An anti-inflammatory approach to diagnosis and treatment of combines PTSD and mild TBI

The proposal is to join our clinical study with an ongoing clinical research effort involving the Veteran Affairs (VA) Medical Center and the University of Kentucky College of Medicine in Lexington, Kentucky. While the study population is represented by veterans rather than active duty personnel, this study's cohorts coincide exactly with ours, being represented by subjects with combat-related mild traumatic brain injury (mTBI), PTSD, mTBI & PTSD, and healthy combat controls. In this study, subjects are vetted carefully under stringent eligibility criteria to exclude noise in the TBI and PTSD data from self-reported information [Combs et al, 2014]. Subjects already enrolled and evaluated under the referenced VA study as well as another study, initiated at an earlier time [Combs et al, 2014] can be recalled, re-evaluated and blood samples can be collected for the pursuit of our specific aim. Under the older Lexington VA study, subjects were recruited about 3.5 years, on average, after trauma. Going forward, the average chronicity is expected to be closer to 5 years both for newly recrnited subjects and new samples collected from previously recruited subjects. Recruiting sufficient numbers of subjects with more recent injuries will be more challenging. While this is a drawback imposed on us by the mutated situation in theater, clinical and neuropsychological data, and neuroimaging in some of the subjects already in the study have been collected more than two years ago from combat veterans. Our participation in the study will allow this cohort to answer the additional question of what may have changed from years 3 to 5 years post injury in those parameters.