Tai Chi as a Potential Intervention for Symptoms of Mild Traumatic Brain Injury in Veterans

Abstract

Many Veterans of the conflicts in Afghanistan/Iraq who experienced repeated concussions due to blast exposure, also referred to as mild traumatic brain injury (mTBI), have persistent post-concussive symptoms (PCS). Additionally, these Veterans often have comorbid, overlapping posttraumatic stress disorder (PTSD) symptoms that further impact recovery. PCS include sleep disturbance, headaches, musculoskeletal pain, anxiety, dizziness/balance problems, fatigue, insomnia, impaired concentration and attention, memory problems, and increased irritability. Veterans with mTBI and PCS tend to have higher rates of unemployment and disability, report a decline in self-rated health and often suffer from anxiety and depressed mood. Multi-modal treatment options remain very limited. Emerging evidence supports the effectiveness of Tai Chi in improving physical and mental well-being, including many common PCS. Adverse events reported in Tai Chi studies tend to be on par with other exercise interventions. Despite this, potential health and physiological benefits of Tai Chi practice in Veterans with mTBI have not been investigated. Physiologically, TBI is associated with chronic autonomic dysregulation along with elevated levels pro-inflammatory cytokines causing neuroinflammation. Numerous studies have demonstrated decreases in pro-inflammatory immune markers following Tai Chi practice. In addition, Tai Chi studies of physiologic measures of noradrenergic function demonstrate short-term decreases in sympathetic tone, and overall greater parasympathetic outflow in Tai Chi practitioners. Given the vast potential for Tai Chi as a treatment modality for mTBI and associated comorbidities, controlled trials, especially in Veterans, are sorely needed.