By Blanchfield Army Community Hospital Public AffairsMarch 21, 2018
FORT CAMPBELL, Ky, -- A short computer-based program that plays more like a memory game than a medical assessment is recording personal data that can help Soldiers affected by traumatic brain injury.
The Department of Defense introduced the assessment in 2008, across all services for service members deploying to specific areas of operation. The Automated Neuropsychological Assessment Metric is a computer-based assessment given during pre-deployment screening and is one measure that can be used in evaluating Soldiers for TBI.
"ANAM is a means to evaluate a Soldier's cognitive function before and after deployments. The beauty in this model is that help is available and we can support patients' efforts in healing," said Dr. Bret Logan, director of Fort Campbell's Intrepid Spirit Center. The Intrepid Spirit team administers ANAM on Fort Campbell and treats patients with TBI.
A TBI can occur after a jolt or blow to the head disrupts normal function of the brain. It may cause a loss of consciousness briefly or for an extended period of time, or make an individual feel confused or "see stars". Not all blows or jolts to the head result in TBI.
The ANAM takes a record of neurological activity, like attention, concentration, reaction time, memory, processing speed, and decision-making. By completing an assessment prior to deployment, medical officials have a measure of a Soldier's pre-deployment cognitive function to compare against should the Soldier experience trauma to the brain.
"It's just a baseline. It takes about 20 to 30 minutes to complete. It's a combination of reaction and memorization activities. In one section, there is a picture that comes up for three seconds and then goes away. After a moment two pictures come up and you have to use the mouse to pick one of the two pictures that matches what you saw before. In another section, a sequence is displayed and then you have to determine the missing item in another sequence. At the end of the day, individual assessment data is encrypted and sent off to our headquarters in San Antonio, Texas, for storage," said Donald R. Thomas, a health systems specialist, who has overseen ANAM assessments at Intrepid Spirit since 2009.
Like blood pressure, pulse, respirations and body temperature, ANAM is just another measurement recorded into a Soldier's record. It serves as a point of reference that doctors can use in monitoring a patient's health and detecting certain medical conditions.
"If a service member or civilian is exposed to a concussive event, like an explosion, motor vehicle accident or serious fall, resulting in trauma to the head, their health care provider can request the ANAM data which can be used to measure differences," said Thomas. The assessment does not test for traumatic brain injury, but if a Soldier sustains a head injury during deployment, or even in an off duty-accident, another test may be ordered and differences can be used when evaluating for TBI.
The most common form of TBI in the military is mild, more commonly known as a concussion. Defense and Veterans Brain Injury Center reports that the majority of TBIs that service members and veterans sustained between 2000 and 2013 were diagnosed outside of combat. Falls and motor vehicle/transportation crashes are the two leading causes of TBIs -- both of which are preventable.
Common signs and symptoms of concussion or mild TBI are divided into three categories; physical, cognitive and emotional. Physically, individuals may have headaches, trouble sleeping, dizziness, balance problems, nausea or vomiting, fatigue, sensitivity to light, visual disturbances and ringing in the ears. Cognitive symptoms include slowed thinking, poor concentration, memory problems and difficulty finding words. Person's with TBI may feel anxious, depressed, and irritable and have mood swings. TBIs are classified as mild, moderate, severe and penetrating. The sooner a person gets checked out the sooner they can return to normal life.
"Rest is always the first measure to take for anyone who has experienced a head trauma by blacking out or seeing stars. If our beneficiaries continue to experience concerns, they need to speak to their primary care manager. Our multidisciplinary team within the Intrepid Spirit applies both modern and ancient techniques to support provider referred patients who may not be progressing with the PCM protocols given after patients actively apply the protocols," said Logan.
Nationwide, Americans average more than 2 million TBIs annually, according to the Centers for Disease Control and Prevention. Whether on the battlefield or in the backyard, individuals who experience a jolt or blow to the head and exhibit any symptoms associated with TBI should contact their primary care manager for further evaluation.
Fort Campbell's ANAM site, located across from the hospital, is open weekdays. Pre-deployment assessments are conducted on laptop computers and the center can accommodate 32 Soldiers at a time. Thomas said that units with more than 20 Soldiers requiring assessments should call ahead so they can block out a time to reduce wait.
Because of the significance ANAM could have, Thomas said Soldiers should report to the assessment well-rested. Medications, alcohol and lack of sleep can lead to poor performance. Participants complete a questionnaire prior to testing that helps Thomas to identify candidates who may need to be rescheduled.