Study: Soldiers' stress linked to brain injury

By Marilynn Marchione

The role of traumatic brain injury - blamed for symptoms plaguing thousands of soldiers returning from Iraq - might be overstated, contends a provocative military study that offers hope for successful treatment.

In many cases, post-traumatic stress and depression may be driving the symptoms, doctors reported Wednesday. That's good news because those are treatable.

The study by U.S. military doctors was praised by outside experts who found the conclusions convincing.

Returning soldiers have struggled with memory loss, irritability, trouble sleeping and other problems. Many have suffered mild blast-

related concussions, but there is no easy way to separate which symptoms are due to physical damage and which are from mental problems caused by the traumatic stress of war. Imaging of the brain is being tested but hasn't yet proven to be helpful.

The new study, based on a survey of 2,525 soldiers, found that brain injuries made traumatic stress more likely. The study tied only one symptom - headaches - specifically to brain injury.

"We found that the symptoms and health concerns that we expected to be due to the concussion actually proved to be more strongly related to PTSD" -post-traumatic stress disorder - and depression, said Dr. Charles Hoge, a colonel and psychiatry chief at Walter Reed Army Institute of Research who led the study. "There isn't a clear delineation between a psychological and a physical problem."

Other doctors were optimistic about treatment efforts.

"It gives us hope, because we've got good treatments for PTSD," said Barbara Rothbaum, a psychologist who heads a trauma recovery program at Emory University in Atlanta. "If we can relieve the PTSD and depression, I'm hoping we'll see alleviation of a lot of these physical symptoms."

Hoge reported on the survey Wednesday at a military health conference in Washington.

The case of Eric O'Brien, 33, an Army staff sergeant from Iowa's Quad Cities, suggests the researchers may be right.

After an explosion in Baghdad in 2006, O'Brien was treated at Vanderbilt University's brain injury rehabilitation program and at Fort Campbell, Ky., for post-traumatic stress. Now he is preparing to redeploy, this time to Afghanistan.

"I retested on a lot of the tests and they showed a pretty decent increase," he said of his mental function tests.

As for stress, "I don't know if it's something you just learn to deal with or if it just gets a little bit better over time," he said. "It's not as bad as it was."

The vast majority of brain injuries are mild, but the military previously estimated that one-fifth cause symptoms lasting a year or more.