Brain imaging is an important tool for clinicians in diagnosing patients who have suffered from traumatic brain injury (TBI). Brain imaging techniques generally focus on either structure or function. With TBI, the focus is typically on the extent of structural brain damage, which is often assessed using computed tomography (CT). Structural brain scans provide information regarding the severity of TBI, which is largely determined by the extent of damage. But, what about measures of brain function?
Another brain imaging technique that has become a crucial instrument for scientists trying to learn more about how the brain works is functional magnetic resonance imaging (fMRI). fMRI allows the examination of human brain function in a way that is not invasive and, in contrast to a CT scan, does not involve radiation. With the help of math and statistics, brain mappers are able to measure brain activity patterns. But, can fMRI also be used as a diagnostic tool for TBI? Because (a) no two brain injuries are identical and (b) the way in which brain injuries affect cognition and brain function is highly variable, the current picture of fMRI use as a diagnostic tool for TBI is unclear.
Nevertheless, new tools and techniques have recently been developed that allow for the assessment of brain function in TBI, as well as other types of brain injury. Using fMRI could thereby add a whole new dimension to our understanding of TBI and TBI recovery. To get a better sense of the present state of fMRI applications with TBI, we have asked three TBI experts the following question:
Given that the utility of fMRI is still relatively undefined in the clinical realm, how do you see modern neuroimaging techniques playing a role in TBI in the future, beyond conventional scanning (CT, structural MRI)?
At the age of just 24, Ryan Boyle is an accomplished author and has won a silver medal representing the United States at the Paralympic Games – all this after overcoming a tremendous obstacle when he was young.
In October 2003, Boyle suffered a traumatic brain injury when he was hit and dragged by a truck at nine years old. He spent two months in a coma and then only had movement in one finger but his will to recover never faded.
At the age of 10, he had to learn how to do everything all over again. During that time, he asked himself how he could be an athlete again and never gave up.
So back in 2016 at the Rio Paralympics, he won the silver medal in time trial cycling. He also finished fourth, just out of medal contention, in the road race.
He’s currently training for the 2020 Paralympic games in Tokyo.
But his main mission, especially during the month of March which is brain injury awareness month, is to inspire others.
“When the will is there, when you want to get better, to have that life you once had. You can do anything,” Boyle said. “It won’t be easy. It takes a lot of work but if you want it, it will eventually turn around for you.”
To do this, Boyle wrote an autobiography called “When The Lights Go Out: A Boy Given a Second Chance.” The book was written when Boyle was an eighth grader so all the experiences of his recovery and accident were all fresh.
Every day, 138 people die from injuries that include a traumatic brain injury. Those lucky enough to survive, don’t escape unscathed. Moderate-to-severe cases result in a lifelong condition, according to the Centers for Disease Control and Prevention.
Traumatic brain injuries are not always caused by traumatic events
Traumatic brain injury in the United States is one of the leading causes of death and disability, contributing to about 30 percent of all injury deaths, reports the CDC. What makes TBIs so prevalent? What many people don’t understand is that TBIs can occur from incidents that don’t seem that traumatic.
Top 4 causes of traumatic brain injuries
One of the first steps toward preventing TBIs is gaining awareness on common injury origin points. The top four causes of TBIs listed by the CDC are:
• Falls: Falls accounted for 40 percent of all TBIs between 2006 and 2010. Fifty-five percent of TBIs in children ages 0 to 14 were caused by falls, and 81 percent of TBIs in people over the age of 64 were caused by falls.
• Accidental hit by object: Unintentional blunt trauma accounted for 15.5 percent of traumatic brain injuries. In children under the age of 15, blunt trauma was the cause of TBI in 24 percent of cases. (Oftentimes, these injuries occur on the job, such as at a construction site or in an oil field.)
• Motor vehicle crashes: Motor vehicle crashes accounted for 14 percent of traumatic brain injuries. However, motor vehicle wrecks were the cause of 26 percent of all TBI-related deaths between 2006 and 2010.
• Assault: Approximately 10 percent of TBIs were caused by assault, and about 75 percent of these injuries occurred in people between the age of 15 and 44.
There’s more to your eyesight than just whether or not you can see. Often, your vision can be a window to other health issues, like autism, Parkinson’s and even whether you have a concussion. That’s the idea behind RightEye’s EyeQ system, which aims to revolutionize the optometrist office with eye-tracking tech to not only diagnose issues, but to offer therapeutic measures to correct them as well. At CES 2018, the company released a brand new all-in-one EyeQ terminal that incorporates a PC, a monitor as well as a Tobii eye-tracking camera that promises to do all of that and more.
In what her mother calls a “Christmas miracle,” a Nova Scotia woman who suffered a catastrophic brain injury in a 1996 car accident communicated one-on-one with her mother for the first time in 21 years.
Louise Misner said her 37-year-old daughter Joellen Huntley used eye-motion cameras and software on an iPad to respond to a comment from Misner about her clothes.
Huntley has been severely disabled since she was 15, unable to walk or talk and fed through a tube. She has always responded to family members’ presence by making sounds, but was unable to communicate any thoughts.
Michael Bisping has fought professionally in mixed martial arts since 2004. Last year, the journeyman won his first title. He knocked out Luke Rockhold in the first round to win the middleweight belt in the Ultimate Fighting Championship, or UFC, the most popular of several MMA organizations.
On Nov. 4 of this year, at age 38, Bisping defended his title for a second time. His opponent was the Canadian Georges St. Pierre, a former UFC champ. The fight, held in New York’s Madison Square Garden, was close until the third round, when a series of blows knocked Bisping to the canvas. Pierre pounced on the fallen fighter and applied a rear-naked choke, cutting off oxygen to Bisping’s brain. His body went limp.
On Nov. 25, within weeks of going limp, Bisping was in the octagon again. This time 7,000 miles away in Shanghai, China. He had volunteered to fight a young up-and-comer after the original opponent, Anderson Silva, was pulled from the card following a failed drug test. It was no contest. Bisping got knocked out in the first round.
Three weeks. Two brutal fights.
These days, with more science available on brain injuries in sports (especially CTE, or chronic traumatic encephalopathy), the National Football League, National Hockey League and other organizations are doing more to protect athletes. Executives are making rules changes, establishing more stringent health checkups, and some groups have introduced improved headgear.
A judge has voided a 2011 marriage involving a man who suffered a serious brain injury and the woman he had broken up with prior to the accident.
The ATV accident took place in June 2011 near Gravenhurst, leaving the man with serious brain injuries that took months to rehabilitate and left long-term effects. He was released from Health Sciences North in Sudbury in October of that year under the care of two of his sons, who ensured that he took his medications and looked after him.
Three days after his release, however, he left the home and was picked up on the roadway by the uncle of a former girlfriend, without the knowledge of the man’s sons. The uncle took the man to Barrie, where his former girlfriend was living under a court order because of a drunk driving conviction.
Once there, they were quickly married by an officiant secured by the woman’s family. By the time his sons were able to locate him through credit card receipts, the wedding had already taken place.
At that point, the woman claimed partial ownership of a house the couple had shared before they separated and before the accident. But the court heard the man had gained sole ownership of the house by that time, paying the woman $52,000 for her share in 2010. A total of $27,000 went to her, and the man paid another $25,000 to the woman’s lawyers whom she needed to pay to settle an outstanding bill.
The Ontario government has announced 12 projects in the province that are being supported by the Health Technologies Fund.
A local Health Innovation Team among those recipients is formed by the Kingston Health Sciences Centre, ArcheOptix, and Queen’s University.
That team will receive a $498,667 grant toward developing and testing a portable device that will detect and image brain bleeds in traumatic brain injury patients awaiting CT (computed tomography) scans, particularly suitable to improving the management of frail and elderly patients.
This announcement came from the Ministry of Health and Long-Term Care as part of the government’s efforts toward improving patient care through innovative health technologies.
With National Disability Insurance Agency Information, Linkages and Capacity Building Organisational Readiness Project funding, Brain Injury Australia has completed extensive surveys with eighteen Australians with lived experience of post-concussion syndrome/ “mild” traumatic brain injury (PCS/mTBI) – part of a larger commitment to raising awareness about disability that results from less severe, but often repeated, brain injuries that occur in sport, military service or domestic and family violence.
Survey respondents reported that: where they sought medical advice, attention was paid to physical injury less than the potential for brain injury, especially where there was nothing found on diagnostic imaging; their General Practitioners (GPs) had limited knowledge of brain injury or provided confusing or conflicting advice about what recovery to expect or how long it would take, and what activities – such as return to work or driving or sports – they could engage in.