Traumatic brain injury (TBI) is a serious issue affecting thousands of people in the U.S. every year. For military service members, the impact is even more profound. Since 2000, over 492,000 cases of TBI have been reported, making it one of the defining injuries of modern warfare, according to the U.S. Department of Defense. Many veterans have experienced multiple TBIs, raising concerns about long-term effects on brain health. Given the subjective and nonspecific nature of symptom presentation, treatment and prognosis can be difficult.
Researchers from UTSA, the South Texas Veterans Health Care System and UT Health San Antonio are combatting this challenge thanks to a grant from the San Antonio Medical Foundation.
Jeffrey Howard, associate professor of public health at UTSA, Alicia Swan, director of rehabilitation research at the U.S. Department of Veterans Affairs, and Sara Mithani, assistant professor at the UT Health San Antonio School of Nursing, will receive a $200,000 grant to provide insights that could revolutionize the treatment of TBI in veterans.
Using medical records, clinical assessments, surveys and other resources, the team plans to identify sub-types of TBI in veterans and to analyze associations between those TBI profiles and biomarker, behavioral and clinical outcomes. Ultimately, they will translate those findings into a dashboard that clinicians can use to treat patients with TBI.
“We want to create that immediate feedback loop to translate these findings to something that can be used by the actual clinicians who are treating these patients,” Howard explained. “The dashboard would be interactive, and the clinicians would be able to see useful data trends.”
The team is working with data from a sample of 3,000 veterans, but there’s a challenge to overcome.
The current classification for TBI is based on only a few symptomatic issues. Additionally, this classification doesn’t always account for repeated exposures or severity, so treatment plans sometimes fail.
“There’s so much variability in terms of how patients recover, what their symptoms are and how that translates into subsequent health risks later on,” Howard said. “We are using other kinds of data, like biomarkers and neurological assessments, to come up with a better way to classify TBI patients into more clinically meaningful groupings with a more physiological basis.”
With this innovative plan, the team hopes to provide the insights to create more personalized plans for clinicians to adopt.
As the PI for the research program, Howard primarily will be responsible for the development of the informatics dashboard prototype. Swan will work with the VA to recruit a panel of clinicians who will provide feedback on the dashboard, and Mithani will provide the clinical relevance and oversight to the project.
"Addressing the complexities of TBI requires a collaborative effort across institutions,” said Mithani. “By combining clinical expertise, biomedical research and data-driven approaches, we can develop innovative solutions that truly impact the lives of veterans."
The San Antonio Medical Foundation awards up to five collaborative grants each year to foster and encourage health care and bioscience research organizations to partner in new initiatives. The team hopes that with time and after feedback and fine-tuning, this clinical dashboard can be applied to a wider population of those suffering from TBI.
By redefining how clinicians understand and treat brain trauma in veterans, this innovative project offers hope to a population that sometimes falls through the cracks. For veterans who have struggled with memory loss, chronic pain or the fear of a future shaped by neurodegeneration, this treatment represents more than medical progress.
"Addressing the complexities of TBI demands a unified effort. By leveraging the strengths of multiple institutions, we can accelerate discovery, refine treatment strategies and ultimately improve care for those who have served," Mithani said.