Monday, May 30, 2011
UCSD and the VA Medical Center in San Diego are researching ways to establish physical proof of invisible injuries in the brain.
Veterans suffering the invisible wounds of war cannot show proof of their injuries like someone with broken bones or missing limbs. New research in San Diego is finding ways to measure the physical evidence of a signature injury of the current wars: traumatic brain injury.
Mingxiong Huang, a researcher at UCSD’s radiology lab, opens the heavy door of the room where the magnetoencephalograpic, or MEG, brain scanner is kept. It is like opening the door of a space capsule.
Huang helps his subject, retired Marine Col. G.I. Wilson, to take a seat inside the machine. It’s like sitting on a throne with an enormous headpiece.
Huang says this is one of only 20 MEG scanners in the country, and the only one being used to identify the physiological evidence of traumatic brain injury.
He instructs Wilson to keep his eyes closed for five minutes, then open them, then close them again - for a scan of his brain in the resting state.
Wilson, who is 64, suffered traumatic brain injury on his last deployment in Iraq in 2005. He’d been deployed numerous times before, but this time his family noticed a big difference in him when he came home.
His daughter Kendra says he was a changed man – his normally sunny personality became withdrawn and dark, and he short-term memory was shot.
“We would have a discussion and 10 minutes later he would ask me a question about what we just discussed, “ Kendra explained, “ and I’m, like, 'Dad we just talked about that.' ”
Wilson described it as like being shut in a dark room
“I thought everyone was reacting differently,” he said. “My daughter reacted differently, my dog reacted differently, and my wife reacted differently, and I thought it was them, and of course it was me.“
Most people diagnosed with mild traumatic brain injury recover in a matter of hours, days or months. But Wilson still had a hard time focusing, finding words and remembering things, even some years after he returned home.
Eventually he went to see Dr. Dewleen Baker at the VA Medical Center in La Jolla.
“I knew from his rank and his past experience that he’d done high-level work.” Baker said, “He’s written long treatises and he was telling me he was having difficulty doing the same kind of work after the blast injury.”
Baker said there were no tests or brain scans to provide objective evidence of more lasting damage to the brain.
“So you were in the dark,” she said, “as was the patient. I needed help, an objective measure as to whether they had TBI.”
That’s where the MEG brain scan comes in. Mingxiong Huang says conventional MRI brain scans only spot TBI about 10 percent of the time,
“It’s frustrating,” he said, “when the conventional neuro-imaging techniques do not provide the location of injury. So that motivated us - and me in particular - to develop new technology based upon MEG slow wave measurements to make the invisible injury visible.”
Huang says the ultra-sensitive MEG scanner can spot damaged brain-cell tissue caused by traumatic brain injury 90 percent of the time.
Huang showed Wilson his own brain scan on a computer screen. The scanner picked up abnormal activity in four areas of Wilson’s brain, and for the first time he had evidence that what he was experiencing was the result of a physiological injury.
Baker said the MEG brain scans may eventually help her distinguish if patients are suffering from PTSD or TBI, which respond to different kinds of treatment.
“One thing it can track is people who are getting different kinds of treatment,” she said, “and look at the resolution through objective scan evidence, so you can begin to more carefully compare the outcomes of new treatments that might be brought in to help with mild TBI.”
For Wilson’s daughter Kendra, it was a huge relief to get a confirmation of his physical injury.
“He’s not reacting like this because he’s mad at us, or his feelings have changed in any way, “ she said, “There’s an actual physical cause that’s making this happen, and that makes it a little easier to deal with.”
Wilson said he’s lucky to have this objective evidence of his injury.
“What about all those people out there today, the soldiers, sailors, marines and air men who have this injury and don’t know, no one’s seen it?” he said. “What about them?”
Especially for young vets in their 20s, Wilson said, it could make all the difference for them and their families, to know that their invisible injuries are not just in their minds, but have visible symptoms in the brain.