Medical: Progress in determining extent of brain injury

Growing awareness of the toll that concussions and traumatic brain injuries reap on battlefields and playing fields is drawing new ideas from researchers across many disciplines.

One of the greatest challenges for those treating soldiers, athletes or other trauma victims is simply determining whether a brain injury has taken place.

Most concussion symptoms — dizziness, nausea, lack of focus — can also be caused by other medical conditions, making it difficult for athletic trainers or medics to take the next steps toward diagnosis and treatment of an injury that affects more than 1 million Americans each year.

Even brain-imaging tests done after a concussion may not reveal damage from a mild brain injury, particularly if there is no earlier image for comparison.

Now a team of doctors and engineers at the University of Pennsylvania has developed a "blast badge" that changes color in a spectrum that reflects the intensity of an explosion to which a wearer has been exposed.

Made of color-changing crystals designed to break apart when exposed to shock waves of differing strengths, the badges are lightweight, durable and require no power, yet flexible enough to be attached to uniforms or helmets in thin sheets.

At this point, the scientists have demonstrated that the material will react to explosive shock waves. Next, they will be working to calibrate color changes to correspond to the potential harm a certain level of blast might cause to the brain, and what kind of medical response might be needed.

The work was published in a recent issue of the journal Neuroimage.

Researchers at Georgia Tech Research Institute, meanwhile, have developed a simple portable radar system to screen individuals for brain injury. The test involves asking the patient to walk a few feet while saying the months of the year in reverse order.

"When a person with a concussion performs cognitive and motor-skill tasks simultaneously, they have a different gait pattern than a healthy individual, and we can identify those anomalies in a person's walk with radar,"said Jennifer Palmer, a research engineer at the institute who was part of the development team. The researchers presented their work at a defense and security conference in Orlando, Fla., on April 26.

Now, the scientists plan to collect more data from healthy people of various heights and weights and do tests on those who already have been diagnosed with concussion through conventional screening tests.

They also want to reduce the size of the gear to make it more portable for battlefield or sports-sideline use.

Elsewhere, scientists at the Salk Institute for Biological Studies reported early this year that a synthetic drug derived from the curry spice turmeric appears to dramatically improve behavioral problems and molecular damage in rodents with traumatic brain injury.

Partnering with researchers at the University of California, Los Angeles, who report the rodent study in the May issue of the journal Neurorehabilitation and Neural Repair, the researchers found that sustained doses of the compound given to brain-injured rats reversed both movement and memory deficits.

The drug was able to maintain critical nerve-cell signaling pathways as well as restore nerve-cell connections lost with the injury.

Other studies have shown that the drug has similar benefits for rodents in which a stroke has been induced, and also enhances memory in normal animals.

At the University of Texas Health Science Center in Houston, scientists are setting up a small study involving 10 children ages 18 months to 17 years to determine if cells derived from their own umbilical-cord blood banked at birth can be safely used to treat traumatic brain injury.

The study will only treat children and teens who sustained moderate to severe brain injuries six to 18 months earlier and have lingering neurological symptoms. A similar study using stem cells derived from bone marrow already has been done and showed positive safety results, the scientists said.

Although children generally have better outcomes for most types of brain injury than do adults, head injuries continue to be a leading cause of trauma death among children. Researchers are hopeful that the cells will help speed healing of nerve cells and connections in damaged brains of the young.

(Contact Lee Bowman at BowmanL@shns.com)