Medical Physics Seminar – Monday, December 10, 2012
Chronic Traumatic Brain Injury Neuroimaging is the answer. And it isn't
Terry Oakes, PhD, (guest of Dr. Brad Christian)
Chief, Traumatic Brain Injury Image Analysis, NICoE/Walter Reed National Military Medical Center, Bethesda, MD
Traumatic Brain Injury (TBI) is one of the leading causes of injury and disability in the USA, particularly in younger people. Approximately 1.7 million cases of TBI are reported annually, with a corresponding financial burden of ~$56 billion for lifetime total cost of treatment. Within the military, TBI has been called the “signature injury†of the recent conflicts in Iraq and Afghanistan, affecting several hundred thousand service members. Mild TBI (mTBI) is the most prevalent form of TBI and accounts for 80-90% of all reported TBI incidents. However, one of the requirements for a diagnosis of mTBI includes absence of findings from a standard MRI or CT scan. This creates a unique opportunity to apply advanced neuroimaging techniques to diagnose and guide treatment for this poorly understood disease. Within the military, explosive blast is the major factor in TBI, but its chronic effect has few experimental models. Other methodological challenges include injury heterogeneity across patients, difficulty obtaining pertinent injury details, poor correspondence with animal models, and frequent comorbid conditions such as PTSD with similar clinical presentations. Whether you see your glass as half empty/full, these obstacles/opportunities contribute to a challenging diagnostic problem.