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On June 20, 2013, NCIRE hosted the sixth annual The Brain At War conference, a  discussion of the psychological and physiological consequences of combat. The academic presentations focused on the integration of new technologies into emerging treatments for military-related injuries.

Convergent interests in Veterans health from different fields of expertise - researchers, game developers, clinicians, Veterans, and agency leaders - have led to remarkable ideas and innovations. The 2013 The Brain At War program served to present new uses of technology, and further facilitate collaboration in developing new health care techniques for Veterans.

  • After brief introductory remarks from NCIRE Board Chair Paul Volberding MD,  Marines Memorial Board of Directors Representative VADM Jody Breckenridge, USCG (Ret.), and NCIRE Executive Director Robert Obana, the conference turned to a keynote presentation from a new voice in Veterans Affairs leadership. Assistant Secretary for Public and Intergovernmental Affairs Tommy Sowers, PhD - an 11 year Veteran of the United States Army - spoke of both the successes and challenges of VA in caring for a new generation of Veterans. Dr. Sowers stressed the need for ongoing collaboration, engagement and cooperation between the VA, the Veterans it serves, the research community, and the private sector.

  • The academic presentations showed tremendous advancement in the understanding of the physiology of recovery from combat stress. SFVAMC Chief of Mental Health Service Sophia Vinogradov, MD presented an overview of new approaches for brain plasticity, and the potential for game technology to serve as a clinical tool for regenerating brain functioning which has been compromised by injury.

  • The field of schizophrenia research has provided a particularly rich venue for the development of these tools, and SFVAMC Staff Physician Dr. Michael Minzenberg added to Dr. Vinogradov’s continuum of research by showing the impact of schizophrenia research on the understanding of suicide risk. Dr. Aoife O’Donovan presented her research into the computerized modification of attention bias, a novel approach to altering the typical course of chronic stress in Veterans.

  • Guest speaker Albert “Skip” Rizzo, PhD, Associate Director for Medical Virtual Reality at the Institute for Creative Technologies, University of Southern California, presented a media-rich overview of his work with Virtual Reality (VR) techniques as clinical tools. Dr. Rizzo’s work included remarkable displays of VR as a tool across many disorders, but focused on the implications for Veterans with combat stress.

     

    Dr. Rizzo’s new work in the field of simulated therapies offers promise for the large number of Veterans who do not have immediate access or amenability to standard ‘talk’ therapies. Dr. Rizzo’s balance of technical expertise and understanding of the importance of skillful clinical management in VR therapies underscored a theme of the conference - combining human expertise with computerized power and accessibility.

  • A tribute to MAJ Walter S. Newman, former NCIRE board member and iconic San Franciscan, was delivered by Keith Armstrong, LCSW. Mr. Newman, who passed away in December 2012, was a key supporter of Bay Area Veteran’s causes, ranging from his work with NCIRE to his support of City College of San Francisco Veterans Alliance.

  • Michael Weiner, MD, Director, Center for Imaging of Neurodegenerative Diseases, presented a progress report on an internet-based research registry called The Brain Initiative. On this new platform (http://www.thebraininitiative.org), Dr. Weiner aims to register participants via the web, and create a network of research subjects large enough to engineer sophisticated prevention trials of Alzheimer’s Disease.

    The afternoon presentations focused on new insights on diseases and conditions which are particularly pronounced in the Veteran population - Alzheimer’s, Traumatic Brain Injury (TBI), and Parkinson’s.

  • Guest speaker Caroline Tanner, MD, PhD, who serves as Director of Clinical Research at the Parkinson’s Institute gave a unique presentation on the relationships between environmental exposures, neurotoxins, genetic markers and TBI in Veterans. Her work with neurodegenerative diseases sheds new light on the unique aging processes for Veterans with repeated exposures to traumatic stress.

  • Geoff Manley, MD, PhD, UCSF Professor and Chief of Neurosurgery at San Francisco General Hospital, presented his research on TBI in a Level-1 trauma center, and discussed its implications for the Veteran population. Researching this condition, which is challenging in a VA environment due to the chronology of impact and injury in relation to the time point of clinical contact, has been robust and fruitful in the civilian trauma environment. The need for new criteria in the diagnosis of TBI, as well as the urgent need for better treatments and understandings of pathways to recovery, has enormous implications for the Veteran population.

  • The Brain At War 2013 continued with a panel discussion of potential multidisciplinary collaboration. COLs. Karl Friedl, Drs. Tanner, Rizzo, and Vinogradov explored the choices and challenges facing researchers, along with the potential for convergence in the understanding of Veterans health.

  • The program closed with a presentation from NCIRE Executive Director Robert Obana and Associate Chief of Staff for Research and Development Carl Grunfeld, both reflecting on the responsibility of the civilian community to the military community, and discussing a future of Veterans health in San Francisco in which the NCIRE research community is even more deeply embedded and collaborative with the private sector, UCSF research, and Silicon Valley biotechnology and information technology.