Service Members and Veterans
According to a recent study, "U.S. military service members who endured a mild concussion after blast injury while deployed in Iraq or Afghanistan may continue to experience mental health symptoms as well as decreases in quality of life for at least five years after their injury...The authors note that this suggests the need for more targeted treatment options with longer-lasting benefits."
Websites created by the VA and the Department of Defense for veterans with traumatic brain injury
Make the Connection is a Department of Veterans Affairs website which provides resources for more information for veterans experiencing TBI.
Defense and Veterans Brain Injury Center
This Department of Defense website provides Veterans, Service members, and their families with TBI educational materials and information on care coordination and research.
Mental Health: Effects of TBI is a Department of Veterans Affairs website for those dealing with symptoms of concussions or any severity of TBI.
VA Research on Traumatic Brain Injury gives in-depth descriptions of the following:
VA research into TBI
Information about all aspects of TBI
Investigational treatments for TBI
Coping strategies for Veterans and their families
Government treatment centers
This video is from the PINK Concussions panel "The Faces of Female Brain Injury" at the 2017 National Institutes of Health workshop "Understanding Brain Injury in Women."
Defense and Veterans Brain Injury Center (DVBIC)
The Defense and Veterans Brain Injury Center is the manager for the traumatic brain injury “Pathway of Care” within the Military Health System. DVBIC “promotes state-of-the-science care from point-of-injury to reintegration for service members, veterans, and their families to prevent and mitigate the consequences of mild to severe TBI.”
The Defense and Veterans Brain Injury Center (DVBIC) supports a network of 22 sites around the country which work with traumatic brain injuries. These sites include 18 military treatment facilities and five Department of Veterans Affairs medical centers. Activities at each DVBIC center varies by site and may include research, education, direct care to service members and their families, and helping locate TBI services.
As an example, The Madigan Traumatic Brain Injury Program in Washington State is comprised of an interdisciplinary team that treats TBI in a holistic fashion. All service members, retirees, and families are eligible for this program.
The team includes “Primary Care, Neurology, Psychology, Neuropsychology, Physical Medicine and Rehabilitation, Optometry, Psychiatric NP, PT, OT, Creative Arts Therapist, LPN, Nurse Case Managers, Nurse Educators, Ombudsman (Speech therapy and Integrative modalities including acupuncture, chiropractic care pending).”
National Intrepid Center for Excellence (NICoE)
The National Intrepid Center for Excellence “helps service members and their families manage traumatic brain injury and psychological health” with a holistic, interdisciplinary approach to care. The NICoE center provides cutting-edge diagnostic evaluation, individualized treatment planning, clinical care, and research. There is a 4-week intensive outpatient care program as well. NICoE is an initiative of the Walter Reed National Military Medical Center and is located in Bethesda, Maryland.
Treatment centers which provide free services to veterans
The UCLA Operation Mend intensive treatment program provides:
“intensive, structured treatment program for service members/veterans who have suffered service-related mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD). The six-week program begins with three weeks on the UCLA campus and is designed for patients who require more than regular outpatient care as part of their treatment plan.
Prior to referral into the program, potential participants will spend two-to-five days at UCLA consulting with a multidisciplinary team of TBI and PTSD specialists to ensure the intensive program is the most appropriate treatment option.
Participants in the program will receive the personalized care for which UCLA Operation Mend is known. All care, travel and accommodations are arranged for and provided at no cost to Operation Mend patients and their families. In addition, patients and family members will be picked up at the gate of the airplane upon arrival and transported to and from their hotel and all activities and appointments. Following the onsite three-week program, participants will take part in an additional three weeks of provider-facilitated peer-to-peer support via telehealth to continue refining skills and building community.”
The Brain Treatment Foundation provides veterans with a comprehensive, individually tailored treatment program, at no cost to the veteran. The foundation is located in Irving, Texas, but works with veterans from around the country.
Homecoming For Veterans and the EEG Institute, a world leader in neurofeedback research and training offers neurofeedback, at no cost, for veterans suffering from concussion, mTBI, and Post-Traumatic Stress Disorder (PTSD) through a network of clinicians across the country. Find a neurofeedback clinician here.
Neurological Recovery for the Armed Services is a nonprofit extension of the Neurological Recovery Center. This physical therapy clinic provides free one-on-one rehabilitation services to military and military families affected by neurological impairments including mTBI (mild traumatic brain injuries). The comprehensive neurological rehabilitation clinic includes new technology robotic therapies and virtual reality therapy, plus yoga, massage, therapeutic exercises, and aquatic therapy. The clinic is located in the Dallas Fort-Worth area.
Nonprofit organizations that serve Veterans
Veterans Community Project
“The Veterans Community Project refuses to let any Veteran fall through the cracks. From providing housing to offering walk-in support services, we’re here for everyone who took the oath to serve America.” Veterans Community Project.
The American Legion
The American Legion has good resources for veterans with a concussion / traumatic brain injury. The website has in-depth information on many pertinent topics, such as
how to apply for enrollment in the VA health-care system
community-based outpatient clinics (a good resource for acupuncture treatments, for example)
Veterans of Foreign Wars (VFW)
The Veterans of Foreign Wars provides extensive support to veterans with all types of needs. You can also see recent news concerning the VA and traumatic brain injuries by typing in “traumatic brain injury” into the search tool on the website.
APPs developed by the VA
MAX Impact app for TBI screening, connections to providers, and tools to manage symptoms
MAX Impact is a free app designed by the Washington State Department of Veterans Affairs, and the app is used by veterans in Washington State and around the world.
The app is a “virtual service dog designed to make an impact for veterans who have experienced a traumatic brain injury. Veterans can use a screening tool to determine whether symptoms may be related to a TBI, be connected with area providers who can help, learn how to manage symptoms and better relax, and connect with other veterans with TBIs all in the safety of their own home.”
CBT-i Coach is a free app to help with sleep, using cognitive behavioral therapy
CBT-i Coach is a cognitive behavioral therapy (CBT) app developed by the U.S. Department of Veterans Affairs. Cognitive Behavioral Therapy apps were found to be effective in combatting insomnia in a 2017 research study. The study also concluded the CBT apps have “likely benefits beyond sleep to mental health and well-being.” NPR has an excellent article (Oct 8, 2018) about CBT apps for insomnia, in which several sleep doctors recommend the CBT-i Coach.
Concussion Coach app helps with self-assessment, education, relaxation, and resilience
The U.S. Department of Veterans Affairs has developed a free Concussion Coach app, available at the Apple App Store and Google Play. It is geared towards Veterans and Service members with a mild to moderate concussion. The app provides:
Symptom relief tools including relaxation exercises, and planning tools to build resilience
Educational materials about concussions
Immediate access to crisis resources, personal support contacts, or professional healthcare resources
Veterans using CBD (from hemp or marijuana) as a treatment
For research on CBD use for concussions, go to our section on CBD Research.
There is a growing movement to provide ease of access to CBD products (from either hemp or marijuana) to veterans. Several nonprofit organizations provide no-cost CBD products to veterans as well as a community, group meetings, and policy advocacy: HEROGROWN (national, also includes First Responders) SC VETERANS ALLIANCE (California only), WEED FOR WARRIORS PROJECT, and VETERANS CANNABIS PROJECT.
A suggested reading is this article about SC Veterans Alliance and the promise of cannabis for Veterans on Mashable.
Look for military discounts for CBD hemp products; discounts can be as 40% for veterans. Marijuana dispensaries typically give 10% discounts to veterans. See additional information about using CBD products for a concussion in our section CBD and Concussion Recovery.
Marijuana and the Federal Government
'The benefits of research are unquestionable,' Sens. Orrin Hatch (R-UT) and Kamala Harris (D-CA) wrote in a letter to Sessions on Thursday. 'Ninety-two percent of veterans support federal research on marijuana, and the Department of Veterans’ Affairs is aware that many veterans have been using marijuana to manage the pain of their wartime wounds. America’s heroes deserve scientifically-based assessments of the substance many of them are already self-administering.'” April 12, 2018, Marijuana Moment
Treatments for Concussions
See our section Treatments including Vestibular Therapy (for balance problems/dizziness), Vision Therapy, Physical Therapy, and Hormone Treatment. Additional treatments include Craniosacral Therapy, Massage, Light Therapy, and CBD from marijuana or hemp, focusing on the research related to this issue.
From the VA website:
“TBI and endocrine dysfunction—The work at the VA Puget Sound Health Care System has demonstrated that Veterans with repetitive mTBI have a risk of developing growth hormone deficiency. Having growth hormone deficiency can lead to increased body mass index (BMI), fatigue, and symptoms of depression. These symptoms can then lead to decreases in sleep hygiene, self-esteem, psychological health, cognition, and quality of life. The Puget Sound investigators are in the process of proposing a multisite clinical trial that will investigate the efficacy of growth hormone replacement in those with TBI and growth hormone deficiency.”
See our section on hormone treatment for men and women.
We recommend PINKConcussions which advocates "to improve the pre-injury education and post-injury care for women and girls challenged by brain injury including concussion." PINKConcussions runs a closed Facebook support group for women who are active military or veterans. You can go directly to the Facebook group and click +Join Group.
Light Therapy (Photobiomodulation)
Light Therapy TBI treatment program for veterans
The LED TBI Clinic at the VA Boston Healthcare System at JP Campus is offering the LED treatment to Veterans with traumatic brain injury (TBI). The LED TBI Treatment Program is sponsored by the VACO, CCI. Dr. Yelena Bogdanova, PhD, the LED Clinic Lead, directs the LED Home Treatment Program development and implementation.
Light editing diode (LED) therapy is a noninvasive treatment modality that can be used in the office setting and at home (when indicated). LED is a painless, non-thermal neuromodulation treatment that directly targets cellular functioning of injured brain cells.
Please contact Vivian Ho (email: firstname.lastname@example.org; phone: 857-364-4001) for more information on how to participate in our studies.
A potentially relevant study to veterans is the study by Dr. Margaret Naeser of two retired professional football players who had suffered repetitive head impacts. These men had PTSD, depression, and cognitive difficulties. The in-clinic and in-home light therapy treatments significantly improved their symptoms and their quality of life. See our blog post “New research on light therapy shows promise for patients who have suffered repetitive head impacts and may have CTE based on their medical history.”
There are additional clinical trials studying the use of near-infrared light which is applied directly to the head. These trials are intended to expand upon earlier clinical trials that showed positive results. See the article Can light therapy help the brain? in Research News from the U.S. Department of Veterans Affairs.
Margaret Naeser, PhD, is located at the Boston VA Medical Center, and is a Research Professor of Neurology, Boston University School of Medicine. In this interview with Vielight, she discusses her work studying application of transcranial photobiomodulation (tPBM) as a possible treatment modality to improve cognition in individuals with traumatic brain injury (TBI) and in retired professional football players who may be developing chronic traumatic encephalopathy (CTE).
Article: Traumatic Brain Injury: A Major Medical Problem That Could Be Treated Using Transcranial, Red/Near-Infrared LED Photobiomodulation
We recommend the article by Dr. Margaret Naeser and Dr. Michael Hamblin, published in the journal of Photobiomodulation, Photomedicine, and Laser Surgery. "Clinical studies showing improvements in cognition (executive function and verbal memory), PTSD, and sleep, following a series of transcranial LED treatments in chronic TBI, are promising. For example, significant improvements were reported in executive function and verbal memory, after a series of 18 red/NIR tLED treatments in chronic TBI patients who began LED therapy at 10 months to 8 years post-TBI.
Participants reported improved sleep, and fewer PTSD symptoms, if present. Post-transcranial LED therapy, one participant was able to write checks and pay bills for the first time since an MVA 5 years earlier. For another participant, his mTBI was caused by having been pulled into a blast furnace. His recurring nightmares of this TBI, which had lasted for 2 years, ceased post-tLED. One of the participants was still active duty military but had been unable to return to his unit for 3 years following blast TBI. Post-tLED he returned for further evaluation by his special operations unit." See article.
Pledge your brain to help accelerate research into concussions, TBI, PTSD, and CTE
Boston Brain Bank, a project of the VA, Boston University, and the Concussion Legacy Foundation
The military and veteran communities are encouraged to pledge their brains to the VA-BU-CFL Brain Bank jointly managed by the US Department of Veterans Affairs, Boston University, and Concussion Legacy Foundation. Brain donations will allow researchers at the Boston VA Healthcare System and Boston University to gain a better understanding of military brain trauma exposure. The goal of this research is to advance effective treatments for TBI and CTE.
Pacific Northwest Brain Donor Network - Service Members and Veterans
The Pacific Northwest Brain Donor Network, launched in 2016, is part of an effort to understand the impact of concussions, or impact of mild traumatic brain injury (mTBI), on active-duty military members and veterans. "Researchers at the University of Washington and the local Veterans Affairs health-care system have begun collecting the donated brains of service members to examine them for possible dementia and other disorders linked to repeated blast injury and head trauma." The researchers will be looking to see if the brains of veterans have signs of Chronic Traumatic Encephalopathy, or CTE, which is marked by abnormal accumulations of Tau protein in the brain.
The donated brains will be stored at UW’s brain bank which also stores brains for research into diseases such as dementia. This is the first Brain Bank to focus on studying military injuries.
Contact the Research Hotline at the VA Puget Sound Health Care System at 206-277-5566 or toll-free at 800-329-8387, ext. 65566. The researchers are also working with SightLife.org and the office of the Pierce County Medical Examiner to reach out to the family members of potential donors.