Nursing Research Provides Clues for Determining TBI and PTSD Risk among Veterans
Twenty-two percent of all U.S. injuries in the most recent wars in Iraq and Afghanistan were Traumatic Brain Injuries (TBIs).
If you or a family member were impacted, were you aware of the potential consequences of those injuries? The most common comorbid condition with a TBI is post-traumatic stress disorder (PTSD). Of soldiers with TBI, more than 40% have also been diagnosed with PTSD.
The problem is that PTSD cannot be seen, and so we wait on individuals to report symptoms, but by then it’s often too late! According to the United States Department of Veterans Affairs, as many as 22 veterans committed suicide per day in 2013.
What if a blood test could tell you who is at risk?
My research, conducted at Johns Hopkins University School of Nursing, specifically explores the inflammatory related proteins and whether they contribute to a diagnosis of PTSD in military personnel and veterans with a TBI.
When a solider gets a TBI, one of the first things that happens is inflammation of the brain.
There is a release of proteins, which includes inflammatory proteins (IL-6, IL-10 and TNFα). This is a good thing; it helps to repair the body and maintain balance within the immune system…. except when the body is dysregulated and unable to control the process. This can lead to a state of sustained inflammation. Sustained inflammation has been linked to damaged neurons which leads to functional and structural deficits in the brain as well as PTSD.
So far, this has mostly been proven in mouse models. Could the same be true for humans? Could inflammatory proteins found in the blood following a TBI tell us who is at risk for developing PTSD?
What we found from our analysis is that one of the inflammatory proteins, IL-6, is significantly increased in military personnel and veterans with TBI and PTSD, particularly in those with multiple TBIs. This finding is important for several reasons:
- Policy – We should do both physical and psychological testing for individuals who have had a TBI.
- Medication – Very few medications currently exist for treatment of PTSD. We should explore anti-inflammatories, which if given at the right time could reduce some of the negative outcomes.
- Education – In my opinion, it is very important to educate individuals about the risks.
But having a TBI is not a sign of mental or physical weakness. What it does tell us is that there are biological changes that put you at risk for mental health disorders like PTSD. Identification of IL-6 gives us an objective measure to work with so we don’t have to wait to notice the obscure but potentially fatal outcomes. So the next time someone says “Do you know?” your answer can be “Yes!!!! I do know… at least a little bit more. Nursing research is trying to provide more answers to these questions.”
Tamar Rodney is a Geneva Foundation/Jonas Veterans Healthcare Scholar at Johns Hopkins University School of Nursing.
This blog post is part of a series focusing on different aspects of nursing research in recognition of National Nurses Week. Visit https://www.researchamerica.org/advocacy-action/national-nurses-week-2018 for more information.