UVA fights TBI at home

For the past five years, UVA’s neurotrauma laboratory has gathered the school’s top doctors to study what has been called a “signature wound” in American military conflicts in Iraq and Afghanistan. Traumatic Brain Injuries—known as TBIs—have afflicted 200,000 soldiers since the start of Operation Enduring Freedom in 2001. In an effort to develop TBI testing fit for the battlefield, the Department of Defense provided the UVA neurotrauma lab with $6 million to create portable ultrasound machines that can evaluate brain injuries during combat.

Dr. James Stone, an assistant professor of radiology and medical imaging at the University’s School of Medicine, is working with neurological surgeon Dr. Greg Helm to develop a hand-held ultrasound unit. However, before the technology can be built, Stone and Helm must validate the theory the entire project rests on—that ultrasound measurement of tissue stiffness can actually detect TBI.

According to Stone, the basis for the ultrasound research stems from a collaborative project with Temple University investigators, which “showed alteration in tissue stiffness in a measurable fashion following experimental brain injury.” If Stone can prove that tissue stiffness is correlated with TBI, brain injury diagnosis could become more reliable.

Current military tests fail to catch nearly 50 percent of brain trauma cases, according to a NPR report. “Although we have spent the better part of a century exploring how TBI occurs, we still have much to learn,” admits Stone.

The Center for Disease Control lists TBI as a contributing factor in one-third of all injury-related deaths, with 1.7 million Americans suffering from brain trauma each year. In military conflicts in Afghanistan and Iraq, hundreds of thousands of soldiers have experienced head injuries ranging from mild to life threatening, usually caused by mines and improvised explosive devices. Military helmets offer protection against bullets, but still face challenges from roadside bombs.

“In terms of resulting clinical symptoms, injuries can be mild and manifest as mood disturbances, difficulty sleeping, headaches, and memory loss,” explains Stone. Patients with more severe brain trauma have experienced lifelong debilitation, coma, and death. A study from Vanderbilt University reveals that 30 percent of TBI patients will develop clinical depression—three times greater than the national average.

In 2007, UVA recognized the urgent need to better detect and understand instances of TBI on the battlefield. For the past six years, says Stone, UVA’s neurotrauma lab “has been entirely focused upon exploring questions related to combat [inflicted] TBI.”

In addition to Stone and Helm, there are several other UVA doctors developing applications for the DOD. Dr. George Rodeheaver directs the University’s Wound Healing Lab, where his highly successful burn treatment gel caught the government’s attention. Last November, Rodeheaver’s company PluroGen signed an $8.6 million federal contract to fund the regulatory approval process and increase manufacturing of the gel.

Despite the death of al-Qaeda figurehead Osama bin Laden last week, the country remains enmeshed in the war on terror. President Obama’s 2012 budget devotes $80 million to Department of Defense research development, which may help programs like UVA’s neurotrauma laboratory further limit the deadly effects of a decade-long war.