More than 2.6 million U.S. servicemembers have been deployed to Iraq or Afghanistan since September 11, 2001. Post-traumatic stress, depression, chronic regional and widespread pain, and traumatic brain injury symptoms are common among these veterans, as well as among civilian trauma survivors. In response to an executive order from President Obama to initiate major research efforts to better understand and treat these disorders, the National Institutes of Health has agreed to fund the most comprehensive longitudinal study of trauma survivors ever performed.
The $21 million study – the AURORA Study – will utilize the efforts of 19 institutions and more than 40 scientists. Trauma survivors will be enrolled in the immediate aftermath of trauma and followed longitudinally for one year. Sophisticated adaptive sampling methods will be used to perform a comprehensive, state-of-the-art assessment of genomic, neuroimaging, physiologic, neurocognitive, psychophysical, behavioral, and self-report markers.
The study's Sleep and Circadian Core, led by Thomas Neylan, MD, professor of psychiatry at UC San Francisco and director of the San Francisco VA Medical Center's Post-Traumatic Stress Disorders Program, will analyze sleep and circadian measures from the full sample of 5,000 participants using a research-grade, wrist-wearable monitor linked to a smart phone. “This study provides us a unique opportunity to test hypotheses about the critical role of sleep and circadian rhythms in the successful recovery from traumatic stress that have been suggested by previous epidemiologic studies,” said Neylan.
Study uses new approaches to achieve discoveries for veterans and civilian trauma survivors
The study will not use traditional symptom checklists to define illness, and instead will use the wealth of biologic data collected to create new diagnostic categories. “Assessing biologic and physiologic processes directly, during the critical period of time after trauma when these disorders develop, is the best way to gain the breakthroughs in understanding that we need to prevent and treat these outcomes,” explained Samuel McLean, MD, at the University of North Carolina Chapel Hill and lead principal investigator of the study.
Another major goal of the study is to develop tools that clinicians in emergency departments, military hospitals, and military aid stations can use at the bedside to identify trauma survivors at high risk of persistent sufferings. Such tools are urgently needed, so that trauma survivors at high risk can be identified for early preventive treatments.
Study investigators are currently pursuing additional foundation and philanthropic support. “$21 million sounds like a heck of a lot of money, and it is," said McLean, "but given the very high costs of the latest science - comprehensive molecular, neuroimaging, and bioinformatic methods - we actually need to leverage these public dollars with private support so that we can take full advantage of this once-in-a-generation opportunity to advance care for veterans and civilian survivors of traumas such as sexual assault.”
This study is funded by the National Institute of Mental Health.
About UCSF Psychiatry
The UCSF Department of Psychiatry and the Langley Porter Psychiatric Institute are among the nation's foremost resources in the fields of child, adolescent, adult, and geriatric mental health. Together they constitute one of the largest departments in the UCSF School of Medicine and the UCSF Weill Institute for Neurosciences, with a mission focused on research (basic, translational, clinical), teaching, patient care, and public service.
UCSF Psychiatry conducts its clinical, educational, and research efforts at a variety of locations in Northern California, including UCSF campuses at Parnassus Heights, Mission Bay, and Laurel Heights, the UCSF Medical Center at Mt. Zion, Zuckerberg San Francisco General Hospital and Trauma Center, the San Francisco VA Health Care System, and UCSF Fresno.
About the UCSF Weill Institute for Neurosciences
The UCSF Weill Institute for Neurosciences, established by the extraordinary generosity of Joan and Sanford I. "Sandy" Weill, brings together world-class researchers with top-ranked physicians to solve some of the most complex challenges in the human brain.
The UCSF Weill Institute leverages UCSF’s unrivaled bench-to-bedside excellence in the neurosciences. It unites three UCSF departments—Neurology, Psychiatry, and Neurological Surgery—that are highly esteemed for both patient care and research, as well as the Neuroscience Graduate Program, a cross-disciplinary alliance of nearly 100 UCSF faculty members from 15 basic-science departments, as well as the UCSF Institute for Neurodegenerative Diseases, a multidisciplinary research center focused on finding effective treatments for Alzheimer’s disease, frontotemporal dementia, Parkinson’s disease, and other neurodegenerative disorders.
About UCSF
UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences; and a preeminent biomedical research enterprise. It also includes UCSF Health, which comprises two top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospital San Francisco, and other partner and affiliated hospitals and healthcare providers throughout the Bay Area.
