By Barbara Peters Smith, Herald-Tribune. Sarasota, FL.
Anthony Driscoll, a Booker High graduate with 24 years in the military, including tours for Operation Desert Storm and Afghanistan, has a hard time sitting still.
His foot jiggles constantly, he has trouble remembering things, and a sudden noise takes him right back into the moment of dodging rocket-propelled grenades — all signs of the post-traumatic stress disorder that military doctors have diagnosed in him.
Driscoll went to the Roskamp Institute on Tuesday to hear its associate director, Fiona Crawford, discuss her research into the ways combat trauma can affect the brain. Crawford, who has studied Gulf War Illness, PTSD and traumatic brain injury, is recruiting veterans such as Driscoll here and nationally for a large investigation of how the environment and human genetics interact to help brains heal — or hinder their recovery from the hazards of modern warfare.
“The Alzheimer’s research we have been doing for 20 years is like a roadmap for us” to find new ways to diagnose and treat veterans, Crawford said.
One promising possibility: building on Roskamp’s chemical studies to identify biomarkers in the blood — proteins that change slightly as a result of injury. The military could use this someday in the field, to test everyone in the vicinity of a blast and quickly determine who has suffered a concussion.
State-of-the-art body armor has allowed Iraq and Afghanistan war veterans to survive, and cope with the effects of brain injury — more than 200,000 so far. Because people who have sustained repeated brain trauma are significantly more likely to develop Alzheimer’s, Crawford said, she is especially interested in the “so-called ‘mild’ cases where folks don’t even know they’ve sustained an injury. We now know that repetitive mild injury is extremely detrimental.”
Crawford’s team has found a biomarker — one of three common forms of the ApoE gene — that correlates to a risk for poor recovery from traumatic brain injury, and also a higher probability of developing Alzheimer’s disease. The correlation has also been confirmed in mice.
Crawford’s concentration on TBI grew out of its relevance to Alzheimer’s patients. Her team has studied a population of veterans who had sustained brain injuries. After six months, the veterans with the problematic form of the gene were doing worse in memory and function tests than the ones with other forms.
To better understand the role of genetics in the brain’s recovery from combat trauma, Crawford wants to recruit as many veterans as possible. They will be grouped by such factors as age, ethnicity and deployment history, and their blood samples will be mapped against the mice models developed in Roskamp’s lab.
“As you can imagine, we’re going to need a lot of people to make that happen,” Crawford said. “I am very confident, with the technology we have, that if we get enough people participating we will be able to see patterns.”
Driscoll, who experienced both the chemical assaults of Desert Storm and a year working in Afghanistan’s notorious Bagram prison, is the kind of veteran Crawford hopes to help. He relates his current bouts of depression and anxiety to the near-constant stress of Bagram.
“We had these ‘fallen comrade’ ceremonies where we’d have to line the street and render them our salute as they were carried by, and in the morning we had to go back to the prison,” Driscoll said. “The guys I went to combat with — once they get home, they’re all ghosts; they disappear. They drink like me. That’s the way they cope.”
Driscoll is seeking a medical retirement from the Florida National Guard, and finds the lengthy process frustrating. He had a job as a veterans coordinator with the 12th District Court, he said, counseling former service members in the criminal justice system. But talking with them made him too anxious to continue the job.
“Their stories started impacting me,” he said.
The Roskamp Institute is a nonprofit research facility founded in 2003 by Sarasota philanthropist Bob Roskamp. Director Michael Mullan and Crawford were part of a British team that 20 years ago discovered the first genetic mutation that causes Alzheimer’s disease. In 2010 the Roskamp Foundation became a public charity, and the institute has broadened its original mission from studying Alzheimer’s to tackling other neurological disorders.
Of the three areas of research Roskamp is pursuing with military funding, the Gulf War Illness studies of 1991 veterans are the most developed. Sufferers report a range of symptoms, from headaches and memory problems to joint pain and tumors.
“When the soldiers started complaining of neurological signs and symptoms, they were up against a lot controversy,” Crawford said. “It is a real condition; there is absolutely no question about it. We now know that GWI is the result of pesticide poisoning, essentially.”
Roskamp has developed laboratory models of the syndrome by exposing mice to the same chemicals and pesticides used in Desert Storm. This has revealed “what’s actually going on in the brains of those animals at a cellular level,” Crawford said. “We are initiating a program on PTSD, with a similar plan.”
In the third area — TBI — the institute is collaborating with specialists at the James A. Haley Veteran’s Hospital in Tampa, one of four Veterans Administration sites for treatment and research of the disorder.
According to the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, the leading military causes of TBI are blasts, fragments, bullets, vehicle accidents and falls. Since 2008, the military has accelerated research like Crawford’s, aimed at improved screening for injured service members before they return to combat.
The Roskamp Institute also is involved in a smaller but related military study, screening 470 troops before and after their deployment.
“We will be matching blood profiles” from both screenings, Crawford said. “We’ll be able to look at those individuals who experience TBI and PTSD and see what has changed.”
For more information: www.rfdn.org.
