Researchers at St. Louis University (SLU) are recruiting participants for a first-of-its-kind study to map and better understand the brain injuries of both combat veterans and civilians. The study is funded by a $5.3 million grant from the U.S. Department of Defense.
Researchers will use three types of imaging equipment together to acquire better data leading to a more complete classification of brain injuries:
1. 3 Tesla MRI (magnetic resonance imaging)
2. 64 Slice PET/CT (positron emission tomography / computed tomography)
3. MEG (magnetoencephalography)
Investigators hope this information will lead to better treatment for patients with traumatic brain injury as well as post-traumatic stress disorder (PTSD).
Traumatic brain injury (TBI) seems to be on the rise, but is it really? TBI is caused by physical trauma to the head. Symptoms may be be mild to severe and include headaches, nausea, seizures, and decreased levels of consciousness. In the United States, approximately 1.4 million people experience TBI each year, with 230,000 of them hospitalized and 50,000 dying. This seems like a huge number of people. However, we are in a time of war, a time of war when combat soldiers are equipped with better body armor and armored vehicles than ever before. It's thought that many combat veterans are now surviving injuries with TBI that were previously fatal.
Dr. Richard Bucholz, lead investigator for the study, explained:
"It’s an extraordinarily significant study. We are casting about with a new net. We think there is a lot of information that we don’t know about brain injuries... It’s an opportunity to get a better handle on the problem, to see what actually constitutes head injury as opposed to relying on a vague description of someone who is having problems after a blow to the head.
The aim of the study is to try to understand situations where patients with moderate head injury have anatomically normal brains but significant neurological impairment... We have noticed soldiers coming out of the Iraqi conflict whose MRI and CT images look structurally normal, but who nevertheless have significant neurological deficits. We’re trying to figure out why these brains are structurally normal but functionally abnormal... The situation is akin to looking at a city from 50,000 feet. We can see the highways and bridges and we can make out the outlines, but that doesn’t tell us anything about how the traffic is moving on the ground. That is what functional imaging will tell us."
It was once believed that the brain, once injured, was permanently damaged; that function could not be restored or recovered. However, it now seems that the brain is highly resilient, and it may have the ability to "rewire" itself. If one neural pathway is damaged, another may be able to compensate. To take advantage of this remarkable capability, doctors must determine which areas of the brain continue to function, which the imaging will be able to demonstrate.
Researchers hope to find correlations between injured circuits and neurological symptoms. If they can determine which area of the brain corresponds with a particular neuropsychological problem, such as speech or movement of a specific finger, they may, in some cases, be able to develop therapies. In this way, researchers hope to learn more about (PTSD). If doctors are able to detect the disorder in images and quantify it, they’ll be better equipped to treat it.
The study will run for four years.
Participants must be 18 years of age or older.
Participants must have suffered traumatic brain injury.
Between 120 and 150 participants will be enrolled in the SLU study.
Participants will include veterans and civilians with traumatic brain injury, as well as healthy civilians who have not suffered injury.
Veterans will be enrolled from across the nation.
Civilians will be enrolled from the St. Louis area.
Active duty military personnel are not eligible to participate in the study.
Patients will be given neuroimaging and neurocognitive evaluations, which will last about two days.
Up to 30 patients may be asked to enroll in a follow-up study 12 months after their initial participation.
Non-active duty military veterans who participate in the trial will be provided with travel, lodging, and meals.
All participants will be compensated for their time and all study related procedures will be provided at no cost.
Summary and comments:
This is the type of research that can benefit many people and address multiple health issues. In addition to the advances that researchers are hoping to make in treating TBI and PTSD, it is quite possible that the information from this study can help researchers find better treatments for other disorders and diseases affecting the brain.
As a final note, Dr. Bucholz commented,
"There is a lot of interest on the part of those who have head injuries to know ‘What is wrong with me? Why am I not the person I was before the head injury?´ For these people, I think it’s incredibly frustrating to get a structural image that says nothing’s wrong, and yet to know that, indeed, something is wrong."
Newswise Press Release. "Unlocking the Mysteries of the Brain: Investigators Search for Answers about Injuries, PTSD." St. Louis University. August 5, 2009.
Published On: August 09, 2009