Monday, November 17, 2008

Doctors can now detect mild, traumatic brain injuries easier

Doctors can now detect mild, traumatic brain injuries easier

By Mary Brophy Marcus, USA TODAY Nov 17,2008

WASHINGTON — Scientists are coming up with new ways to detect mild traumatic brain injury (TBI) and treat it, according to research presented Sunday at the annual meeting of the Society for Neuroscience here.
Mild traumatic brain injury affects an estimated 1.4 million Americans a year, including as many as 20% of soldiers returning from combat in Iraq and Afghanistan. It can cause disabling injury.

Among the findings:

• Researcher Mingxiong Huang of the University of California-San Diego and colleagues reported that by combining two advanced brain scanning techniques — MEG (magnetoencephalography) and DTI (diffusion tensor imaging) — they were able to discover brain injury that conventional MRI (magnetic resonance imaging) and CT had missed. The patients they diagnosed included people who were injured in mild explosions and sports-related accidents.

The scan combination "is substantially more sensitive than conventional CT and MRI in detecting subtle neuronal injury in mild TBI," says Huang, who adds that more research is needed before the dual technology can be used clinically in patients with such injuries.

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• University of Miami researcher Andrew Maudsley and colleagues reported that they used a new whole-brain method of magnetic resonance spectroscopic imaging (MRSI) to detect for the first time widespread brain damage that sometimes fails to show up in conventional brain scans of patients with mild to moderate TBI. MRSI is an advanced type of MRI that creates images from hundreds of voxels, three-dimensional units of brain tissue.

The researchers studied 17 patients who had been admitted to a trauma center with closed head injuries. They looked at changes in three major brain chemicals and compared them with healthy brain images. They found the MRSI images picked up diffuse chemical changes in the TBI patients, "even in people who had been classified as having very mild injury," Maudsley says.

• Eli Gunnarson of the Karolinska Institute in Stockholm says she and colleagues found EPO, a major growth factor of blood cells, reduced swelling of the brain, called brain edema, in animal studies. "Brain edema is a much-feared consequence of brain trauma and stroke," Gunnarson says.

Brain edema most commonly occurs as water that accumulates in star-shaped cells called astrocytes. Gunnarson says when astrocytes swell, the risk of tissue death goes up. By preventing the swelling with EPO, that tissue may be saved, limiting brain injury.

The researchers tested it in rats and found those that got EPO showed significantly fewer neurological symptoms than those that got a salt solution.

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