With athletics and military service in his past and present, Alex Balbir knew that traumatic brain injury could be lurking in his future.
So a few years ago Balbir pledged to donate his brain to posthumous research into traumatic brain injury in veterans. As independence services director for the Jacksonville-based Wounded Warrior Project, he is now asking other veterans to do the same.
The nonprofit, which serves wounded veterans and active-duty military personnel, has launched a partnership with the Boston-based Concussion Legacy Foundation to boost research into traumatic brain injury in veterans and help determine the best ways to diagnose and treat the disorder.
“This is an opportunity to advance research … It may not help an individual right now but it may help future generations,” said Balbir, who is currently an active-duty reservist. “I may be fine. But we need to investigate what could happen to people like me.”
Traumatic brain injury can stem from a “violent blow or jolt to the head or body” or from an object, such as a bullet or shrapnel, impacting brain tissue, according to the Mayo Clinic. The damage may be minimal and temporary but can also produce long-term complications such as physical, sensory, cognitive or behavioral symptoms, according to Mayo. Symptoms can be immediate or appear years later and can be risk factors for suicide.
“Spreading the word is vital,” Balbir said. “Working with the Concussion Legacy Foundation can help us learn better ways to care for and treat these invisible wounds.”
The foundation’s Project Enlist was developed to increase the number of veteran brains donated for research on traumatic brain injury, chronic traumatic encephalopathy — brain degeneration likely caused by repeated head trauma — and post-traumatic stress disorder, or PTSD.
Studying veterans’ brains can help determine if repeated traumatic brain injuries in combat and in training lead to long-term health issues. Research is also necessary to help health care providers correctly diagnose traumatic brain injury and PTSD, which require different treatments, Balbir said.
Posthumous research is underway at the Veterans Affairs-Boston University-CLF Brain Bank and other leading brain banks.
“We don’t have all the answers for veterans right now,” said Chris Nowinski, the foundation’s co-founder and CEO. “Brain-bank research is an essential step in developing effective treatments … so we can protect and support the heroes who courageously fight for our nation.”
The Department of Defense reported roughly 400,000 cases of traumatic brain injuries in service members in the last 20 years, according to the Wounded Warrior Project. In the nonprofit’s 2020 Annual Warrior Survey, at least one in three reported experiencing a traumatic brain injury during their military service.
After U.S. military involvement in conflicts in Irag and Syria, among other locations, “we are starting to realize the long-term consequences,” Balbir said.
For the NFL, that realization came to the forefront in 2013 with the league’s nearly $1 billion concussion settlement with former players who claimed that years of hits on the field caused traumatic brain injuries that led to chronic traumatic encephalopathy. The same year a PBS television series Frontline aired a two-hour investigation: League of Denial: The NFL’s Concussion Crisis that also pumped awareness.
The NFL has since instituted a series of rule changes in an attempt to reduce violent collisions and a five-step protocol for concussed players before they can return to the field. Player concussions dropped by 5 percent in the 2020-21 season, the third consecutive year when the NFL has had a reduction in concussions.
“Making veterans aware of the research opportunity is more difficult than it is with athletes because sports media has done an incredible job covering CTE [chronic traumatic encephalopathy] issues in sports,” Nowinski said.
The Wounded Warrior partnership, he said, is “going to make an enormous difference” in recruiting veterans. And one veteran and family joining the cause often lead to their friends and colleagues joining as well, particularly “people who have lost someone they care about … who suffered a long time,” he said.
Project Enlist is also seeking pledges for posthumous brain donations from people who are not veterans. Their brains would be used as a control group to make comparisons and for genetic studies, Nowinski said.
“You can’t do genetic studies without thousands of brains,” he said.
Currently about 80 percent of the brain donations are the result of pledges made before death. In other cases, Nowinski approached families after veterans died.
CONCUSSION LEGACY FOUNDATION/PROJECT ENLIST
Veterans who want to pledge posthumous brain donation or want more information should go to concussionfoundation.org/programs/project-enlist. Other people who want to make a pledge should go to concussionfoundation.org/get-involved/research-registry.
WOUNDED WARRIOR PROJECT
To donate, volunteer or get more information, contact the nonprofit at 4899 Belfort Road, Suite 300, Jacksonville FL, 32256; (877) 832-6997; or go to woundedwarriorproject.org.
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