Research Shows Promise for Wounded Warriors, Public

By Donna Miles
American Forces Press Service

March 4, 2010 - A sign on the highway identifying the exit ramp for Fort Detrick gives little indication of the revolutionary science being advanced behind its gates aimed at unlocking everything from cures for breast and prostate cancer to new ways to treat post-traumatic stress and traumatic brain injuries. The U.S. Army Medical Research and Materiel Command is overseeing these and dozens more innovative projects through its Congressionally Directed Medical Research Programs.

Congress funded the initial effort in 1992 to promote cutting-edge breast cancer research. Eighteen years later, CDMRP is the world's second-largest funder for breast, prostate and ovarian cancer research.

But with a $400 million budget now funding 17 different programs, it has expanded its focus to confront some of the world's most devastating health problems.

The CDMRP differs from many other medical research programs because it's willing to take on promising but high-risk research, recognizing the potential payoffs, explained Navy Capt. (Dr.) Melissa Kaime, the program director.

"Innovation has been our watchword from the beginning," she said, with a goal of moving beyond incremental science to spawn big advances and even breakthroughs.

The projects tap into some of the world's most respected minds at universities and medical centers around the country, working together through consortia on some programs to conduct research and clinical trials. Many involve wounded warriors receiving care at military medical facilities or Department of Veterans Affairs' clinics.

One program will test new ways to identify and treat combat veterans suffering from post-traumatic stress disorder or traumatic brain injuries.

Among eight planned clinical trials, one, to begin this spring, will test the benefit of administering a synthetic form of a neurosteroid drug to PTSD patients. The drug appears naturally in the brain, but at lower levels among some PTSD patients, explained Dr. Holly Campbell-Rosen, grants manager for the program.

"The idea is that by giving it to people, it will help relieve them of some anxiety, rage, aggression and other PTSD symptoms," she said.

Another program aims to assess behavioral therapies to treat combat-related PTSD something Dr. Kim del Carmen, grants manager for the 15 associated research projects that are part of the STRONG STAR consortium, says has not been done for active duty service members.

Another research project under her purview is studying the benefit of providing treatment in primary-care facilities, rather than dedicated mental health clinics. Anecdotal evidence shows there's less stigma associated with getting care in primary-care settings, but the study will provide scientific evidence of its impact, del Carmen said.

One project already under way in central Texas is studying the benefit of providing troops diagnosed with PTSD four 30-minute sessions with a behavioral health consultant over the course of six weeks.

Just over a dozen participants have completed their full treatments to date at Brooke Army Medical Center, Wilford Hall Medical Center and the South Texas Veterans Health Care Services facility. The results are showing promise, del Carmen said, with almost half of the participants no longer being diagnosed with PTSD and most others exhibiting less-severe symptoms.

Yet another consortium, being conducted by four academic institutions and their associated hospitals and training centers in the Houston area, is seeking to develop better ways to diagnose mild traumatic brain injury and improve patients' prospects of overcoming it through almost immediate treatment.

One clinical trial will study the link between endocrine dysfunction in participants with mild TBI, and the benefit of treating them with hormone supplements, explained Dr. Charmaine Richman, grants manager for the program.

Another trial will attempt to identify biomarkers – biological changes in the cells or blood associated with TBI. The idea, Richman explained, is to come up with a quick, relatively noninvasive way to diagnose TBI, ideally, within 24 hours of the injury when the signs are the most obvious. This, she said, will lead to faster intervention and a better likelihood of reversing the damage.

Research being funded through the Congressionally Directed Medical Research Programs will benefit not only warfighters, but society as a whole, Kaime said.

"Good research has a way of extending itself beyond its borders," she said. "So if we find good research techniques or novel pathways and it can be translated into the broader scientific context, we all win in ways we can't even imagine now."