War veterans sometimes return home from far-flung battlefields with thinking and emotional issues that defy diagnosis with standard methods.
They may have suffered brain injuries that go undetected in typical “functional” MRI scans, leaving veterans and their families stymied in their pursuit of answers and potential treatment.
But two scientists at the Center of Excellence for Research on Returning War Veterans in Waco are making waves nationally by pioneering a data-driven approach. Veterans referred to the center from Veterans Affairs hospitals in Waco, Temple and Austin receive multiple MRI-generated brain scans over several hours and days, giving scientists a chance to pinpoint subtle changes that may produce symptoms.
“What we’re most excited about is that we are starting to detect and better understand traumatic brain injury, and how one part of the brain talks to another,” said Dr. Richard Seim, public affairs officer for the Center of Excellence, housed in Waco’s VA Medical Center. “Veterans are suffering, saying they ‘don’t feel right but no one believes me.’ Now we have a better chance to make a difference.”
Seim said this approach remains in the research stage, and is aided by the center’s 3 Tesla MRI, “which has twice the power of MRIs found in local hospitals.” The long-range goal is to make this data-producing protocol available to serve veterans at VA centers nationwide.
The new technique represents the work of Dr. Evan Gordon and Dr. Steven Nelson, both cognitive neuroscientists at the Center for Excellence, as well as their collaborators at Washington University in St. Louis, Missouri.
Their findings will be published as the cover article in “Neuron,” one of the most prominent journals in the field of neuroscience, Seim said.
Science Friday, a call-in show distributed by Public Radio International and featured on public radio stations, will devote a segment to it this week.
Dr. Nelson, 37, a Minnesota native who completed his graduate and post-graduate studies at Washington University, said he was inspired to apply research and data collection to traumatic brain injuries and PTSD by the work of Russell Poldrack, a professor of psychology at Stanford University and director of the school’s Center for Reproducible Neuroscience.
According to published reports, Poldrack in 2012 collected brain imaging, behavior and biological data on himself for 18 months, during which he was scanned with magnetic resonance imaging more than 100 times.
Data analysis revealed brain changes during this period, and showed that changes within an individual are different from changes between various people who were tested in previous MRI-based studies.
“There was a time when what we knew about brain functioning was derived from group testing, but we wanted to move toward a more individualized approach,” Nelson said. “Traumatic brain injuries and PTSD are very specific to the person, and to better understand the markers of these disorders we needed to proceed on an individualized level instead of classifying individuals based on how they fit some pre-set criteria.”
He said the backbone of the research is having access to data on both healthy and injured veterans “to see what the healthy brain looks like.”
Considering that patients receiving brain scans using MRI technology are bombarded with unusual sounds as they lie still in a tight-fitting chamber, Nelson said he has been amazed at the dedication of veterans who return two, three and four times to expose themselves to the testing.
Dr. Gordon, 35, a Dallas native who completed undergraduate work at Duke University and post-graduate studies at Georgetown University, said he feels privileged to work in the VA’s Center of Excellence.
“It’s a fantastic new facility, a nice environment to work in, with great people dedicated to helping vets,” he said. “They are so focused on their mission, and as neuroscientists doing research, they have access to an MRI every day and can scan people and produce data as often as they need to. We probably scan two or three veterans every day. That may not sound like many, but remember each one receives hours of scanning.”
Seim said veterans taking part in the research pay nothing for the scans.
High on the list of priorities, said Gordon, is research into brain damage caused by explosions as opposed to blows to the head.
Dr. Nico Dosenbach, a pediatric neurologist in St. Louis and a colleague of Dr. Nelson and Dr. Gordon, said in a phone interview their studies began in 2013 and he speaks with them weekly.
Dosenbach said he treats young people with head injuries, and expects research going on now to benefit patients in the private sector in addition to veterans. He said the 12 two-hour MRI scans he requires of those involved in his studies “produce a lot of data and a really nice high-fidelity, highly-detailed map of the brain that can detect brain injuries.”