Department of Defense Launches Study Aimed at Mild TBI Treatments


Unfortunately, mild traumatic brain injury (TBI) is a signature wound of the wars in Iraq and Afghanistan. Soldiers returning home often suffer persistent symptoms related to their brain injuries including difficulties with memory, concentration, attention and judgment.

The Department of Defense has teamed up with the Veterans Affairs Department in order to launch the Study of Cognitive Rehabilitation Effectiveness, dubbed the SCORE trial. The SCORE trial aims to discover the best methods to treat combat troops who are suffering with mild TBI symptoms. The study will attempt to discover the effectiveness of various cognitive rehabilitation therapy treatments.

Neurologist Douglas Cooper, the study’s leader, has seen anecdotal evidence of cognitive rehabilitation helping soldiers to cope with and manage cerebral deficits. However, the study aims to establish an evidence-based precedent for cognitive rehabilitation’s effectiveness. Cooper’s goal is to prevent insurance companies from denying cognitive rehabilitation as a stand-alone treatment. For example, TRICARE, the military’s healthcare plan, will not cover cognitive rehabilitation therapies that haven’t been proven to be effective stand-alone TBI treatments.

Sadly there is no shortage of servicemen available to participate in the study. More than 202,000 servicemen have sustained a TBI since 2000. Most of these injuries have been concussions or mild traumatic brain injuries. Many of these servicemen suffer regularly from the symptoms of their traumatic brain injuries and could benefit from the study’s findings.

“We have a lot of great interventions to help … in the first few days after concussion,” said Cooper in an interview with American Forces Press Service. However “we don’t have as many good interventions later on –six months, 12 months or two years post-injury.”

Cooper and his colleagues will offer treatments to 160 patients in two-week cycles over the course of two to three years. Patients will be treated two times a day, five days a week in one of four treatment paths. These paths include: individual therapy, group sessions, computer treatments and behavioral health.

SCORE will hopefully determine which interventions are most effective and then relay that information to VA and DOD centers. Cooper also hopes that civilian health care providers will be able to draw insights from the study that can be used to treat TBIs that are not related to combat. Through SCORE we might see the end of the arguments insurers use to avoid paying for cognitive rehabilitation and create opportunities for individuals with traumatic brain injuries to obtain treatment that will solidify their recovery.

About Rolf Gainer Ph.D.

Dr. Rolf Gainer is the founder of the Neurologic Rehabilitation Institute at Brookhaven Hospital in Tulsa, Oklahoma as well as the Neurological Rehabilitation Institute of Ontario, in Toronto, Canada. Dr. Gainer is a psychologist with more than twenty-five years of experience in the treatment and rehabilitation of individuals with brain injuries and a dual diagnosis. Dr. Gainer has designed and operated innovative rehabilitation programs in the United States and Canada for individuals who have been regarded as difficult to serve. He is currently involved in conducting two outcome studies related to the long-term issues faced by individuals with brain injuries and a dual diagnosis. He has presented papers throughout the United States and Canada in many professional conferences and educational forums.

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