Category Archives: Government/Military

“From Invisible Injury to Precision Medicine” with Metabolism

The mildest brain injuries, the most common, leave no trace on CT or MRI scans. New research says the answer to this conundrum may lie in metabolism, how the injured brain burns fuel.

Diagram of brain glucose metabolism, oxygen use, ATP production, and neuronal energy pathways

In a July 2026 Open Access Government article, VA and University of Washington scientist James Meabon argues that FDG-PET (Fluorodeoxyglucose positron emission tomography), which uses a radioactive sugar tracer to show the brain’s glucose use, can expose blast injury where structural scans cannot. Tracking the executive-function problems of 79 blast-injured veterans, this Journal of Neurotrauma study found that a single deep-brain hotspot heightened glucose uptake in the left pallidum.

At the molecular level, a May 2026 npj Metabolic Health and Disease journal review details how blast-related injuries stall the brain’s energy cycle. In particular, metabolites – succinate, lactate, altered pyruvate-dehydrogenase activity – it “spills” into blood and urine.

While the work was funded by the Department of Defense, VA, and NIH, and focused on brain injury in the military, the findings are universally applicable. “By viewing blast injury through metabolism,” Meabon writes, medicine can move “from invisible injury to precision medicine.”

Domino Effect: How a Concussion Can Buckle a Body

A mild traumatic brain injury doesn’t just rattle the head; it may set the stage for a torn ligament or a stress fracture. In June 2026, the JAMA Network published the findings of a study that found U.S. servicemembers who suffered a mTBI, such as a concussion. The researchers tracked 26,784 troops who enlisted between 2016 and 2020. Musculoskeletal injuries are the leading cause of lost duty days in the military, and it was found that those who had a mTBI were 2.24 times more likely to later suffer this secondary injury.

Infographic titled “BI-DIRECTIONAL RELATIONSHIP: MUSCULOSKELETAL INJURY AND mTBI,” showing four steps: 1. ACUTE CAUSE—Falls, collisions, and physical impact can lead to both MSK injury and head impact (mTBI). 2. RISK FACTOR FOR RECOVERY—Pain, restricted mobility, and changes in physical activity hinder cognitive rest and rehabilitation. 3. INCREASED MSK RISK—mTBI symptoms increase vulnerability to falls and subsequent MSK injuries. 4. ALTERED MECHANICS—Neurological deficits and slow reaction times lead to improper movement patterns and higher re-injury rates.
This infographic explains how musculoskeletal injuries and mild traumatic brain injuries can reinforce one another through a cycle of pain, impaired recovery, and increased reinjury risk.

“There appears to be a bi-directional relationship between musculoskeletal injury and mild traumatic brain injury,” said Amy Silder, PhD, a biomedical engineer at the Naval Health Research Center. Referred to as post-concussion syndrome, PCS can include a disruption of balance, coordination, and reaction time long after the headaches fade. As is, it costs the military billions of dollars a year and leaves tens of thousands of troops unable to deploy.

The study’s authors urge clinicians to screen troops’ bodies after any brain injury. Screening concussion patients for lingering physical deficits, the researchers say, could keep more service members healthy and ready. (Though this recent study focused on the military, the clinical suggestions seem that they would be true for all those who have suffered a mTBI.)

Coast Guard Forced to Confront Brain Injuries

Coast Guard boat at sea

Coast Guard “surfmen” continuously absorb thousands of violent wave impacts while piloting rescue boats through rough surf. As the director of the University of Miami’s concussion program told the local NBC affiliate, “These are… significant waves, and sometimes it’s like hitting a concrete wall.” On July 31, 2026, US Coast Guard finally acknowledged the danger, through Admiral Kevin Lunday’s statement: “We owe it to [the crew] to protect [their] long-term health from the damage caused by relentless wave pound, blast overpressure and other concussive events that may cause injury.”

This reckoning was prompted by a citizen-investigation by 18-year-old Kayleigh Bonner, whose surfman father died by suicide in 2025. Soon after, this information was picked up by the New York Times, who reported that the service “has never studied the hazard that waves may pose to the brain.”

Repeated impacts can cause cumulative brain trauma, CTE-like degeneration, as the brain moves back-and-forth inside the skull. It has been determined that fast-boat operators have a roughly 45 percent chance of traumatic brain injury, but recreational boaters, powerboat racers, and commercial mariners are at risk too.

The US Coast Guard now pledges decisive action to better prevent, detect, and treat those effected by the impact of consistent wave pounding, and other such neurologically damaging events. On an individual scale, precautions include shock-mitigating suspension seats, gravitational force (G-force) sensors, speed limits, medical baselines, and prompt symptom reporting.

Birth Brain Injury at Army Hospital Results in $11 Million Settlement

Legal settlement papers for birth brain injury

On September 11, 2021, Sarah Panter delivered a daughter at Blanchfield Army Community Hospital at Fort Campbell, on the border of Kentucky and Tennessee. She was then given Pitocin, a synthetic medication version of oxytocin used to induce pregnancy.  Monitors signaled fetal distress, a noted effect of the drug, and Panter’s attorneys say a C-section should then have been offered, to prevent the infant from injury. Instead, hours later, a midwife delivered the baby, who initially didn’t breathe.

Panther’s daughter now lives with hypoxic-ischemic encephalopathy, brain damage that occurs when a newborn’s brain does not get enough oxygen or blood flow before, during, or right after birth. Additionally, the child lives with cerebral palsy, epilepsy and cortical blindness, known consequences of brain injury. She also cannot walk or sit unaided, uses a feeding tube, and needs round-the-clock nursing for life.

While birth injury is known to “only” be about 2% for normal vaginal delivery and 1% for cesarean delivery, statistics in the United States report that that birth injury occurs in about 25.3 to 31.1 cases per 1000 hospital births. Because the head is typically the first part to enter the birth canal, it is also the most vulnerable and, therefore, common birth injury, as recognized by various studies available in the NLM database.

In September 2026, the Justice Department agreed to an $11 million settlement funding a lifetime-care trust. While the government settled mid-trial, prior to the judge’s ruling, it has not formally accepted responsibility.

An Investigation into the Navy’s Response

On September 8, 2026, House Committee on Oversight and Accountability Chairman James Comer and Subcommittee on Military and Foreign Affairs Chairman William Timmons released “Unseen Impacts.” This report capped an investigation that began last year into the Navy’s Project Odin’s Eye, which purportedly delved into potential brain injury in naval aviators who routinely endure up to nine Gs, from catapult launches and high-G turns. Navy medical officials then reasoned, in Catch-22 fashion, that with no evidence a problem existed, no study was needed. Therefore, none was done.

This secret TOPGUN program wasn’t disclosed to Navy leadership until the New York Times exposed it in 2024. Now, after examining Project Odin’s Eye, investigators have concluded that the program’s “research” wasn’t TRUE research.  Based on this new information, the Committee and Subcommittee are now urging Congress to mandate a comprehensive long-term aviator brain health study.

For more information on Project Odin’s Eye: https://tbionthehill.com/2025/09/17/navys-secret-brain-injury-study/

Diagnose TBI, No Blood Draw Necessary

The military’s effort to create a system to easily and quickly test for a brain injury did not end with the i-STAT blood test, that I first reported in 2017. The DHA (Defense Health Agency), a federal Combat Support Agency, is now promoting a new product with the same goal. However, this new DHA product takes a different route.

Camp Lejeune entrance sign reading Marine Corps Base Camp Lejeune

On June 30, Navy Hospital Corpsmen from II Marine Expeditionary Force, located at Camp Lejeune, North Carolina, tested diagnoses prototypes under the Traumatic Brain Injury Field Assessment Program: A handheld hemorrhage detector, a non-invasive scanner like low-power radiofrequency waves, was tested, as it measured changes in optical density or electromagnetic fields. Additionally, medics tested a number of digital neurocognitive assessments. This testing software can be stored on a phone or tablet, thereby replacing paper-and-pencil assessments. Importantly, the prototypes tested do not require blood proteins and, therefore, no blood draw is needed for diagnosis.

Pentagon Started Tracking Blast Injuries Then Ran Out of People

The Department of Defense launched brain-health monitoring for troops exposed to weapons blasts. However, a federal watchdog report released August 18, 2026 found that the DoD lacks the staff, technology, and funding to fully deliver on it.

Government Accountability Office building at 441 G Street NW with American flags

The DoD is highly aware, and the US Government Accountability Office report GAO-26-107829 warns, that firing certain weapons exposes service members to blast overpressure waves, which “may cause problems such as headaches, memory loss, or traumatic brain injury.” As with similar brain injuries, these waves can then travel through the skull and cause micro-injuries in the brain. (In fiscal 2025, 198,161 recruits completed baseline cognitive assessments, and 86% of high-risk personnel were screened, though the Navy lagged at only 59%.) Additionally, the GAO recognizes that a shortage of industrial hygienists remains the “primary barrier” to tracking exposures.

Assistant Secretary of Defense for Health Affairs Keith Bass agreed with both GAO recommendations, noting DoD “estimates it will complete the actions for both recommendations by December 2026.”

$2.44 Billion Reclaimed: Inside the VA Recoupment Fight

Two women exchange cash and a check at an office desk

Under a law dating to the 1940s, veterans who received separation pay, compensation for time served, had to repay it if they later qualified for VA disability benefits. (Federal rules barred receiving both.) The VA would withhold disability checks until the debt was cleared. From 2013 to 2023, this debt recoupment structure equaled $2.44 billion in separation pay and bonuses from 112,834 veterans.

To many, this payment structure may seem like punishment to the disabled veteran. In 2023, Senator Ruben Gallego’s (AZ) Restore Veterans’ Compensation Act of 2023 which would have barred this practice, arguing the two payments serve different purposes. Since that time, the bill has been reintroduced many times. Most recently, Representative Bilirakis (FL) brought the Restore Veterans’ Compensation Act of 2026 to Congress on January 13, 2026. (HR7027 was referred to the Subcommittee on Disability Assistance and Memorial Affairs on May 7, 2026.)

“It is ridiculous to claw back money from a veteran who has put life and limb on the line, just because later in life they qualify for disability benefits,” stated Gallego, acknowledging the fact that traumatic brain injury symptoms often surface or worsen years after service.

*The bill’s chief criticism is fiscal: ending recoupment means the government forfeits future collections.

Serious Gap in Veteran TBI Care Found

On August 5, 2026, the VA Office of Inspector General (VA OIG) released a national review that found a serious gap in traumatic brain injury care for post-9/11 veterans: Of 301,177 veterans who agreed to a comprehensive TBI evaluation after screening positive between September 11, 2001 and March 31, 2025, only 158,907 received one, leaving 142,270 without the assessment.

Though the evaluation largely draws on the same screening data of VA’s congressionally mandated TBI Veterans Health Registry, this oversight review is distinct in auditing the screening-to-evaluation pipeline rather than cataloging diagnosed cases. While very much not excusing the lapse, it was found to have several causes. In a 100-record sample, 65% of veterans canceled the appointment or did not respond to VA’s attempts to schedule it. But investigators also faulted the VA itself, as in 15% of cases the staff never placed the required consult, and a single-use electronic template blocked repeat evaluations for redeployed veterans. One VA official told investigators that once completed, the template effectively “locks down.”

The VA Inspector General Cheryl L. Mason issued three recommendations: (1) review the referral process after positive screenings, (2) consider a uniform system for directing veterans to Polytrauma System of Care specialists, (3) revise the template’s one-time-use limitation. The VA has agreed with the first two and agreed with the third, in principle.

Veterans’ Brain-Injury Cases Surge as Research Funding Falls

Graph showing surge in confirmed veterans brain injury cases from 2018 to 2022 with key contributing factors

New data from the VA’s Traumatic Brain Injury Veterans Health Registry reveals that 556,502 veterans entered the registry between September 2001 and September 2025. (This 26 percent jump in just four years averages more than 28,000 new cases annually since 2021.) This data was make available in July 2026, just as the federal funding for TBI research has dropped from $175 million to $40.5 million. (Of course, this drop does not apply to state funding.)

In a joint statement, Disabled American Veterans National Commander Coleman Nee and Invisible Wounds Foundation CEO Shannon Connell urged Congress “to increase funding and direct greater focus toward service member and veteran-centered TBI research. The response from Congress has echoed this and crossed party lines. In a May 2026 hearing reviewing that budget, Senate Appropriations Chair Susan Collins blasted proposed budget reductions targeting the National Institutes of Health.” Rep. Mike Levin (CA) called the current level “a drastic cut from prior years” and pledged to fight for more funding.