Army

June 14, 2012

Trials for TBI blood test underway

Tags:
Story and photo by Rob McIlvaine

The Army is developing a blood test for traumatic brain injury, so Army combat medics, like Cpl. Joel Kuhn, can test a Soldier on the spot of injury for brain damage.

WASHINGTON — The Army is now running trials on a blood test, similar to one used to test blood sugar, that can be used by medics on the battlefield to determine if a Soldier has sustained damaged brain cells, especially from a mild traumatic brain injury, also known as TBI.

“We’ve actually found some unique products, proteins in the blood that are only present when brain cells are damaged,” said Col. Dallas Hack, a doctor, and director of Combat Casualty Care at Medical Research & Materiel Command, Fort Detrick, Md.

The proteins they’ve found to be the most sensitive and specific for acute brain injury are called UCHL1 or ubiquitin carboxyl-terminal esterase L1, and GFAP or glial fibrillary acidic protein.

Hack said the more serious the brain injury, the more of those proteins get into the blood.

One of the problems with brain injuries, Hack said, has been knowing if somebody has damage to their cells.

“We have ongoing clinical trials right now in patients, and we have some articles that have now been published in peer review literature that show a really good sensitivity and specificity,” Hack said. “This test is both specific [in that] it measures that brain cells are damaged, and it’s sensitive enough to be able to find when even mild brain injury occurs.”

One challenge in developing the test is doing studies on the battlefield.

“We actually have a current study going on with a limited number of troops out there in Afghanistan,” Hack said. “We’re assessing them immediately after an exposure to a blast and comparing those individuals with others who haven’t been exposed to a blast over there, and comparing them to people in our civilian trials back here in the United States.”

Right now, Hack said, there is currently no objective way to diagnose if a Soldier has mild TBI. Tests now for TBI might involve asking a patient questions and seeing if they are able to answer properly. Also, patients can be asked to do a balance test, or to repeat some words, or to follow an object.”All of those require your active participation, and there’s a variety of things that make those relatively inaccurate,” he said.

The current trial is designed to obtain the data that would enable the Army to file for Food and Drug Administration clearance of the test for head injury. Multiple U.S. and international sites are part of the study, which is expected to be complete before the end of 2013, with plans to file an application with the FDA shortly thereafter.

Working with industry

In order to make the TBI test work, Hack said, the Army must partner with industry in its development. Working with industry is a collaborative experience that has yielded many new ideas on how to solve problems in battlefield medicine, Hack said.

One place where industry and the Army come together is at the Military Health System Research Symposium, which has been happening for about 15 years now.

“The blood test for TBI was actually started at one of these conferences. The morning of 9/11, before things happened, a breakfast meeting was going on with the researchers from the University of Florida and our researchers from the Walter Reed Army Institute of Research,” Hack said. “We met and agreed to work on this blood test for brain injury program.”

Hack said the conference brings together “really amazing” scientists, who bring new ideas and a new level of energy to military health research. The conference, he said, facilitates interaction between stakeholders in military medical research.

“This conference really contributes to finding solutions for battlefield medicine,” he said.

The next conference, Aug. 13 – 16 in Fort Lauderdale, Fla., will involve full Army, Navy, and Air Force participation.

Neuroplasticity — another exciting breakthrough

“I think we have some exciting new things going on in the area of traumatic brain injury that are coming along, both in the diagnosis and the rehabilitation areas,” Hack said.

Not only is the Army working hard to develop new drugs, it is also working to develop new rehabilitation strategies, including neuroplasticity. That, combined with rehabilitation, can accelerate recovery from TBI.

“One of the things we traditionally thought in the medical community was that you’re basically born with all the cells you’re going to get in your brain, and you don’t grow cells as time goes along and at a certain point the connections stay very static in the brain,” Hack said.

That understanding of the brain is not proving to be completely true, Hack said.

“What the Army is finding are ways to re-wire the brain, combined with advanced rehabilitation techniques,” Hack said.

During the recovery of Rep. Gabby Giffords, for instance, some of the rehabilitation techniques that were used with her along the way were developed as part of Army efforts. Giffords is making major progress now that wouldn’t have been conceived of a few years ago, Hack said.

Hack said the human brain has been an under-addressed area of medicine.

“A lot of work has gone into strokes and we’ve made very little progress on that,” he said. “Brain injury has had very little effort, comparatively. Spinal cord injury, on the other hand, has had a fair amount of effort.”

The whole area of neuroscience has been rejuvenated since the military began showing interest in 2007, Hack said.

“I go around and talk to a lot of universities and other places and they say there’s almost a renaissance in neuroscience,” he said. “The military has energized a whole community by what we’re doing.”




All of this week's top headlines to your email every Friday.


 
 

 
photo-2

USAEPG responds to Army radio test needs

A dismounted tester and a Humvee with the SRW-A radio mounted inside collect evaluation data on the radio is shown with the Huachuca Mountains in the background on Dec. 12. The U.S. Army Electronic Proving Ground, USAEPG, recen...
 
 
U.S. Army photo

Army puts Gray Eagle, One System Remote Video Terminal through test

U.S. Army photo The MQ-1C Gray Eagle, the Army’s largest unmanned aircraft system in the inventory, recently underwent follow-on test and evaluation, which culminated June 14 at the National Training Center in Fort Irwin, Cal...
 
 
Natalie Lakosil

HT-JCOE commanders change during June 19 ceremony

From left, outgoing Commander Col. John Boucher, Human Intelligence Training Joint Center of Excellence; Maj. Gen. Robert Ashley, commanding general, U.S. Army Intelligence Center of Excellence and Fort Huachuca; and incoming C...
 

 

BLM Jackson Hotshots hosted at Fort Huachuca for portion of 2015 fire season

TUCSON, Ariz. — The only Bureau of Land Management (BLM) hotshot firefighting crew east of the Mississippi River will be based in southern Arizona for a portion of the 2015 fire season. The 20-member Jackson Hotshot crew from Jackson, Miss. will be housed in the Sierra Vista community thanks to a partnership between BLM and...
 
 

Fort Huachuca Exchange partners with Sears for savings

The Army & Air Force Exchange Service is teaming up with Sears to offer military shoppers special savings on cleaning, home improvement and repair services. Fort Huachuca Exchange shoppers can now receive special offers on cleaning services including: carpets, upholstery, protector and deodorizer for carpet and upholstery, title and grout, air ducts, dryer vents and...
 
 
Mike Williams

Monsoon season is here — use caution when going outdoors

Mike Williams Water races across the road near the Bonnie Blink housing area on post during a monsoon storm last summer. Before crossing, be sure your vehicle has the clearance to make it through a wash if it has water in it. E...
 




0 Comments


Be the first to comment!


Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>