Though the National Intrepid Center of Excellence's (NICoE) primary mission is to provide medical care to individuals with traumatic brain injury (TBI) and associated psychological health conditions, effective medical approaches require a basis in scientific literature. Since its inception, NICoE authors have published over 280 peer-reviewed publications that inform the scientific community's understanding of the pathophysiology of conditions such as TBI and posttraumatic stress disorder, and examining the efficacy of various therapeutic strategies for the benefit of service members, veterans, and their caregivers.

Below are two highlighted publications. For a full list of NICoE-authored publications, visit the NICoE Library Guide.

Highlighted Publications

A Randomized Clinical Trial of Plasticity-Based Cognitive Training in Mild Traumatic Brain Injury

The BRAVE study was a randomized controlled trial—considered the "gold standard" in clinical research—involving five VA and military sites, including the NICoE. This study demonstrated that service members (SM) and veterans with a history of mild TBI using a computerized brain-training program in their homes for 12 weeks, with remote coaching from clinical staff, significantly improved cognitive performance. These benefits were sustained for at least three months without further training. These data provide preliminary evidence that in-home, self-paced use of this computer program can supplement the standard mild TBI cognitive rehabilitation protocol, offering flexible, remote rehabilitation options without sacrificing efficacy.

Reference: Mahncke, H. W., DeGutis, J., Levin, H., Newsome, M. R., Bell, M. D., Grills, C., French, L. M., Sullivan, K. W., Kim, S. J., Rose, A., Stasio, C., & Merzenich, M. M. (2021). A randomized clinical trial of plasticity-based cognitive training in mild traumatic brain injury. Brain, 144(7), 1994–2008

Efficacy of an Interdisciplinary Intensive Outpatient Program in Treating Combat-Related Traumatic Brain Injury and Psychological Health Conditions

A study performed at the NICoE demonstrates that the four week interdisciplinary intensive outpatient program (IOP) combining conventional rehabilitation therapies with integrative medicine significantly improved symptoms in SMs with combat related mild TBI and behavioral health conditions. The results confirm the value of this holistic diseased-based model of care, demonstrating significant improvement across the clinical domains to include neurological symptoms, PTSD, anxiety, depression, sleep disturbance, headache and quality of life at four weeks and sustaining to six months. This study is impactful as previously many SMs have not responded to conventional treatment and were forced to disengage from full active duty status or prematurely medically retire, thus reducing military readiness. Future goals include leveraging the skills-based training in the IOP earlier in service member's careers to build resilience in the training environment and enhance performance.

Reference: DeGraba, TJ, Williams, K, Koffman, R, Bell, JL, Pettit, W, Kelly, JP, Dittmer, TA, Nussbaum, G, Grammer, G, Bleiberg, J, French, LM, & Pickett, TC. (2021). Efficacy of an Interdisciplinary Intensive Outpatient Program in Treating Combat-Related Traumatic Brain Injury and Psychological Health Conditions. Frontiers in Neurology, 11(1741).