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.


 
 

 
Maranda Flynn

Combat Lifesaver Course trains Soldiers to save lives on, off battlefield

Maranda Flynn From left, Fort Huachuca Combat Lifesaver Course instructors Sgt. James Atcitty, U.S. Army Medical Department Activity, and Sgt. James Fender, 111th Military Intelligence Brigade, wrap a casualty in a heat protect...
 
 
David Vergun

Senior leaders explain Army’s drawdown plan

David Vergun No commander is happy when notified that a Soldier from his or her command has been identified for early separation. But commanders personally notify those Soldiers and ensure participation in the Soldier for Life ...
 
 

Military Intelligence – Moment in MI history

INSCOM photos Lt. Col. Frank Moorman and his staff of the Radio Intelligence Section are pictured at American Expeditionary Forces Headquarters. Tactical Signals Intelligence originates in World War I July 28, 1917 On July 28, 1917, the American Expeditionary Forces G2, Brig. Gen. Dennis Nolan, tasked Capt. Frank Moorman, a Coastal Artillery officer, to form...
 

 
David Kamm, NSRDEC

Chow from a 3-D printer? Natick researchers are working on it

David Kamm, NSRDEC Natick food technologists already believe they serve up the best food science can offer. Now they are working to incorporate 3-D printing technology into foods for the warfighter. NATICK, Mass. — Army resea...
 
 
United Kingdom Ministry of Defense

Army researchers develop Cargo Pocket ISR

United Kingdom Ministry of Defense A British Soldier holds Prox Dynamics’ PD-100 Black Hornet, a palm-sized miniature helicopter weighing only 16 grams. Researchers with the U.S. Army Natick Soldier Research, Development and ...
 
 
U.S. Army IMCOM photo by Amanda S. Rodriguez

Civilian mentor program shapes Army installation management’s future

U.S. Army IMCOM photo by Amanda S. Rodriguez U.S. Army Installation Management Command mentors and mentees work on teambuilding skills, building a block tower in total silience, during the IMCOM Headquarters Centralized Mentori...
 




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=""> <strike> <strong>


Directory powered by Business Directory Plugin