Project Background: Acupuncture can be effective for many of the specific co-morbidities that make up war-related Trauma Spectrum Disorder in both TBI and PTSD patients, including pain, ameliorating stress and anxiety, insomnia, somatic and post-operative pain and, recently, PTSD, with studies finding very large effect sizes (Cohen's D .85 to 1.4). Thus, there is good reason to believe that acupuncture will induce recovery across a number of trauma spectrum dysfunctions in patients with TBI and PTSD, at low cost and with little risk. Project Objectives: The overall objective of this application is to determine the efficacy of adjunctive acupuncture for improving quality of life and function and alleviating co-morbidities associated with TBI and PTSD in service members injured in the current wars. The primary hypothesis of this study is: OIF/OEF veterans who screen positive for TBI or PTSD and are treated with a 12 week standard individualized acupuncture method will experience improved HRQL (as measured by the Veteran's SF-36) at 6, 12 and 24 week follow-up, compared to veterans randomly assigned to standard care alone. Project Methods: This is a pilot study on veterans who screen positive for TBI or PTSD in the VA healthcare record, which is being submitted to obtain additional pilot data, confirmation of recruitment strategies, information on non-participants and larger geographic coverage by including sites where the PI already has multisite collaborations. Frequency distribution and summary statistics for demographics and baseline variables will be presented by intervention group and for all subjects combined. Key demographic variables to be summarized are: age, gender, time to deployment, number of deployments, and diagnosis. Key baseline variables are: PTSD CAPS score, VSF-36, and ANAM score. This two arm pilot study will lead to a multisite test of the full 3 arm design, which will include a sham acupuncture arm.
Anticipated Impacts on Veteran's Healthcare: Almost 20% of returning soldiers suffer from PTSD, and 40% have stress related symptoms which interfere with societal re- integration. The proposed research is innovative, rigorous and pragmatic because it could lead to a completely new and improved treatment for recovery from combat poly-trauma with potential for the reduction in medical costs for those suffering from trauma, as well as reduction in long-term care provided to veterans after the end of active-duty service.
