V E TE R AN S AFFAI R S & M I LITARY M E D I CI N E O UTLO O K
THE VA’S BRAIN REHABILITATION RESEARCH CENTER
Harnessing the Brain’s Ability to Recover from TBI and Stroke
n IN 1999, WHEN THE DEPARTMENT of Veterans Affairs (VA) established its Brain Rehabilitation Research Center (BRRC) at the Malcom Randall VA Medical Center in Gainesville, Florida, it was in part a response to exciting new discoveries in neuroplasticity (the brain’s ability to form new connections and pathways after injury); neurogenesis (the ability of the brain to grow new neural cells and the dendrites that connect them); and angiogenesis (the generation of new blood vessels that oxygenate tissue and restore function). These advances helped to establish a core mission for the new BRRC: to identify the mechanisms involved in each of these areas – how, exactly, the brain might be induced to generate new pathways and neural tissues – and use that knowledge to develop interventions for people who suffer central nervous system damage. Veterans who’ve suffered injuries to the central nervous system also suffer impairments in cognitive, motor, or emotional functioning – often in combination. Even a single functional impairment can significantly affect a person’s health and quality of life and can impose significant emotional and financial burdens. In the BRRC’s two decades of existence, its investigators have focused their efforts primarily on recovery and neuro-rehabilitation from two of the most prevalent causes of these impairments: traumatic brain injury (TBI) and stroke.
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CREATIVE AND INNOVATIVE COLLABORATIONS Supported by the VA’s Office of Rehabilitation Research and Development (RR&D), the BRRC is adjacent to the University of Florida (UF) campus, and each of the center’s investigators is dually appointed to the university’s College of Medicine. The two facilities share resources, including the BRRC’s 11,000 square feet of laboratories and workstations and sophisticated tools for measuring and analyzing both brain function and motor control performance. The BRRC is also part of a research consortium that includes colleagues in the UF College of Medicine and the Brooks Rehabilitation Hospital in Jacksonville, Florida, whose Clinical Research Center shares the BRRC’s mission of advancing neural rehabilitation. Nationwide, BRRC investigators collaborate with other VHA institutions, including the health care centers in Portland, Oregon, and Tampa, Florida, as well as two other RR&D centers in Cleveland, Ohio: the Functional Electrical Stimulation (FES) Center, which evaluates neurostimulation methods, and the Advanced Platform Technology (APT) Center, where investigators explore engineering solutions to create new rehabilitation interventions. By design, BRRC’s investigative leadership is composed of 12 scientists, each with his or her own research program
in basic or clinical science. The fields studied by each, while varied, are also interrelated, including neuroscience, biomedical engineering, electrical engineering, neuropsychology, experimental psychology, neurology, physical therapy, biomechanics, and muscle physiology. According to Janis Daly, Ph.D., the BRRC’s director, the interdisciplinary nature of the center’s work “gives us the capability to consider a problem from multiple vantage points.” These different perspectives often generate creative and innovative explorations that hold promise for new treatments. For example, BRRC investigators are working to discover neuropathologies underlying the cognitive problems often associated with TBI. Neuroscientists Prodip Bose, M.D., Ph.D., and Floyd Thompson, Ph.D., have identified structural and functional damage to a structure called the locus coeruleus (LC) during brain injury. Located in the pons of the brainstem, the LC is a hub of neural activity that, under normal circumstances, relays critical brain signals to parts of the brain that serve other functions – the spinal cord, cerebellum, cerebrum, hypothalamus, amygdala, and others. Damage to the LC causes a complex of dysfunctions, and now that Bose and Thompson have identified it as a consequence of brain injury, several new clinical studies have been launched to address these dysfunctions. William Perlstein, Ph.D., a BRRC
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PTRUMP16 VIA WIKIMEDIA COMMONS
By Craig Collins
