Starting more than three years ago, physicians from Landstuhl Regional Medical Center, teamed up with physicians from the Washington University School of Medicine, St. Louis to research a new way to detect blast-related traumatic brain injury in U.S. Military personnel. The study was published in the prestigious New England Medical Journal of Medicine, June 2, 2011.
“When injured servicemembers come back, they are screened with a series of questions,” said Lt. Col. (Dr.) Raymond Fang. “If they answered yes to the series of questions, they were diagnosed with potential TBI and referred for additional specialized TBI evaluations.
This simple screening test could not provide a treatment plan or give a definitive answer on the severity of the diagnosis.” Dr. David L. Brody, Washington University School of Medicine, and Dr. Stephen F. Flaherty, formally of LRMC, met during a Department of Defense-sponsored casualty care medical conference in 2007. Brody was looking for a way to test U.S. Military members returning from deployment for TBI and Flaherty had the military members.
With support of a grant from the Congressionally Directed Medical Research Program, the team of 11 doctors were up and running. By November 2008 they had 63 subjects with traumatic brain injury and 21 control subjects (those without TBI).
In 2009 when Flaherty left LRMC for an assignment at Walter Reed Army Medical Center, Washington, D.C., Fang took over as the point of contact at LRMC. “We used diffusion tensor imaging (DTI) to detect damage in the nerves of the brain, specifically in the axons, the wiring that allow nerves to communicate with one another,” said Fang. “We were able to see where the nerves were damaged and monitored the injuries over the course of the year.” Lt. Col. (Dr.) John R. Witherow was the radiologist on the team. His specialty was brain imaging and DTI.
“Without [Dr. Witherow], this research would have never gotten off the ground,” said Fang. “He was the DTI expert. Initially this couldn’t have worked without him.” The team was able to find that some abnormalities revealed on DTI were consistent with injury in many of the subjects with TBI. This was only step one.
“The study is not over,” said Fang. “Next the team is hoping to research TBI on a larger scale. We are working to test a number in the hundreds to confirm our initial findings.”
“Even though this was a study on a relatively small scale, I believe it was published to get other researchers thinking of different ways to detect TBI,” said Fang. “The care of our [servicemembers] is so important and research makes care better for everyone.”
Lt. Col. John Witherow passed away on July 31, 2010. Fang is getting ready for a permanent change of station. He will no longer be the LRMC point of contact for the research.