The Military Health System improved warfighter brain health efforts in 2023, spearheading advancements in health care, research, training, and treatments.

Developments in Traumatic Brain Injury Research and Treatment

The Warfighter Brain Health Initiative, launched in 2022, continued its critical work to bring together operational and medical communities for a more unified approach concerning service member brain health and preventing traumatic brain injuries. The initiative’s recent focus is on assessing cognitive capabilities, monitoring brain threats including blast overpressure, and minimizing the effects and risk from exposures and TBIs to improve the health and overall performance of service members.

“We want you in for the long haul, and we want you to have a highly functional and productive life when you leave the military,” said Kathy Lee, lead for the Warfighter Brain Health Initiative in the Office of the Assistant Secretary of Defense for Health Affairs.

The Defense Health Agency continued as a global leader in research on the effects of concussion—known as mild traumatic brain injury—in the military. Its research through the DHA’s Traumatic Brain Injury Center of Excellence fueled updates to concussion protocols to help providers assess and treat concussion from initial injury to acute and post-acute medical settings, and rehabilitation.

Sharing a personal story of a U.S. Marine Corps Sgt. Maj. Troy Black, TBICoE recognized service members may not always seek help after suffering a TBI and reminded service members and their families of available resources.

“In the last 20 years, we now have technology and [an] understanding of TBIs that are different now,” said Black during a TBI-focused podcast. “The knowledge, the capability, the communities’ ability to understand the brain differently, has changed. But concussions have not.” 

TBICoE also reflected on lessons learned from the last 20 years of conflict and how growing knowledge has impacted TBI clinical care for the service member with a presentation on the history, impact, and future of brain health in the military.

New Training Resources 

The DHA’s Hearing Center of Excellence provided in-person clinician training on treating dizziness and imbalance in patients with mild traumatic brain injury.

The week-long, hands-on Military Vestibular Assessment and Rehabilitation course focused on mechanisms of injury less common in the civilian world, such as blast-related trauma and combative blunt trauma. In addition to teaching exercises and movements to restore balance in patients with a concussion, the course highlights return-to-duty requirements and considerations.

TBICoE also published video training for warfighter brain health including specific training for leaders and clinicians. It introduces TBI basics, overlapping signs and symptoms of TBI and PTSD, leader responsibilities, and general diagnostic best practices and explanations of clinical support tools.

Anomalous Health Incidents Assessment Tool

The DHA’s National Intrepid Center of Excellence and the TBICoE developed an assessment tool for sudden, unexplained sensory events, known as anomalous health incidents, or AHI. The tool evaluates patient symptoms to better understand AHI.  

Symptoms may include headache, confusion, memory concerns, pain, nausea, hearing, dizziness, balance issues, or sleep disturbances, and can lead to a condition similar to a post-concussion syndrome.

It helps providers who find “no clear, attributable cause” for these symptoms, according to Dr. Louis French, NICoE’s deputy director.

“Our goal is to maximize recovery of those we treat, regardless of the root cause,” French said. “For those AHI patients whose symptoms diminish their quality of life, we work to ameliorate that.” 

In 2024, the MHS will continue work to protect brain health by connecting its medical expertise and bridging its resources to the operational community.

For the latest on what the MHS is doing to support service member brain health, visit the Warfighter Brain Health Hub, which contains links to brain health and brain injury resources, comprehensive Q&A, the DHA’s Traumatic Brain Injury Center of Excellence, and a reference list of more than 40 news articles, videos, and other updates.