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Multiple choices, multiple answers as brain injury research evolves for future battlefield

Dr. Marcello Pilia of the U.S. Army Medical Research and Materiel Command's Combat Casualty Care Research Program tests the I-Portal PAS tool - one of several emerging TBI detection devices - during a presentation at the Pentagon in May 2017. (Photo Credit: Adam Wyatt, TATRC) Dr. Marcello Pilia of the U.S. Army Medical Research and Materiel Command's Combat Casualty Care Research Program tests the I-Portal PAS tool - one of several emerging TBI detection devices - during a presentation at the Pentagon in May 2017. (Photo Credit: Adam Wyatt, TATRC)

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"We're just trying to address as many military needs as possible," said Drexel University Professor Dr. Baruch Ben Dor during his breakout session presentation on cutting-edge traumatic brain injury detection technologies at the 2017 Military Health System Research Symposium in Kissimmee, Florida.

One technology Ben Dor highlighted was an infrascanner device, developed through a multi-university partnership agreement that included Drexel University. The device uses near-infrared spectroscopy technology to locate pockets of intracranial pressure that may, in turn, indicate a potential TBI. By applying multiple sensors to the head, forehead and limbs, the infrascanner measures the absorbance of light at four separate areas of the brain. The device provides data that is then interpreted by a clinician.

This type of technology, which has been previously used to measure the amount of oxygen in a patient's tissue as well as heart rate, may now serve an important role during en-route care and evacuation scenarios in future battlefield situations.

"This is something like ultrasound was 40 years ago," said Ben Dor. "And so we're excited to take that existing technology and then mold it to whatever is needed in the field."

When it comes to the world of TBI, that willingness to "upcycle" already proven technology is now en vogue as investigators try to not only establish biomarkers for the diagnosis of TBI severity, but also try to develop non-invasive neurological assessment devices for all TBI. For researchers, the buzzword is "fusion."

"While we'd love to have just one device for all our needs, the reality is that we're taking more of a 'Frankenstein's monster' approach to head injury detection and diagnosis," said Dr. Tammy Crowder, manager of the U.S. Army Medical Research and Materiel Command's Neurotrauma and Traumatic Brain Injury portfolio.

Said Crowder, "We're excited about all the products here, but in many ways they're all just one part of the larger whole."

Given that more 360,000 Service Members worldwide have suffered a TBI since 2000, questions about the cause, scope and impact of TBI far outnumber current solutions. In addition, products currently being developed to aid TBI diagnosis are further complicated by the recent Army-wide focus on prolonged field care, which dictates attention to the concepts of miniaturization and portability in addition to reliability.

"Right now we're working on imaging the entire head," said investigator Dr. Jason Riley, referring to the infrared transcranial hematoma imaging device he developed with his private-sector partners. "And even better, we've got the whole thing down to the size of a briefcase, which is a big plus to operators in the field."

While always a high-profile capability gap for the Army, the process of developing diagnosis solutions for TBI and TBI risk factors now stands at a crossroads where the need for immediate solutions collides with a parallel need for compact integrity. For both Ben Dor, whose device is the size of a supermarket scanner, and Riley, whose device is currently engaged in clinical trials, their respective efforts put them at the very leading edge of TBI research.

Said Crowder, "It's truly exciting to watch all these efforts take place right here, right in front of you."

The MHSRS is the DOD's premier scientific annual meeting, which combines three previous conferences, including the former Advanced Technology Applications for Combat Casualty Care Conference; the Air Force Medical Service Medical Research Symposium; and the Navy Medicine Research Conference. By combining these conferences into one event, the meeting serves as a critical strategy session for leaders to set future milestones for the Department of Defense's deployment-related medical research programs, centered on the needs of the Warfighter.

Disclaimer: Re-published content may have been edited for length and clarity. Read original post.

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