Thousands of veterans return home from duty with scars invisible to the naked eye: traumatic brain injury. Linked to depression, substance abuse, and PTSD, and manifesting itself as memory loss, headaches, dizziness, and confusion, TBI has been called a signature wound of modern warfare.
mTBI: Finding the needle in a haystack.
Nearly two decades since the attacks on 9/11 and TBI remains astonishingly difficult to diagnose. The challenge isn’t diagnosing severe cases like blows to the head. Rather, it’s in the subtler ways injuries can often go unnoticed. We call these mild TBI, or “mTBI.”
For years, the medical community has gone along with this broader umbrella term because we lacked the tools to quantify the physiological distinctions. Until now. Today, new, more powerful MRIs, coupled with advanced digital-image processing, give us access to nuances that before were impossible to identify. These improved glimpses into brain function are helping doctors to see the finer distinctions between injuries, which in turn are helping to give patients better, more targeted treatments. And that means better outcomes.
A key player in this new research is the Defense and Veterans Brain Injury Center, or DVBIC. A joint effort between the Department of Defense and the Department of Veterans Affairs, the DVBIC brings the expertise of nearly 500 staff members, working across 17 military hospitals and five VA medical centers nationwide. Their efforts, along with the efforts of experts at both public and private centers, are helping to cast new light on what we thought we knew about mTBI.
One such major advancement is diffusion tensor imaging. By measuring the diffusion of water throughout the brain, doctors are able to see the white matter tracts in greater detail that electrical signals use to travel from one part of the brain to another. By comparing the brains of mTBI sufferers to control groups, we hope to develop standardized measures for determining the extent of a patient’s injuries—along with treatment courses and likely outcomes.
Just like common blood tests, we now foresee one day having a panel of standard neuroimaging tests that can quickly classify brain injuries and indicate the best way to treat them. While there’s still work to be done, for many, there’s a light at the end of the tunnel.
The implications go far beyond just the military and veteran communities. From brain damage suffered by professional athletes to head injuries in youth sports, public awareness of TBI is only growing. And our ongoing research and scientific evidence can help shape this understanding.
DVBIC is studying the effects of brain injuries on vision and hearing, as well as on emotional disturbances. The data from these studies are enhancing our understanding of resilience and how to reduce the impact of these injuries. And in many cases, being added to the Federal Interagency Traumatic Brain Injury Research Repository: a national database and joint venture between the DoD and NIH that allows researchers from both the public and private sectors to build on the breakthroughs being made every day.
The effects of combat on warfighters is why DVBIC’s focus will always be on service members and veterans, first and foremost. Bombs and bullets notwithstanding, even the routine firing one’s own weapon can come with powerful concussive force. And luckily, we’re beginning to better understand how violent energy affects the brain, and how the right training and treatment can help patients improve.
It’s been a long journey, but for both TBI research its sufferers’ long-term prognoses, the future is looking bright.