NeuroRehabilitation - Volume 55, issue 3

Authors: Hinds II, Sidney R. | Cifu, David X.

Article Type: Research Article

Abstract: BACKGROUND: Conducting mild traumatic brain injury (mTBI) longitudinal studies across multiple sites is a challenging endeavor which has been made more challenging because of COVID-19. OBJECTIVE: This article briefly describes several concerns that need to be addressed during the conduct of research to account for COVID-19’s impact. METHODS: The recent actions and steps taken by the Long-term Impact of Military-relevant Brain Injury Consortium (LIMBIC)-Chronic Effects of Neurotrauma Consortium (CENC) researchers are reviewed. RESULTS: COVID-19’s effects on the conduct of LIMBIC-CENC for the short-term and long-term were considered to ensure the study continued safely for …participants and researchers. COVID-19 may have long-lasting health and especially neurological effects which may confound the quantitative and qualitative measures of this any comparable longitudinal studies. CONCLUSION: The recognition, understanding, and preparation of COVID-19’s impact on a longitudinal military and veteran mTBI population is crucial to successfully conducting LIMBIC-CENC and similar neurological research studies. Developing a plan based on the best available information while remaining agile as new information about COVID-19 emerge, is essential. Research presented in this special issue underscores the complexity of studying long-term effects of mTBI, in a population exposed to and symptomatic from COVID-19. Show more

Keywords: Traumatic brain injury, COVID-19, military, veteran, neurotrauma, neurorehabilitation, neurodegeneration

DOI: 10.3233/NRE-230272

Citation: NeuroRehabilitation, vol. 55, no. 3, pp. 369-374, 2024

Authors: Ragsdale, Katie A. | Nichols, Anastacia A. | Mehta, Mansi | Maples-Keller, Jessica L. | Yasinski, Carly W. | Hyatt, Courtland S. | Watkins, Laura E. | Loucks, Laura A. | Carbone, Elizabeth | Rauch, Sheila A. M. | Rothbaum, Barbara O.

Article Type: Research Article

Abstract: BACKGROUND: The Emory Healthcare Veterans Program (EHVP) is a multidisciplinary intensive outpatient treatment program for post-9/11 veterans and service members with invisible wounds, including posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), substance use disorders (SUD), and other anxiety- and depression-related disorders. OBJECTIVE: This article reviews the EHVP. METHODS: The different treatment tracks that provide integrated and comprehensive treatment are highlighted along with a review of the standard, adjunctive, and auxiliary services that complement individualized treatment plans. RESULTS: This review particularly emphasizes the adjunctive neurorehabilitation service offered to veterans and service members with a …TBI history and the EVHP data that indicate large reductions in PTSD and depression symptoms across treatment tracks that are maintained across 12 months follow up. Finally, there is a discussion of possible suboptimal treatment response and the pilot programs related to different treatment augmentation strategies being deploying to ensure optimal treatment response for all. CONCLUSION: Published data indicate that the two-week intensive outpatient program is an effective treatment program for a variety of complex presentations of PTSD, TBI, SUD, and other anxiety- and depression-related disorders in veterans and active duty service members. Show more

Keywords: Posttraumatic stress disorder, traumatic brain injury, military psychiatry, veterans, mental health, therapy

DOI: 10.3233/NRE-230235

Citation: NeuroRehabilitation, vol. 55, no. 3, pp. 375-384, 2024

Authors: Springer, Shauna | Whitmer, Paul | Steinlin, Morgan | Gray, Lindsey | Blankfield, Jason

Article Type: Review Article

Abstract: BACKGROUND: For decades, thousands of active-duty service members have sought treatment for trauma exposure. Stellate ganglion block (SGB) is a fast-acting nerve block documented in medical literature for nearly a century that has shown promise as a potentially life-altering treatment for post-traumatic stress (PTS). OBJECTIVE: This review aims to answer the practical questions of those who support individuals suffering from trauma: (1) SGB’s safety profile (2) efficacy data (3) potential advantages and limitations, (4) a cross-cultural application example, (5) and the use of SGB in combination with talk therapy to optimize clinical outcomes. METHODS: The current …body of literature, to include several large case series, meta-analyses, and a sufficiently powered randomized controlled trial, were reviewed, and presented to describe the history of SGB for emotional trauma symptoms and address the objectives of this review. RESULTS: Critical consideration is given to the safety and efficacy data on SGB and the evolution in safety-related technologies. Advantages such as decreased barriers to care, rapid onset, and decreased dropout and limitations such as treatment non-response, potential adverse effects, and misconceptions about the treatment are then described. Finally, the cross-cultural application of SGB is explored based on the deployment of SGB in Israel. CONCLUSION: SGB is associated with level 1B evidence and a reassuring safety profile. Evolving the model of care through the combined use of effective biological treatments like SGB with trauma informed talk therapy offers a hopeful path forward for supporting those who suffer from post-traumatic stress. Show more

Keywords: Stellate ganglion block, SGB, post-traumatic stress disorder, PTSD, combat stress disorder, nerve block, military health, veterans health

DOI: 10.3233/NRE-230236

Citation: NeuroRehabilitation, vol. 55, no. 3, pp. 385-396, 2024