December 28, 2007 – The Department of Veterans Affairs is starting a multimillion dollar program at the University of Texas to study brain injuries among U.S. troops.
The program will use UT’s new state-of-the-art brain scanner at the J.J. Pickle Research Campus in North Austin. Initially, efforts will focus on the often invisible and debilitating brain injuries sustained by more than 20,000 troops, according to some estimates.
Identifying and treating the wounds is difficult because the injuries can easily be confused with other conditions or missed by even the most powerful scans.
Officials say they hope the $4.2 million program, which got its funding four months ago from the VA, will eventually expand into brain injuries among children and athletes, and possibly even into the physical causes within the brain for psychological conditions such as post traumatic stress disorder.
Dr. Robert Van Boven, the program director, said he envisions a place to test how well new methods of detection and treatment work, “and hopefully be the birthplace for new standards of treatment for victims” of traumatic brain injury.
Brain injury has emerged as the signature wound of the wars in Iraq and Afghanistan. There, roadside bombs detonate with concussive blasts that can jar the brains of nearby troops. The impact can do damage that varies in severity, and the injuries can create a broad range of symptoms, some of which can take months to manifest.
The injury, like the brain itself, is poorly understood, experts say.
“It’s a virtually unexplored area,” said Michael Domjan, director of the Imaging Research Center, which UT opened in January 2006 before any talks with the VA had begun. “We’ve got a powerful research tool we’re pleased to see used to address a serious medical problem, one that is not limited to just veterans.”
That tool, which cost $2.2 million, is among the most sophisticated brain-imaging devices in the world. Van Boven said the VA program is the first to combine the three types of brain scans the machine can perform.
One type of scan takes snapshots of the brain during various activities, such as a question-and-answer session intended to test memory. The snapshots are used to compare how various areas of the brain are working at different times.
Another type of scan focuses on particular stretches of the microscopic highways that connect various portions of the brain and allow them to communicate. A disruption in those highways can manifest in symptoms such as inability to move a limb or to reason through complex problems.
A third type of scan will analyze the chemicals in a disrupted stretch of that highway to determine what, exactly, is wrong.
The combination of techniques is more precise than most brain scans, Van Boven said, and far more reliable than the standard method of making a diagnosis mostly or entirely on symptoms (which include emotional instability, inability to concentrate and balance problems). The symptoms can easily be confused or intermingled with those of post traumatic stress disorder, depression and sleep disorders, all of which require different treatment.
“In general, we’ve been overly reliant on subjective and nonspecific resources, such as interviews or psychological evaluations, to make a diagnosis,” Van Boven said. “When someone says they’re having trouble remembering things, that’s not a diagnosis of Alzheimer’s disease. … The same problem exists for” brain injuries.
That assessment is shared by Dr. Jim Misko, a neuropsychologist in Dripping Springs.
“This is what the field has been waiting for,” said Misko, a member of the Brain Injury Association of Texas who specializes in treating the condition. “Rehab professionals are sorely in need of knowing which treatments really are effective and which ones aren’t.”
Some organizations, such as the National Institutes of Health and National Institute on Disability and Rehabilitation Research, have been funding research into brain injuries for years. But experts and veterans’ advocates say far more money and effort are needed to deal with the consequences of the Iraq and Afghanistan wars.
Among the first tasks for the VA’s new program will be evaluating a series of computer programs created by Dr. Michael Merzenich, one of the world’s leading neuroscientists. Merzenich’s computer programs give the brain mental calisthenics and are designed to tap into the brain’s ability to rewire itself.
As a VA doctor, Van Boven is treating troops with brain injuries, but the program will not begin working with patients until its finer points are approved next year.
After everything is approved, Van Boven said, he will start looking in earnest for patients in Central Texas.
“These guys,” Van Boven said, “deserve real-world solutions, and we’re hoping to help find those solutions.”