deal with resulting brain injuries, principal investigator of the consortium Murray B. Stein said.
These battle wounds — referred to as TBI if they are severe, or concussions if they are mild — have been linked to the onset of symptoms associated with PTSD in a greater frequency than can be explained by chance, said Stein, who is also professor of psychiatry and family and preventive medicine at UCSD, and a staff psychiatrist for the VA San Diego Healthcare System.
Though the specific studies that will take place have not yet been selected, the recent discovery that patients exhibiting symptoms of both TBI and PTSD are less able to function on a daily basis than those with just one of the disorders ensures that their connection will undoubtedly be one of the matters investigated.
“One disorder seems to compound the disability of the other, and we don’t completely understand why that is,” Stein said.
Depending on the focus of the studies, investigators will be presented with a wide range of subject pools from which to draw.
“From the VA hospital to the Level 1 Trauma Center at the UCSD Medical Center to the Navy Medical Center next to Balboa Park, we will have the opportunity to recruit individuals for our research from a large variety of target populations,” Stein said.
Researchers are hopeful that studies conducted on possible treatments for PTSD/TBI at the VA hospital — as well as other outpatient sites — could potentially result in findings that might directly benefit those specific populations in question.
With similar tests going on at all 10 sites, it will be possible for researchers to compile large sums of data combining important information from subjects participating in the study at each research center.
“Studies will be set up and planned to run concurrently at the multiple sites so as to increase the number of subjects participating in our research,” Stein said.
Coimbra said researchers involved with the project will be concerned with three primary goals.
“We will be attempting to better understand the relationship between mild TBI and the development of PTSD, as has been observed in the current Iraq conflict; to work on ways in which to attenuate or prevent the symptoms that result from these disorders; and to research ways in which to reintegrate those individuals who suffer from the chronic symptoms of PTSD back into everyday society,” Coimbra said.
The population recruited for each of the specific projects will depend on the focus of the research study.
“If we, for example, decide to do a study in which we test treatments for those suffering from TBI, we will most likely involve several trauma centers in our tests,” Coimbra said.
Researchers hope they will learn how to intervene in cases in which an individual has a TBI, so as to prevent PTSD symptoms from setting in and making a bad situation worse.
Stein, as the consortium’s director, will work with investigators nationwide in hopes of moving toward solutions to some of today’s biggest unanswered questions regarding PTSD and TBI.
“Personally, I am looking forward to working with talented, experienced researchers, and getting to pick their brains as we work toward developing research that will hopefully make a major impact and produce results and working treatments for PTSD/TBI in the near future, if not immediately,” Stein said.