Columbia VA Podiatrist Dr. Brandon Brooks Wins National Recognition for Groundbreaking Research on DREADD Phenomenon

This achievement marks his third consecutive first place win in national abstract competitions, solidifying his reputation as a leader in podiatric research focused on improving care for Veterans.

The winning abstract introduced the DREADD phenomenon, a term coined to describe the emotional and psychological toll experienced by patients following any diabetes-related amputation. The study focused on “minor, non-traumatic” amputations, such as the loss of a toe. While these procedures are often viewed as relatively minor from a surgical perspective, Dr. Brandon Brooks’ research reveals that they can have significant psychological consequences among patients with Type 2 Diabetes Mellitus.

Dr. Brandon Brooks’ study found that 90% of patients experienced increased depressive symptoms following an amputation. For many, the loss of even a small part of the body is a deeply emotional and traumatic event. This distress can impact their overall health outcomes, leading to issues such as medication non-compliance, missed appointments, and poor dietary choices.

The study highlights a bidirectional relationship between depression and Type 2 Diabetes Mellitus, meaning that one condition often worsens the other. Depression, for example, can make it harder for patients to manage their diabetes effectively, while poorly controlled diabetes can increase the likelihood of complications, including amputations. By understanding this cycle, healthcare providers can better address the full scope of a patient’s needs.

“It’s important to recognize that a ‘minor, non-traumatic amputation’ can still be a traumatic experience for a patient,” Dr. Bradley M. Brooks, a board-certified psychiatrist who is Dr. Brandon Brooks’ brother and co-author in this study, explained. “I believe this study will encourage multidisciplinary limb preservation teams to consider mental health clinicians, such as, but not limited to, psychiatrists and clinical psychologists as team members.”

Dr. Brandon Brooks emphasized the importance of early intervention, recommending that clinicians use validated tools like the PHQ-9 to screen patients for depressive symptoms following an amputation. This step allows healthcare teams to identify those at risk and provide timely referrals to mental health professionals, ensuring that patients receive comprehensive care.

A unique aspect of this project was Dr. Brandon Brooks’ collaboration with his brother, Dr. Bradley M. Brooks. Together, they combined their expertise to explore the psychological and emotional aspects of limb preservation and amputation care.

Dr. Brandon Brooks described their collaboration as a seamless blending of perspectives. “Having my brother’s mental health expertise was invaluable to this study,” he said. Dr. Bradley Brooks also contributed the acronym DREADD, which captures the distress many patients feel following an amputation.

The study advocates for including mental health professionals, such as psychiatrists and clinical psychologists, in multidisciplinary limb preservation teams. This approach ensures that patients receive both physical and emotional support during their recovery. Dr. Brooks noted that this model could improve surgical outcomes by addressing the mental health challenges that often accompany physical trauma.

The findings of this study have significant implications for how healthcare providers approach amputations, particularly among patients with diabetes. Dr. Brandon Brooks suggested that depressive symptoms should be incorporated into existing classification systems for limb preservation, such as the WIfI (Wound, Ischemia, and Foot Infection) system. He believes this adjustment would allow clinicians to take a more holistic view of a patient’s condition and prioritize mental health as part of their treatment plan.

“Adding depressive symptoms as an ordinal variable to classification systems like WIfI could enhance their usefulness,” he said. This adjustment would help clinicians better understand the complex interplay between physical and emotional health, ensuring that patients receive care tailored to their unique needs.

Dr. Brandon Brooks attributed much of his success to the supportive research environment at the Columbia VA Health Care System. He highlighted the flexibility and resources available to researchers, including access to ethics guidance, quality improvement opportunities, and encouragement from leadership.

“Dorn is a great place for research,” Dr. Brandon Brooks said. “The culture here fosters innovation and allows us to push boundaries to improve care for Veterans.”

His work is an example of the cutting-edge research emerging from the Columbia VA, where teams are dedicated to addressing the unique challenges faced by Veterans.

Dr. Brandon Brooks’ first place win in New Orleans follows two previous victories: in 2022 at the Desert Foot Conference in Phoenix, Arizona, and in 2023 at the Scientific Conference of the American Podiatric Medical Association in Nashville, Tennessee. Each of these awards reflects his commitment to advancing podiatric care and his focus on multidisciplinary collaboration.

Despite his growing list of accolades, Dr. Brooks remains focused on the future. He was recently invited to join the Health Equity and Advocacy Committee for the American Limb Preservation Society (ALPS), where he plans to expand upon his research and advocate for addressing social determinants of health in limb preservation.

He also expressed a desire to educate fellow clinicians about the DREADD phenomenon and the importance of mental health in limb preservation. “Lecturing and completing a follow-up study are likely my next steps,” he said.

At the heart of Dr. Brandon Brooks’ work is a deep commitment to the Veterans he serves. He views his research as an extension of his dedication to improving their quality of life.

“It’s an honor and privilege to care for our Veterans,” he said. “They inspire me every day, and I want to do everything I can to help improve their outcomes.”

Dr. Brandon Brooks’ groundbreaking research not only sheds light on the psychological impact of amputations but also paves the way for more comprehensive and compassionate care. His work serves as a reminder of the importance of addressing the whole patient—body and mind—and underscores the Columbia VA’s commitment to innovation and excellence in Veteran care.

For more information about what’s going on at the Veterans medical center, clinic locations and other services available to Veterans in and around Columbia, visit the website https://www.va.gov/columbia-south-carolina-health-care/and follow us on Facebook, Twitter and Instagram, keyword: VAColumbiaSC.