Wednesday, August 15, 2012

Diagnosing & Treating TBI

The Department of Defense and the Veterans Administration are very concerned about brain injuries since so many service members are coming back from Iraq and Afghanistan with Traumatic Brain Injuries (TBI). The Army alone is involved in 472 active research TBI projects alone and is driving the science behind the public health problem that affects everyone from kids involved in sports to service members in Afghanistan.

Severe brain injuries aren’t difficult to diagnose, but it’s more difficult to diagnose mild to moderate TBI. To improve the spectrum of diagnosis-to-treatment of mild TBI, the Army is working with university researchers and organizations like the National Football League and the National Hockey League since their players are a risk for concussions.

The Army and the NFL are both interested in developing helmet sensors that can be used to evaluate concussive events that could lead to TBI. The sensors would be able to measure the severity of impact to a soldier’s head and the data could be collected and incorporated into further TBI research and medical reports.

The current TBI research being funded includes a range of research on neuroimaging or brain scanning technologies, a quantitative electroencephalography or brain mapping, blood tests for biomarkers for brain injury, and drugs that could prevent injuries from mild brain trauma.

The Veterans Administration’s Office of R&D is very actively pursuing ways to help veterans with TBI. The VA has established a VA Rehabilitation Research Center of Excellence at the Michael E. DeBakey VA Medical Center in Houston Texas to focus on mild TBI.

At the center, researchers in the Genetics Core Program are studying the possible link between genetics and the effects of blast exposure during combat. Individuals who meet certain criteria may be asked to participate in studies using a functional MRI to view their brain as they complete computer tasks.

NIH is actively funding and involved in brain research. Researchers at NIH’s Center for Neuroscience and Regenerative Medicine have developed a prototype for a hematoma detector with a motion based sensor. The device images the brain by using near-infrared light to penetrate the skull and characterizes the amount of blood pooling by measuring how much the changing light is absorbed.

An existing handheld device called the InfraScanner developed by the Office of Naval Research has been FDA approved and is used in Europe but this device differs from the NIH device in that the patient has to remain motionless. 

NIH scientists have developed a device to simulate the effects of pressure waves resulting from explosions or blasts on biological tissue. This device would permit real-time monitoring of tissue damage while it is occurring and be able to track the secondary effects of pressure damage after tissue insult. The device is in the prototype stage but for more information, email Michael Shmilovich at at the NIH Office of Technology Transfer.

David Hage, a Professor of Chemistry at the University of Nebraska at Lincoln (UNL) is developing a handheld tool to diagnose TBI on the spot to yield critical and in some cases life-saving information to guide triage decisions from the battlefield to the football field.

SFC Fluidics, a Fayetteville Arkansas based-biotechnology company recently entered into a licensing agreement with UNL’s nonprofit affiliate NUtech Ventures to use the technology developed by Hage.

Hage a bioanalytical chemist has developed the technology to separate and measure specific compounds in complex fluids at a rapid rate. Hage’s methods can measure specific proteins in blood serum released by the brain which would enable the severity of brain injury to be diagnosed with a simple blood test.

Hage has spent two decades designing separation and measurement techniques, many of which are patented for a wide range of applications. These applications have ranged from new clinical tests to improved methods for forensic testing, drug development, and environmental monitoring.

The research is being supported by NIH, EPA, the Nebraska EPSCoR program, the Nebraska Center for Nanohybrid Functional Materials, and DOD. Clinical trials for the device are expected to begin in spring 2014. For more information, call (402) 472-2744.  

In other research, BrainScope Company Inc, a privately held medical neurotechnology company is developing a new generation of handheld, portable simple to use, non invasive tools to rapidly and objectively assess brain function and TBI at the point-of-care.

Clinical studies have been conducted over three years with collegiate and high school football players who sustained concussions. The findings indicate that BrainScope’s technology may be able to detect TBI, categorize the severity of TBI, and provide an indication of the length of time needed for recovery before the players can return to play. For more information, go to