WRNMMC, Bethesda, MD  –   What is a brain warrior?
A brain warrior is someone who protects their brain, realizing you only have one brain.

March is annually observed as Brain Injury Awareness Month (BIAM), and the National Intrepid Center of Excellence (NICoE) at Walter Reed National Military Medical Center (WRNMMC), along with the entire Military Health System (MHS), places emphasize on protecting the brain, as well as seeking treatment for brain injuries, every day.

NICoE hosted several activities throughout March focused on brain health and this year’s BIAM theme, “Be A Brain Warrior: Protect, Treat, Optimize.” A virtual program March 23 focused on healthy brain games and activities for brain warriors.
Evelyn Galvis, a speech language pathologist and certified brain injury specialist who has worked with the active-duty mild traumatic brain injury (TBI) population for 15 years, discussed some of the priority areas of the Global Council on Brain Health (GCBH). These areas include restorative sleep, stress management, engaging and challenging your brain, social engagement, physical activity, and nutrition.

The GCBH includes doctors, scientists, policy experts and more “who debate the latest in brain health science in order to reach consensus in what works and what doesn’t,” said Galvis, who works at the Intrepid Spirit Center on Eglin Air Force Base, Florida.

“Brain health is vital to overall wellbeing throughout our lifespan,” Galvis added. She said positive sleep habits help promote brain health, and these practices should include minimizing noise and light, maintaining a comfortable room temperature and having a sleep-friendly environment.

Stress, which can be harmful to brain activity, can be managed through exercise, listening to soothing music, laughter, engaging in art activities and spending time with friends and family, Galvis said. She added people can avoid stress, as well as engage and challenge their brains by learning new languages, playing games, doing puzzles, taking new classes and other stimulating activities.

“Engaging your brain with mental activities you enjoy can help keep your brain sharp,” Galvis continued. “The concept of ‘use it or lose it’ does apply to staying sharp. The more that we’re intellectually engaged, socially engaged and physically engaged, the healthier our brains are,” she added.

Doris Davis, a speech language pathologist at Martin Army Community Hospital’s TBI Clinic at Fort Benning, Georgia, discussed the importance of social engagement and brain health. Davis is also the creator of BRAIN CORE (Cognitive Optimization for Readiness and Engagement), a brain fitness program that uses a multi-model cognitive rehab approach to help brain-injured patient recover and regain optimal functioning. She said a survey conducted by the American Association of Retired Persons (AARP) on adults over the age of 40 showed 37 percent reported a lack of companionship, 35 percent perceived social engagement as something difficult to do, and approximately three out of 10 reported that they felt isolated.

“Individuals with diminished social lives tend to report cognitive decline as they age,” Davis stated. “Individuals who choose to isolate themselves or severely restrict outside interactions may have an increased risk of depression and dementia. Socializing directly stimulates cognitive skills, reduces stress and improves an overall sense of wellness,” she added.

Regarding physical activity, Davis said, “Reported benefits include an improved self-image, better social and cognitive skills, and decreased symptoms of anxiety and depression. Aerobic exercise enhances the part of the brain known as the hippocampus, which supports verbal memory and learning. I think 30 minutes a day for a few days a week is an excellent start. Some exercise is better than no exercise.”

Concerning nutrition, Davis said when there is too much inflammation in the body or it has become chronic, it can lead to the beginning of a disease process and other conditions such as Alzheimer’s Disease, cancer, heart disease, diabetes, migraines, chronic pain, obesity and depression.

“Nutrition plays a direct role in sleep, cognition, physical activity and health, and mental health. Excessive simple sugars during the day can negatively affect sleep,” Davis continued. “Brain-rich foods include dark chocolate, blueberries, fish oils, olive oil, nuts, fish, poultry, beans, and leafy green vegetables,” she added.

Jamie Kaplan, a certified therapeutic recreation specialist and assistive technology professional, discussed rehabilitation in a digital world with a clinical look at gaming. He stated characteristics of TBI include sensory stimulation (double vision, ringing in the ears, tingling/pain); cognitive processing (difficulty learning, focusing, remembering, making decisions and reasoning); and behavior management (difficulty with social cues and situations, relationships, self-control and aggression).

Kaplan, who manages the Virtual Reality and Adaptive Video gaming program at the James A. Haley VA Hospital in Tampa, Florida, said neuroplasticity focuses on the ability of the brain to form and reorganize synaptic connections, especially in response to learning on experience following injury.

“This means that theoretically, it is possible to change dysfunctional patterns of thinking and behaving and to develop new mindsets, new memories, new skills and new abilities,” he added.

“So, does gaming lead to growth? Studies from the National Institutes of Health and various universities concluded that video gaming can stimulate neurogenesis, growth of new neurons, and connectivity in the brain regions responsible for spatial orientation, memory formation and strategic planning, as well as fine motor skills,” Kaplan stated.

“Neurogenesis and neuroplasticity improvements were observed in the right hippocampus, right prefrontal cortex and the cerebellum. These brain regions are involved in functions such as spatial navigation, memory formation, strategic planning and fine motor skills of the hands,” Kaplan shared.

NICoE at WRNMMC focuses on improving the lives of patients and families impacted by TBI through quality care, research, innovation, collaboration and education. It’s the headquarters to the Defense Intrepid Network for TBI and Brain Health, which includes Intrepid Spirit Centers across the continental United States, as well as TBI and Brain Health Clinics in Germany and Alaska.

Last year, more than 15,000 service members experienced a TBI, most occurring from car accidents, falls and sports, according to Defense Health Agency (DHA) officials, who add that TBIs can impact mission readiness. Therefore, DHA officials encourage people to stay safe, learn TBI symptoms, and seek medical treatment if you think a TBI has occurred.

DHA encourages people to protect themselves by:

• wearing a properly fitting helmet when riding a bike or playing football, hockey, snow sports, skating or skateboarding
• always wearing a seatbelt
• not driving while under the influence of alcohol or drugs
• improving lighting and eliminating trip hazards in the home or workspace
• using nonslip mats and installing grab bars next to the toilet and in the tub or shower for older adults
• installing handrails on stairways
• improving balance and strength with regular physical activity

For more information about NICoE, visit, https://health.mil/Military-Health-Topics/Centers-of-Excellence/NICOE/About. For more information about TBI, visit https://health.mil/TBIPatientResources and https://health.mil/TBIFactSheets.