Back to Top Skip to main content

Emerging technology improves ability to see ‘invisible’ wounds

As well as providing high-resolution clinical imaging capabilities, the 3T Magnetic Resonance Imaging (MRI) scanner used at the NICoE provides researchers access to cutting-edge image acquisition methods, such as multiband diffusion tensor imaging (DTI) and echo planar imaging (EPI) sequences. (Photo courtesy of NICoE) As well as providing high-resolution clinical imaging capabilities, the 3T Magnetic Resonance Imaging (MRI) scanner used at the NICoE provides researchers access to cutting-edge image acquisition methods, such as multiband diffusion tensor imaging (DTI) and echo planar imaging (EPI) sequences. (Photo courtesy of NICoE)

Recommended Content:

Traumatic Brain Injury

The active lifestyle of servicemembers can increase the possibility for concussion or mild TBI because recreation often involves vigorous activities or contact sports, and training can include rigorous physical activity. Deployments also can put warfighters in hazardous situations such as near blasts.

Statistics compiled by the Department of Defense show that servicemembers – both deployed and nondeployed – sustained more than 315,000 mild Tramatic Brain injuries, or mTBI, from the year 2000 through the first quarter of 2018. A recent study of brain injuries in the military republished by the National Institutes of Health noted that the absence of external damage to the head can lead servicemembers to believe they should feel fine. But they don’t.

Fortunately, most mTBI sufferers recover fully under the supervision of a health care professional using a protocol such as the Progressive Return to Activity.

For some, however, symptoms may persist, and can include mood changes, headaches, sleeplessness, and trouble concentrating. With the damage seemingly “invisible,” current methods of looking at bone, blood vessels, and soft tissues in the brain often can’t find a physical cause of these lingering problems. These testing methods include magnetic resonance imaging, known as MRI, or computed tomography X-ray, commonly called CT scans. But a special type of MRI called diffusion tensor imaging or DTI, takes a different approach to examining the brain for traumatic injury. This technology, still in its infancy, may one day serve as a powerful tool for understanding concussions at the molecular level.

“Diffusion tensor imaging is really a way of looking at the connections in the brain,” said Dr. Louis French, deputy director for operations at the National Intrepid Center of Excellence, or NICoE, at Walter Reed National Military Medical Center in Bethesda, Maryland. “Rather than focus solely on the structures there, DTI examines the connections and communication between the various parts of the brain.”

DTI works by observing the flow of water molecules along nerve fibers called axons in the brain, looking for signs of disruption, French explained. Those fibers usually direct water to flow through the brain in one direction, along one of many such channels. In the case of TBI, say after a blast concussion, those fibers and pathways can be deformed or distorted and may even be torn or structurally malformed, causing the water that was flowing along one axis to seep out into other spaces, which can be measured through DTI.

French has been using DTI as one of many evaluation tools in a 15-year, congressionally mandated study of servicemembers with mild to severe TBI. He said most have had multiple concussions or multiple exposures to potentially concussive events. “In that population, we’re really interested in the cumulative brain changes associated with those exposures,” he said. In addition to the study group, researchers also have two control groups: individuals with no injuries and individuals with bodily injuries that don’t involve the head or brain.

DTI is helping to increase understanding of TBI as a process, not an event, French said. “The neuro-imaging that we do, including the MRI with diffusion tensor, enables us to look at the relationship of the changes in the brain as the person recovers.”

“This is a way we can point out to people that, yes, we can see here on the computer screen physically the origin of your complaints,” said French, explaining that the data is objective evidence of subjective complaints.

DTI is available at NICoE, but not widely used across the MHS, partly due to some MRI units unable to run the required software. Additionally, not all MTFs have experts able to evaluate the data produced by DTI. French says the technology is constantly being refined and improved upon, but currently it’s so technically challenging and time consuming, it’s not available for regular use.

He said the MHS is at the forefront of TBI research and care, with abilities that are equal to, or better than, any in the civilian sector. “This isn’t just about treating problems but also understanding wellness,” he added. “We are interested in protecting servicemembers across their lifespan. We want to understand what happens to people when they go through the process of training and deployment and then re-acclamation to society, and this is all part of that effort.”

You also may be interested in...

DVBIC study focuses on concussion-related headaches

Article
9/17/2020
Soldier (center) standing at attention receives an award pinned to their uniform, from a soldier standing directly before her, with a soldier standing at attention to one side. A long building is seen in the background with two flagpoles, one flying the US flag.

Service members with concussion-related headaches experience more frequent and severe pain compared to those with headaches unrelated to this condition.

Recommended Content:

Traumatic Brain Injury | September Toolkit

Air Force opens Intrepid Spirit Center at Eglin AFB

Article
9/15/2020
Soldiers holding a long ribbon and cutting it

The EISC...recognizes the need for a medical facility dedicated to invisible wounds.

Recommended Content:

Posttraumatic Stress Disorder | Traumatic Brain Injury

Head Check: Know Your Helmet, Bicycle and Motorcycle

Fact Sheet
8/6/2020

A Head for the Future aims to raise awareness about TBI among service members, veterans and their families. This fact sheet provides tips for choosing the right helmet for the right ride, with information about different safety features in helmets for bicycling and riding motorcycles.

Recommended Content:

Traumatic Brain Injury | TBI Prevention | TBI Symptoms | TBI Resources

AHFTF Ride Right Fact Sheet

Fact Sheet
8/6/2020

This bicycle safety fact sheet provides tips to protect your head and help prevent TBI while riding a bike. It also includes the signs and symptoms of TBI, and how to get help if you think you sustained a brain injury.

Recommended Content:

Traumatic Brain Injury | TBI Prevention | TBI Resources

Head Check: Know Your Helmet, Football and Baseball

Fact Sheet
8/6/2020

A Head for the Future aims to raise awareness about TBI among service members, veterans and their families. This fact sheet provides tips for choosing the right helmet for the right sport, with information about different safety features in helmets for football and baseball.

Recommended Content:

Traumatic Brain Injury | TBI Prevention | TBI Resources

Cruise with Control

Fact Sheet
8/6/2020

One of the leading causes of military traumatic brain injury is motor vehicle crashes. This fact sheet provides tips on how to stay safe on motorcycles to help prevent TBI while riding. It also includes the signs and symptoms of TBI, and how to get help if you think you sustained a brain injury.

Recommended Content:

Traumatic Brain Injury | TBI Prevention | TBI Resources

Head Check: Know Your Helmet, Winter Sports

Fact Sheet
8/6/2020

A Head for the Future aims to raise awareness about TBI among service members, veterans and their families. This fact sheet provides tips for choosing the right helmet for the right sport, with information about different safety features in helmets for skiing, snowboarding and snowmobiling.

Recommended Content:

Traumatic Brain Injury | TBI Prevention | TBI Resources

Respect the Road

Fact Sheet
8/6/2020

One of the leading causes of military traumatic brain injury is motor vehicle crashes. This car safety fact sheet provides tips to help prevent TBI while driving a motor vehicle and safety measures to take to keep passengers safe. It also includes the signs and symptoms of TBI, and how to get help if you think you sustained a brain injury.

Recommended Content:

Traumatic Brain Injury | TBI Prevention | TBI Resources

TBI Hot Topics Bulletin February 2020

Publication
8/4/2020

Are you a busy health care provider? Not enough time to keep up with research? Stay informed with the TBI Hot Topics Bulletin. We track the latest TBI scientific studies, advances, and discoveries most relevant to health care providers. This issue covers the fourth quarter of calendar year 2019.

Recommended Content:

Traumatic Brain Injury | TBI Resources | Research and Innovation

TBI Hot Topics Bulletin May 2020

Publication
8/4/2020

Are you a busy health care provider? Not enough time to keep up with research? Stay informed with the TBI Hot Topics Bulletin. We track the latest TBI scientific studies, advances, and discoveries most relevant to health care providers. This issue covers the first quarter of calendar year 2020.

Recommended Content:

Traumatic Brain Injury | TBI Resources | Research and Innovation

TBI Hot Topics Bulletin September 2020

Publication
8/4/2020

Are you a busy health care provider? Not enough time to keep up with research? Stay informed with the TBI Hot Topics Bulletin. We track the latest TBI scientific studies, advances, and discoveries most relevant to health care providers. This issue covers the second quarter of calendar year 2020.

Recommended Content:

Traumatic Brain Injury | TBI Resources

Neck Pain Following Concussion/mTBI Fact Sheet

Fact Sheet
7/30/2020

Neck pain can occur together with headaches following a concussion. This fact sheet provides information to help patients manage neck pain. Various techniques are explained, including the use of heat or cold therapy, neck stretches, proper sleep positions and common activities that may contribute to neck strain.

Recommended Content:

Traumatic Brain Injury

Leader Policy Guidance for Mild TBI/Concussion in the Deployed Setting Fact Sheet

Fact Sheet
7/30/2020

This document describes the line leader responsibilities for the Department of Defense (DoD) mandated policy, DoD Instruction 6490.11, “DoD Policy Guidance for the Management of Mild Traumatic Brain Injury/Concussion in the Deployed Setting,” that applies to all service members involved in potentially concussive events in deployed settings.

Recommended Content:

Traumatic Brain Injury | TBI Prevention | TBI Screening | TBI Symptoms | TBI Resources

Healthy Sleep Following Concussion/mTBI Fact Sheet

Fact Sheet
7/30/2020

Getting restful sleep is one of the most important things you can do for your health, and it often takes thoughtful preparation during the day. This fact sheet offers service members and veterans who experience sleep disturbances with healthy sleep tips that can likely improve their sleep.

Recommended Content:

Traumatic Brain Injury | TBI Symptoms | TBI Resources | TBI Prevention

Headaches Following Concussion/mTBI Fact Sheet

Fact Sheet
7/30/2020

Although each headache is different, identifying common causes, or triggers, is important for health care providers and patients to determine appropriate treatment. This fact sheet provides non-drug options to help those diagnosed with a mild TBI and associated post-traumatic headache (PTH) manage symptoms.

Recommended Content:

Traumatic Brain Injury | TBI Symptoms | TBI Resources
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 8

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.