Chronic traumatic brain injury (cTBI) represents one of the largest unmet medical needs in the U.S. healthcare market today, with a current pool of 5 million patients incurring costs estimated at more than $40 billion per year.1 A proportion of the 2+ million new cases of acute TBI in the U.S. each year don’t fully recover, thereby providing a steady stream of new cTBI patients being added to the pool. Yet despite its costs and clear absence of treatment, not a single drug has been approved for cTBI.
With limited treatment options, the effects of cTBI are typically felt throughout the remaining lifetimes of its victims. The impact on victims and their families is often devastating. Many survivors of severe TBI fail to completely recover and require ongoing medical treatments and care. Individuals completing inpatient rehabilitation following an acute TBI episode were over twice as likely to die as individuals of comparable age, sex and race in the general population, with a reduced average life expectancy of 9 years. It is estimated that over a lifetime, it can cost between $600,000 and $1,800,000 to care for a survivor of severe TBI.2 One survey of employment after inpatient rehabilitation for TBI reports that 60 percent of those undergoing rehab are unemployed two years after the event.3
New cases of TBI in developed countries occur at about the same rate as the United States. While the cost of care may vary widely throughout the world, the incidence of TBI is not that different from levels found in the U.S.4 Approximately half of diagnosed TBI incidents are the result of motor vehicle, bicycle, or pedestrian-vehicle accidents, with falls coming in second at 20-30 percent.5
The annual incidence of sport-related TBI appears to be growing, if only as a result of heightened awareness.6 In addition, as professional sports injuries have gathered headlines in recent months, the related publicity is raising questions among parents of younger children whether contact sports like football, hockey, and soccer may be contributing TBI cases that are underreported or not fully recognized in their children.
TBI has also become known as the signature wound of the wars in Iraq and Afghanistan, with over 250,000 service members sustaining a TBI between 2000 and 2012.7 While the use of Kevlar helmets has greatly reduced the incidence of penetrating head injuries, they do little to protect the brain from concussive forces, especially from improvised explosive devices. Approximately two-thirds of army war zone medical evacuations result from blast injuries.8
- Langlois JA, Rutland-Brown , Wald MM. “The epidemiology and impact of traumatic brain injury: a brief overview,” The Journal of Head Trauma Rehabilitation, 2006; 21:375-8.
- Heinzelmann M, Imhof HG, Trentz O. [Shock trauma room management of the multiple-traumatized patient with skull-brain injuries, A systematic review of the literature], Der Unfallchirurg, 107(10):871-880, October 2004.
- Cuthbert, Jeffrey P et al (2015)Tabish SA, Syed N. “Unemployment in the United States after Traumatic Brain Injury for Working-Age Individuals: Prevalence and Associated Factors 2 Years Postinjury.” The Journal of Head Trauma Rehabilitation, Vol. 30, Issue 3, 160-174.
- Tabish SA, Syed N. “Recent Advances and Future Trends in Traumatic Brain Injury.” Emergency Medicine (Los Angeles) 5:229. doi:10.4172/2165-7548.1000229, 2015.
- Stein DG. “Embracing failure: What the Phase III progesterone studies can teach aboutTBIbclinical trials.” Brain Injury, 29(11), 2015, 1259-72. Epub 2015 Aug 14. Review.
- Selassie AW, Wilson DA, Pickelsimer EE, Voronca DC, Williams NR, Edwards JC. “Incidence of sport-related traumatic brain injury and risk factors of severity: a population-based epidemiologic study,” Annals of Epidemiology, 23(12):750-6, doi: 10.1016/j.annepidem.2013.07.02, Epub 20 Sep 2013.
- Zouris JM, Walker GJ, Dye J, Galarneau M. “Wounding patterns for U.S. Marines and sailors during Operation Iraqi Freedom, major combat phase,” Military Medicine, 171: 246-252, 2006.
- Lew HL, Poole JH, Alvarez S, Moore W. “Soldiers with occult traumatic brain injury,” American Journal of Physical Medicine and Rehabilitation, 84:393-398, 2005.