Diagnosing traumatic brain injury faster so treatment can start right away is the focus of a $5 million research project centered at Fort Leonard Wood and nearby Phelps Health Hospital in Rolla.
Traumatic brain injury is a head injury from an external force that can do long-lasting damage to the brain. Phelps Health is a community hospital that serves a county of fewer than 50,000 people, but is conducting research that could revolutionize the way the Army treats everything from concussions to serious brain injury.
“We are in that perfect spot. I know it almost makes you scratch your head. It’s like, really, out here in the middle of Missouri we have this leading-edge traumatic brain injury research going on?” said Matthew Doellman, an Army veteran and director of the research consortium at Phelps.
“And the answer is yes, because to do good research, you have to have good sample sizes. And you can’t go injure soldiers on purpose. It’s we are just in that unique opportunity in which a lot happens at Fort Leonard Wood.”
There are between 400 and 600 cases of TBI at Fort Leonard Wood each year, with most cases being mild concussions.
The research in south-central Missouri includes the development of a machine called BrainScope. It’s about the size of a cellphone but can deliver as much information on TBI as an EEG machine or a CAT scan in a hospital.
“The BrainScope is a very contemporary unit that does the same thing,” said Dr. Donald James, senior vice president of research at Phelps. “And it does it in the field where we can have a person put this unit on their forehead and measure their brain activity.”
Speed is critical to start treatment of TBI. And when the injury is sustained on a battlefield miles away from medical facilities, even knowing there is a problem can be difficult.
“Our goal is to preserve brain tissue by being able to have early intervention by being able to diagnose where there is brain damage occurring and hopefully before those brain cells are irreversibly injured,” James said.
That’s good news to Sgt. 1st Class Matthew Medders. He sustained a TBI when his armored transport ran over an improvised explosive device in Afghanistan in 2017. He now trains soldiers on explosives at Fort Leonard Wood.
Medders said a lot has changed in how the Army approaches TBIs compared to when he enlisted nine years ago.
“Guys were taking IEDs like the one I took, and far worse, and they had no real way of testing them. They were just, ‘Hey, are you good?’ Thumbs up. And they were right back on mission,” Medders said.
Now there is much more urgency in knowing for sure if there is a problem. Medders said a portable device like the BrainScope could make all the difference.
“When you’re operating somewhere that isn’t anywhere near any type of military hospital, then certainly it would be very beneficial to have that kind of capability,” Medders said.
The army is funding the research, which so far includes 12 different studies, all related to TBI. Phelps Health, Fort Leonard Wood and Missouri University of Science and Technology are leading the studies, which also involve Washington University and the University of Missouri in Columbia and Kansas City.
The researchers are looking for certain biomarkers that can confirm TBI in the early stages. Other facets of the research include using a blood test or urinalysis that can be administered on site, away from a lab, to get results immediately.
“We want to have a device, essentially that either through blood or through urine, we can detect these biomarkers that we are seeing and that can tell that unit commander, no, he has to get back to the rear and be further evaluated or, no, he is truly OK,” Doellman said.
While the research is focused on the armed forces, the hope is the new devices or tests that come out of this work could be used to diagnose TBI in many other scenarios.
“At the site of car accidents, when a little kid hits his head on a coffee table, in the locker room of high school football games; this technology could be very valuable to medical personnel in many different applications,” James said.
Correction: A previous version of this story inaccurately described Donald James’ and Matthew Doellman’s job titles. James is the senior vice president of research at Phelps Health Health. Doellman is the director of the research consortium at the hospital.
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