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We need more than brain injury awareness: We need new treatment

Advocates push 'all hands to the pump' approach in push for more resources

Rep. Bill Pascrell Jr., D-N.J., is advocating for increased resources for brain injury treatment research.
Rep. Bill Pascrell Jr., D-N.J., is advocating for increased resources for brain injury treatment research. (Bill Clark/CQ Roll Call file photo)

Over $76 billion — that’s the total direct and indirect costs of traumatic brain injuries (TBI) annually. And that’s just the tip of the iceberg.

There are 611 TBI-related hospitalizations and 176 TBI-related deaths each day in the United States. Even more traumatic brain injuries go untreated, with many of those Americans facing injury unable to access medical care.

We have achieved widespread acknowledgement in recent years that TBI is a public health issue that contributes to disability and death. Yet, little has changed in the standard of care for concussions as the medical community is still striving for therapy that would treat both the symptoms and the underlying concussion. We can do more and should do better.

Each March, we observe Brain Injury Awareness Month to promote learning more about brain injury and work together to end its dangerous effects. There’s no question that more of us understand the dangers of even the mildest of brain injuries, concussions, than we did 10 years ago. Throughout March, brave and dedicated advocates and their families will come to Capitol Hill to advocate for improved care, additional federal investment in brain injury research and greater resources for state programs.

We’ve made critical progress including legislative action addressing TBI with the passage last Congress of the TBI and PTSD Law Enforcement Training Act and the fiscal 2023 National Defense Authorization Act. We’ve also seen the Department of Defense focus on brain injuries and the devastating high rate of suicides in active military and veterans.

The media have done a good job focusing attention on brain injuries at all levels of sports. There’s also been media attention paid to brain injuries incurred in the military and in domestic violence. The most TBIs are sustained from falls — especially among the elderly.

The clock is ticking. As our baby boomers age, we will inevitably see a spike in concussions attributable to falls. Motor vehicle accidents, workplace accidents and recreational activities will also continue to be major causes of concussions.

Despite progress, concussions are still a significant unmet medical need. More than 3 million patients visit hospital emergency rooms with suspected TBI annually. Another estimated 15 to 20 million concussions go without medical attention and are undiagnosed each year. Nearly half (48.3 percent) of patients reported experiencing at least one post-concussion symptom one-year post-injury. Post-concussion symptoms, including headaches, brain fog, sleep disorders, behavioral changes and vision and hearing impairment, can be ongoing and incapacitating.

We’ve seen increases in numbers of reported concussions and visits to hospital emergency departments with suspected concussions in the past few years. This may well be attributable to increased awareness of concussions and their potential long-term complications.

While enhanced awareness is a positive outcome, much more remains to be done. The numbers don’t bode well for the long-term health of many of these individuals. Over the past 20 years, research has increasingly linked concussions to neurodegenerative conditions, including dementia, Alzheimer’s disease and CTE, a degenerative brain disease. How many people are facing this in the future?

A 2003 Centers for Disease Control and Prevention report estimated that post-concussion symptoms cost the U.S. nearly $17 billion. The American Association of Neurological Surgeons put annual direct and indirect costs of the full spectrum of TBIs — from mild to severe — at $48 billion to $56 billion in 2019 and at $76.5 billion today. An estimated over $40 billion in annual health care spending alone is attributable to nonfatal TBI2. The toll ongoing symptoms have on patients, their families, their work and other aspects of their lives cannot be overstated. The costs to society as a whole are substantial and will continue to grow unless we find effective treatments.

More resources are needed today to support cutting-edge research and development for effective treatments for concussion. This year during Brain Injury Awareness Month, we will push for an “all hands to the pump” approach and invite more stakeholders and partners to join the fight against TBI and develop innovative prevention and treatment strategies. We welcome researchers, investors, pharmaceuticals companies and ask them to commit to meaningful action to developing effective treatments to treat concussions. Only then is further progress possible.

Rep. Bill Pascrell Jr. is the co-chair and founder of the Congressional Traumatic Brain Injury Task Force and represents the 9th District of New Jersey in Congress.

Vishal Bansal, M.D., F.A.C.S., is director of trauma surgery at Scripps Mercy Hospital in San Diego and the chief scientific officer and co-founder at Oxeia Biopharmaceuticals, a Boston-based clinical stage biotech company.

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