Brain imaging technology advances at a rapid pace. A new process, called "high definitiion fiber tracking," reveals areas of brain injury with more exactness than standard scans such as CT & MRI and even the newer DTI method.
Millions of Americans suffer a traumatic brain injury, or TBI, each year. Most TBIs are concussions or other milder injuries that generally heal on their own; some are more severe and may lead to death or disability. Because TBIs also affect more than 200,000 soldiers who served in Iraq and Afghanistan, the U.S. defense department supports TBI research studies including that of Dr. Walter Schneider, professor of psychology and neurosurgery at the University of Pittsburgh Medical Center. Schneider's study explains the importance of the new technology and how it works.
Why is HDFT Important for Victims of TBI?
With more serious head injuries, standard scans cannot see beyond bleeding or swelling to tell if the brain's connections are broken in a way it can't repair on its own. But the researchers say the new technology gives them the ability to see previously invisible wounds.
How does HDFT work?
Brain cells communicate with each other through a system of nerve fibers that act like a telephone network, making up what's called the white matter of the brain. White matter runs along cable-like highways called fiber tracts that contain millions of connections. The new scan processes high-powered MRIs through a special computer program to map major fiber tracts, painting them in greens, yellows and purples that designate their functions. Researchers look for breaks in the fibers that could slow or stop those nerve connections from doing their job.
Real Life Example
32-year-old Daniel Stunkard of New Castle, Pa., is one of 50 TBI patients in Schneider's study. He spent three weeks in a coma after his all-terrain vehicle crashed in late 2010. CT and regular MRI scans showed only some bruising and swelling, unable to predict if he'd wake up and in what shape. DTI was unsuccessful for fiber tracking because it had poor-quality visualizations and some false tracks.
When Stunkard woke up, he couldn't move his left leg, arm or hand. Doctors started rehabilitation in hopes of stimulating healing, and the HDFT predicted what happened. The scan found partial breaks in nerve fibers that control the leg and arm, and extensive damage to those controlling the hand. In six months, Stunkard was walking. He now has some arm motion. But he still can't use his hand, his fingers curled tightly into a ball. The doctors say those nerve fibers were too far gone for repair.
This closer look at nerve fibers will provide a valuable diagnostic tool. Dr. Rocco Armonda, a neurosurgeon at Walter Reed National Military Medical Center says: "It's like comparing your fuzzy screen black-and-white TV with a high-definition TV."