A Proven Technology Detects mild-Traumatic Brain Injury in Combat

On October 12 at the International Conference on Behavioral Health and Traumatic Brain Injury, St. Joseph's Regional Medical Center, Paterson, NJ, HeadMinder, Inc., presented results of the first Military IRB-approved prospective study to be conducted in-Theater.

The study compared the HeadMinder Cognitive Stability Index (CSI) computerized test battery and the Department of Defense (DoD) Automated Neuropsychological Assessment Metric (ANAM) with the Repeatable Battery for Assessment of Neuropsychological Symptoms (RBANS), a paper-and-pencil neurocognitive test currently used by the DoD to screen soldiers.

The study was designed by Lt. Col. (sep.) Gerald Grant, MD (USAF), Maj. William Isler, PhD (USAF), Maj. Monty Baker, PhD (USAF), David Erlanger, PhD (Chief Scientific Officer and co-Founder of HeadMinder), Tanya Kaushik, PsyD, and Col. Robert Seegmiller (USAF). The objective was to determine the validity and reliability of both computerized screening measures as compared to the RBANS. The CSI was accurate in assessing the severity of cognitive compromise following concussive blast injuries. The CSI Total Score correlated very strongly with the RBANS Total Score (.789) and also showed strong concurrent validity with the RBANS in the domains of Attention (.706) and Memory (.680), domains critical in the assessment of blast-related concussion. ANAM was not useful for identifying memory problems, the domain most frequently impaired on the RBANS, and only a subset of ANAM measures seemed useful for screening attention problems.

The CSI is a 30-minute, Internet-based, computerized test that provides automated, objective measures of attention, memory, response speed, and processing speed for initial evaluation of cognitive functioning. The CSI produces standardized reports that enable triage and decision-making appropriate to a user's qualifications – from medic to neuropsychologist to neurologist and other treatment team members.

Dr. David Erlanger, Chief Scientific Officer of HeadMinder, commented, "The CSI has now been shown, under combat conditions, to be the only telemedicine tool capable of serving the needs of the armed services. Especially given the large backlog of unscreened service members exposed to blasts, the HeadMinder System offers a simple, accurate, and objective screening method that can play a key role in identifying and treating servicemen and servicewomen with undiagnosed brain injuries. The CSI is unique in its ability to track improvement over time as soldiers travel between the Military Health System and the Veterans Administration and civilian medical resources. We believe the HeadMinder platform provides the Department of Defense the opportunity to fully comply with the Wounded Warriors Act by screening and tracking exposed service members' long-term well-being. If implemented today, the entire backlog could be cleared in less than two years."

After 5 years of ducking the issue, the DoD can get off their collective bottoms and start screening the 400,000 troops that have been exposed to blasts in Iraq and Afghanistan. While the study in no way implied that every service member exposed suffered m-TBI, it did imply that approximately 20,000 service members have suffered the injury. It is time to identify them and treat them. There is no need for mindless dead-end research projects.

Since S. Ward Casscells, MD , Undersecretary of Defense - Healthcare, has actively and willfully avoided detecting and treating both m-TBI and mental health issues, it is time to contact your representatives to start getting answers (find your representative, find your senator). His desire to deny disability payments and under report causalities is repellent.

A special note if you are represented by any of the following members:

Senator Patty Murray (D-WA)
Senator Hillary Clinton (D-NY)
Congressman Jack Murtha (D-PA)
Congressman Bill Pascrell (D-NJ)
Congressman Todd Platts (R-PA)

make an effort to contact them as they have taken leading positions to help service members with mild-Traumatic Brain Injury, PTSD and mental health issues.

The study was initially funded by the Henry M. Jackson Foundation. After funding was discontinued, the study was completed with funding provided by PanMedix, Inc., and HeadMinder, Inc.

PanMedix was founded in New York City in 1999. Initially focused on the development and deployment of assessment software, the company has evolved to encompass a full range of pharmaceutical and medical assessment services.

Founded in New York City in 1999, HeadMinder is a technology company that is dedicated to the development of Internet-based neurocognitive assessment tools. HeadMinder tests have been shown to be valid and reliable instruments for evaluating cognitive deficits in a range of injuries and illnesses, including concussion, mild-to-moderate TBI, Multiple Sclerosis, ADHD, Alzheimer's Disease, and chemotherapy-induced cognitive dysfunction in cancer patients.

The House Veterans Affairs Committee chairman accuses VA of criminal negligence, he should have included the DoD as well.

Dr. Ira Katz got caught lying to the press about suicide rates for veterans so he is now standing before the man. Of course James Peake, Veterans Affairs Secretary, defended Katz because he is largely responsible for the scandalous lack of preparation to handle troops returning from OIF/OEF with neurological and psychiatric problems. James Peake was the US Army Surgeon General from 2000 to 2004. During his tenure, his senior staff officers rejected the implementation of programs that would have dealt not only with mental health issues but also traumatic brain injury. US Army clinicians and researchers attached to Walter Read Army Medical were prepared to implement technology and protocols to deal with these issues before the Afghanistan deployment. AMEDD, the Army Medical Department, represented that they were prepared in 2002 even though it was not; and still isn't.

It is time for the Senate and House to call to account the entire chain of command from DoD and US Army Medcom as they have been responsible for one of the largest medical disasters in US history. Between 400,000 and 750,000 troops have been injured, gone unidentified and are untreated. No one knows who they are. Our jails, homeless shelters, drug rehab clinics and morgues will fill with veterans from these conflicts. This is a crime. It is medical negligence on a grand scale. It is time to go back an investigate the actions and lack of action taken by the DoD and US Army from 2001 forward. Senior officers, the rank of colonel or higher, responsible for epidemiology, traumatic brain injury and mental health should be called before the public, made to explain themselves, and summarily fired. If they are a member of the allied medical professions, their licenses should be revoked.

US Air Force Medcom should be empowered to take over these programs without the oversight of DoD or the involvement of the Joint Services “Red Cell.” The Air Force should further be directed to use the civilian medical sector, particularly the nation’s research hospitals, to treat the massive backlog of wounded active service members and veterans. (The VA should be left to deal with the aging veterans of past wars. It will take years to cure its gross mismanagement.) A hub and spoke system should be implemented similar to the highly successful NCCN cancer program. The objective would be to treat simple cases as close to the veterans homes as possible and complex cases at our finest medical centers that have the resources to handle the most complex injuries.

The $900MM of funding that congress allocated for mental health and traumatic brain injury is being squandered. Research has been delayed and solutions gone unimplemented. The Army’s objective has been to use faulty screening instruments (ANAM), faulty research (the problems related to TBI are transient and stress related), and faulty clinical practice (12 beds for patients in a vegetative state when there is need for 400 – the poly trauma centers are not what they were cracked up to be) in order to demonstrate that they are doing everything. It is pure nonsense.

This is not to say the VA, US Army, and US Navy don’t have some extraordinary practitioners. The field medical personnel of these wars should be lionized as they have demonstrated the resolve to do the undoable. Regrettably, these gallant men and women are not in-charge. Many are separating from the service as quickly as is practical due to incompetent leadership. People like the disgraced general, Kevin Kiley, are in-charge. Follow the party line, don’t report the wounded and don’t treat them. God forbid the Army may have to pay disability for injuries that don’t involve an amputation or blindness. TBI is like a sports injury. Sure! If they understood how serious many sports concussions can be, they would shut up. These blast injuries are far more complex and more serious, but research was repeatedly disrupted or blocked. I will not bother to rant about mental health as the military posture is so outdated it defies comment.

Call your congressmen and demand action. The current buffoons that have abused our troops will exit with this administration, but our active service members and veterans need help now.

Veterans Continue to Get Shafted Again and Again and…

The continued tragicomedy regarding the Department of Veterans Affairs tabulation of cases of suicides continues in Washington. Watching senators and representatives express indignation at the treatment of veterans is good political theater but is unlikely to change anything. Senior staff of numerous senators and representatives have been aware of the documented mistreatment of veterans for years. This is not limited to suicide but also general mental health and traumatic brain injury. No one gets fired, no one gets their pensions reclaimed, and no medical staffer has his or her license revoked. General Kiley was responsible for leaving wounded troops in the snow and he will retire with a full pension and works out of nice office in the Pentagon.

The DoD, VA and Tricare happily represent to our elected officials that everything is being done. Pure nonsense!!! The suicide issue only warranted political action because the VA got caught lying to CBS News. Politicians should transfer all spending on suicide, traumatic brain injury and mental health to an independent commission led by scientists, physicians and psychologists who are not connected to any government agencies. I have no doubt that our research and teaching hospitals can and could have provided excellent treatment and triage without the unneeded expense of attempting to rebuild the VA. A plan of this nature was presented to the Dole commission but was ignored. The civilian medical system is and was prepared to accept patients to clear the backlog and apply the most appropriate technologies to serve our warriors.

Let’s face it. There is a premium on holding the casualty count down and making sure that disability payments are not made. Field medical officers of the military knew what preparations should be made before deployment to Afghanistan especially to address likelihood of neurological insult and psychiatric disorders. As early as 2004, field medical officers in all three branches knew that it was time to start ramping-up psychiatric services as a large number of troopers were returning with depression, anxiety and PTSD. The chain of command did not care and to this day is manned by medically unqualified officers. You will find so-called experts at the DoD include a homeopathic dentist, general practitioners, a PhD in physical rehab. What they know about suicide, mental health or TBI is questionable. Where are the neurosurgeons, the neurologists, psychiatrists and the neuropsychologists? The DoD does not use the people most qualified practitioners because they will not follow a political agenda driven by Washington.

We have no more time for special blue ribbon panels, for veterans’ organizations with their heads in the sand, for politicians blabbering without backing up their words with action. Hundreds of thousands of vets are wounded and can be treated. Stop the nonsense – identify the wounded and treat them. The technology and methodology exist; it simply needs to be applied by parties more concerned with serving the people than a bunch of bureaucrats. It will be cheaper than the costs of incarceration, mortuary services, alcohol treatment, substance abuse treatment and long-term unemployment. The bill is due, and it is time to pay.

Gulf War Syndrome is Real and in Many Cases Explained by Chemical Exposure

The ArmyTimes reported in a story entitled, Review says chemicals caused Gulf War illness, today that a scientist’s review of the symptoms presented by many returning veterans can be explained by chemical families related to those found in pesticides, nerve agents and anti-nerve agents. Tens of thousands of troops were denied treatment, denied disabilities and identified as slackers after suffering a chemical insult.

The travesty is that as early as 1992 scientists and medical officers from within and without the US military strongly suspected that chemical insult was the cause of these reported maladies. The DoD and the VA should be held accountable for the mistreatment of our service members following the first Gulf War. There is no register of those who suffered chemical insult from that war and many more veterans will suffer unexplained debilitating neurological illnesses or explicable neurological illness early in life. It is unlikely that they will either find care or compensation if they were not identified in the early 90’s.

This issue is relevant because the DoD and VA are at it again. During OIF and OEF, tens of thousands troops were and are being exposed to blastwave concussion resulting from IED’s (roadside bombs) used to attack our troops. These injuries were dismissed for years as nothing more than concussion resulting from playing contact sports. The DoD elected to ignore its own experts who identified these wounds as serious in nature and as the signature injury of these conflicts. To great fanfare, $600MM was set aside to research and treat these injuries six years after the problem was identified. Regrettably the DoD and VA have used these funds for ill-considered research, outmoded instruments and pet projects of senior officials of Medcom. The result is that rather than using systems and technologies that were requested by field medical officers as early as December 2002 to screen and track neurological traumas in real-time, the nation lacks even a basic system to validity screen and analyze these injuries. While the DoD and VA deserve the bulk of the blame, Congress, the Senate, and Veterans Organizations all deserve a share of the blame because their lack of action has led to gross mistreatment of those that have served us.

Fifteen years from now we will suddenly awake to thousands of veterans suffering from debilitating neurological illness that could have been avoided or compensated for if someone had bothered to consult and support efforts by experts in the military and not the people who brought us the mistreatment of troops at Walter Reed.

March 10th through the 16th is Brain Awareness Week

Brain Awareness Week is an international effort organized by the Dana Alliance for Brain Initiatives to advance public awareness about the progress and benefits of brain research. The Dana Alliance is joined in the campaign by partners in the United States and around the world, including medical and research organizations; patient advocacy groups; the National Institutes of Health, and other government agencies; service groups; hospitals and universities; K-12 schools; and professional organizations.

For More Information:
Brain Awareness Week
Dana Alliance for Brain Initiatives
745 Fifth Avenue, Suite 900
New York, NY 10151
(212) 223-4040
(212) 593-7623 Fax
bawinfo@dana.org
www.dana.org/brainweek
Materials available
Contact: Kathleen Roina

March is National Brain Injury Awareness Month

Head injury is commonly associated with falls and automobile accidents. In addition, a large cohort of new type of head trauma resulting from injuries suffered during the conflicts in Iraq and Afghanistan Wars is being presented by its veterans (the number and extent of these injuries remains un-researched and unknown). The field of trauma research and rehabilitation demands our support.

Take some time this month to learn more about Brain Injury and its consequences.

How many people suffer from TBI?

Of the 1.4 million who sustain a TBI each year in the United States:
50,000 die; 235,000 are hospitalized; and 1.1 million are treated and released from an emergency department.1

The number of people with TBI who are not seen in an emergency department or who receive no care is unknown.

What causes Traumatic Brain Injury (TBI)?

The leading causes of TBI are:
Falls (28%);
Motor vehicle-traffic crashes (20%);
Struck by/against (19%); and
Assaults (11%).
Source: BIA

War related head trauma - unknown

For More Information:
National Brain Injury Awareness Month
Brain Injury Association of America
8201 Greensboro Drive, Suite 611
McLean, VA 22102
(703) 761-0750
(703) 761-0755 Fax
info@biausa.org
http://www.biausa.org/
Materials available
Contact: Communications Coordinator

The Treatment of Returned Wounded Service Members and Veterans is a Travesty

As Veterans’ Day approaches, The Healing Project wishes to call attention to the appalling level of treatment that our returning wounded service members and veterans are receiving at the hands of a government that is obligated to take care of them.

As of October 26, 2007
Official DoD Count of Troops Killed in Iraq: 3,830
Troops Killed in Afghanistan: 445
Wounded in Action: 30,035

The US Military is composed of on all volunteer force that is stationed on remote federal reservations across the country. Less than 1 ½% of the US population is affected by military deployments. These patriots are subjected to poor pay, long deployments and a general lack of support. It is time we stand up for the people willing to serve this country.

The sacrifices made by these men and women are best articulated by Ben Stein.



First, The Healing Project wishes to extend its support and recognize the extraordinary effort made by forward field medical teams deployed by the US Army, US Navy and especially the US Air Force. The doctors, nurses and medics as well as the medical evacuation teams have pushed the survival rate of injured service members to a level unprecedented in military medical history. It represents the culmination of nearly 70 years research and clinical development that demonstrates when resources and will are combined with leadership and initiative the United States can deliver a level of medical treatment unparalleled anywhere in the world. A recent The Navy Times article illustrates the type of heroic efforts made by military medical personell make on behalf of the wounded.

Nonetheless, both the DoD and Veterans Administration have failed those who have returned. Both the executive branch and the legislative branches of the US government have failed to provide the material assistance, human resources and most importantly the dynamic leadership to ensure the proper treatment of the returning wounded. No less than 9 commissions were empanelled by various organs of the US government and yet nothing has been done to address the needs of those that have been wounded. A story in the Charlotte Observer highlights only some of the problems.

Let’s be clear, the reported casualty figures reflect the number of traditional physical injuries. It is not an accurate reflection of the true number of casualties suffered by our service members. Post-traumatic Stress Disorder (PTSD), depression, anxiety disorders, suicidal tendencies, substance abuse, family violence and various severe mental disorders are triggered by the conditions experienced with repeated extended combat tours thousands of miles from their families. Inexplicably, both the VA and DoD failed to prepare for the enormous number of service members requiring treatment. The experience of returning veterans of the Vietnam War coupled with reports as early as 2005 would have led any epidemiologist to predict a large increase in demand for medical services. The claim that the neither the DoD nor the VA can provide treatment due to a lack of trained personnel is nonsense. This country has more than enough trained personnel in the civilian medical sector to be pressed into service to treat these men and women immediately.

Even more incredible has been the lack of treatment afforded to service members that have suffered combat traumatic brain injury (C-TBI). C-TBI injury has been called the signature injury of the conflicts in Afghanistan and Iraq. Advances in body armor coupled with tactics and weapons employed by our adversaries led to an extraordinary number of injuries that have not been experienced in earlier conflicts. While technologies have existed since before the conflicts to screen and track these injuries, the DoD actively avoided its use. Research dollars have been allocated to projects that will neither benefit the treatment of veterans nor lead to a greater understanding of the injury.

The willful and wanton neglect of our wounded service members by the DoD borders on criminal. The attempt to paint this C-TBI as some sort of mirage is insulting both to those suffering the injury and also those who have spent years trying to characterize it and define its treatment. Pentagon research strongly argues that many service members impacted by combat traumatic brain injury in the next 20 years will develop Parkinson’s-like syndromes and dementia. Of course, much like many of the medical discharges that have been made since the beginning of Iraq and Afghanistan conflicts, compensation will be denied based upon a pre-existing condition.

The DoD seems to be attempting to delay the understanding and cataloging of this injury as it did with Gulf War Syndrome to avoid the costs of disability payments. Regrettably, the service members who develop long-term neurological illnesses will be reduced to penury because bureaucrats in Washington refuse to accept the responsibility for injuries suffered defending our democracy.

It is unacceptable.

The Healing Project hopes you will take action.

Iraq and Afghanistan Veterans of America has created a petition to address the most basic medical issues for our wounded warriors.

IAVA Petition/IAVA Action Commercial



From IAVAAction's Site:

As a recent report from the Government Accountability Office reveals, seven months have passed since the Walter Reed crisis and serious problems in veterans' care remain.

As of October 1, the veterans' budget is late. Until it is approved, the VA will be forced to ration care.

Now, it's up to the President and Congress to approve the budget. Add your name to the statement, and demand they take action.

Please sign and let your friends and Representatives know that our wounded warriors demand the best treatment that can be afforded.

Regardless of how one feels about the Iraq and Afghanistan Wars, our service members and verterans deserve and demand your respect and it is time to stand with them.