IU School of Medicine researchers secure grant to study new treatment method for traumatic brain injury

Indiana University School of Medicine and National Intrepid Center of Excellence (NICoE) researchers are collaborating to study a new treatment method for traumatic brain injury (TBI) thanks to a grant from the United States Department of Defense, Congressionally Directed Medical Research Programs (CDMRP). The treatment will be tested on civilians and service members who have experienced a concussion or mild traumatic brain injury (mTBI).

The project is called Building Emotional Self-awareness Teletherapy (BEST): A Tool to Optimize Psychological Health Outcomes for Persons with Traumatic Brain Injury. NICoE is headquarters for the Defense Intrepid Network and a directorate of the Walter Reed National Military Medical Center (WRNMMC). The NICoE is focused on improving the lives of service members with TBI and other invisible wounds of war. Researchers will deliver the BEST method of treatment remotely to patients with mild traumatic brain injury who have an emotional processing problem called alexithymia. Alexithymia often causes poor emotional self-awareness and difficulty labeling, differentiating, and expressing emotions.

"People must be able to recognize their emotions in order to manage and effectively work through them, which is why studies show that people with alexithymia often have problems managing their emotions (emotion regulation) and frequently struggle with anxiety, anger, depression, and post-traumatic stress," said Dawn Neumann, PhD, associate professor of physical medicine and rehabilitation and principal investigator of the study. Neumann is also the research director of the Rehabilitation Hospital of Indiana. "Given the prevalence of alexithymia and problems associated with it, we created this treatment to improve emotional self-awareness."

In a previous study, research tested the new treatment in-person with civilians who had moderate to severe TBI and saw improvements in their ability to label emotions as well as their emotion regulation, anxiety, and anger. Participants also reported feeling more positive emotions. Now, they want to know if the treatment could also be successful when delivered remotely via teletherapy.

Teletherapy has become more important than ever since the COVID-19 pandemic. Remote therapy could also mitigate transportation and geographical barriers to care, as well as reduce stigma associated with going to an office known for mental health treatment."

Dawn Neumann, PhD, associate professor of physical medicine and rehabilitation and principal investigator of the study

Researchers will also test the BEST treatment in those with mild TBI as opposed to moderate or severe TBI. Mild TBI is common in the military, and half of the participants in the new study will be service members. Researchers will observe any improvements in participants' ability to manage their emotions as well as their resilience, anxiety, depression, anger, and posttraumatic stress immediately after treatment and three months later.

"Because of high frequency of concussions and the prevalence of alexithymia after mild TBI, it is likely to be impacting a large portion of individuals," Neumann said. "We expect BEST training to strengthen emotional resiliency and well-being."

The NICoE will facilitate BEST treatment by helping to refer service members from its associated military rehabilitation facilities.

Co-principal investigators include Flora Hammond, MD, chair of the IU School of Medicine Department of Physical Medicine and Rehabilitation, Jie Ren, PhD, Assistant Professor of IU School of Medicine Department of Biostatistics and Health Data Science, and Treven Pickett, PsyD, department chief of research for the National Intrepid Center of Excellence (NICoE).