The awareness of traumatic brain injury (TBI) has grown quickly in the past few years because of increasing media coverage. Many stories involve veterans and athletes, who comprise a large share of the more than 2.5 million TBI cases annually, according to the Centers for Disease Control and Prevention (CDC).
Behavioral health facilities traditionally have been working on symptomatic treatments, but the future of TBI treatment will revolve around regenerative treatments for the brain and advanced care coordination, according to experts.
Currently, 5.3 million children and adults live with TBI, according to CDC. Though veterans and athletes get the most attention for brain injuries, there are large populations of seniors and young, active adults who are experiencing TBI. Because of the wide range of TBI cases, treatment centers increasingly will have to provide new approaches.
“Behavioral health centers will need to completely change the mindset about treating TBI,” says Theodore Henderson, MD, PhD, co-founder of the Neuro-Laser Foundation, a nonprofit organization in Lakewood, Colo., that researches comprehensive therapies to address brain injuries. “We are just now beginning to think of TBI as an insult to the brain. Treatments that can reverse or lessen that damage will be a revolution. There has been resistance to this mindset shift so far.”
Henderson says that near infrared light therapy (NILT), which has been a controversial treatment for stroke patients, potentially offers promise for TBI patients. A study led by Henderson, published in the Neuropsychiatric Disease and Treatment Journal in August 2015 found that NILT decreased symptoms related to headaches, anxiety, and depression as well as increased cognitive functioning and overall quality of life in 10 TBI patients. Drawbacks to NILT include the risk of skin burning from the laser. Henderson adds that research surrounding TBI has been at a standstill for years, and new therapies that include lasers and hyperbaric medicine move in the direction of improving life for patients.
“Most treatment is focused on symptom amelioration and involves the use of medication, physical therapy, vision therapy and cognitive remediation therapy. Less commonly, some are using hyperbaric oxygen to treat TBI,” Henderson says.
Since hyperbaric treatment isn’t covered by Medicare and most healthcare plans, it isn’t widely used for TBI treatment. Henderson says it’s not even on the radar for most facilities.
The push to include interdisciplinary models of care in TBI treatment will also be important to future care, says Bret W. Logan, MD, director of the Army Intrepid Spirit Center at Fort Campbell, Ky. Intrepid Spirit Centers, located at military bases, assist veterans and other military personnel with TBI and psychological health conditions. Logan says that a combination of traditional therapies and new technologies will encompass coordinated care for TBI patients in the future.
“The Intrepid model employs medical professionals to include occupational therapists, physical therapists, speech and language therapists, primary care providers, neuro-optometrists, mental health counselors, neuro-psychologists, art therapists, neurologists and psychiatrists who work in a coordinated team environment to provide care to the patient,” Logan says.
Because 85% of TBI in veterans occurs during training and other activities—not in combat—Logan says that TBI treatments will continue to be in high demand. Offering multiple treatments and specialists in one facility will be an advantage, he says.
For example, older techniques include acupuncture, yoga and tai chi, but they can be used in conjunction with modern techniques such as quantitative electroencephalogram biofeedback and computer-based cognitive training tools.
A fact sheet by Research America and the Lasker Foundation estimates that average lifetime healthcare costs for TBI are $85,000, but can exceed $3 million.
“Most healthcare costs are going up in general,” Henderson says. “As more effort is put into ineffective treatments, then the costs will go up.”
Donna Marbury is an Ohio-based freelance writer.