1. Department of Veterans Affairs
Rehabilitation Research & Development Service
Translational Research Center for Traumatic Brain Injury and Stress Disorders
[TRACTS]
A Rehabilitation Research and Development Center of Excellence
VA Boston Healthcare System
Melissa Amick, Investigator
Regina McGlinchey, PhD, Director
William Milberg, PhD, Co-Director

2. Prevalence and Incidence of TBI
1.4 million TBI’s in the United States per year
80% mild, 10% moderate, 10% severe
50,000 fatalities annually
5.3 million Americans - 2% of the US population - live with disabilities resulting from TBI

4. Why is there an epidemic of TBI in OEF/OIF?
Improved armor has made combatants more likely to survive injuries that would have been fatal in previous wars.
Improved field treatment and rapid transport to state-of-the-art medical facilities.
90% survival of wounded who have been transported to these facilities.
Weapons have changed: IED are the primary weapon. DOD reports that 73% of all military casualties are caused by explosive weaponry.
Blasts can cause concussion or mild TBI.

5. SPECIFIC BRAIN TRAUMA EVENT(S)
COMBAT
PTSD
SPECIFIC BRAIN TRAUMA EVENT(S)
BLAST
TBI
Vasterling et al. 2010

6. Overlapping mTBI & PTSD Symptoms
Re-experiencing
Shame
Guilt
Headache
Sensitivity to Light
Memory Deficit
Dizziness ++
Depression/
Anxiety
Insomnia
Irritability/Anger
Trouble
Concentrating
Fatigue
Hyperarousal
Avoidance
Stein & McAllister (2009)

7. Mission Statement
The mission of the Boston Translational Research Center for TBI and Stress Disorders (TRACTS) is to understand the modifying impact of traumatic brain injury on the effects of stress-related emotional disorders on brain structure and function so that we may maximize cognitive and behavioral recovery through the development of informed therapeutic techniques.

8. Translational Research Center for TBI and Stress Disorders Organizational Chart
Project 1:
Associative Learning
& Cognition
Core A:
Administrative Core
Project 2:
Cognitive Behavioral
Therapy
Project 3:
Structural and Functional
Neuroimaging
Core B:
Human Characterization Core
Core C:
Database Management
& Informatics Core
Year 1
Cognitive Rehabilitation of Attention
Year 2
Experimental Treatment of Memory and Executive
Function Impairment
Year 3
fMRI Predictors of CPT-C
Outcomes
Year 4
Integrated Treatment for Veterans with Comorbid Pain, PTSD, and PPCS
Year 5
To be determined
Neuro-Imaging
Personality
Neuropsychology
Medical
Bioinformatics
Statistics
We retain the basic structure. Go through the structure

9. Preliminary Findings

11. TRACTS Participants Have Complex TBI Histories

12. Multiple Blast Exposure is common in the TRACTS Sample

13. Uncomplicated mTBI Rare in the TRACTS Sample

14. TRACTS Scientists and Professional Staff
Thanks to:
The Department of Veterans Affairs
Rehabilitation Research & Development Service
TRACTS Scientists and Professional Staff
Regina McGlinchey, Director
William Milberg, Co-Director
Melissa Amick
Mike Esterman
Catherine Fortier
Alex Kenna
Elizabeth Lertiz
John Otis
Ann Rasmusson
David Salat
Jennifer Vasterling
Mieke Verfaellie
Marge Ahlquist
Colleen Barber
Rachael Dayton
Vitaly Dobomyslin
Patrick Kilduff
Lindsay Morra
Wally Musto
Jon Venne
David Zade