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Pitt research unlocks secrets of brain

| Friday, March 2, 2012

An imaging technique that shows never-before-seen details of the brain could help doctors better tailor treatments for people with traumatic brain injuries, say University of Pittsburgh researchers who developed it.

The technology, known as high-definition fiber tracking, uses sophisticated computer algorithms to produce yellow, green and purple images of the fibers that connect the brain's nerve-cell network. Breaks or damage to these cells that don't show up in traditional MRIs or CT scans appear in high-definition color, said Walter Schneider, a professor of psychology at Pitt's Learning Research and Development Center who led the team that developed the technology.

"If you cannot see your enemy, it's hard to defeat it," Schneider said.

High-definition fiber tracking is not available for general use, but Pitt researchers tested it on about 55 patients, said Dr. David Okonkwo, a UPMC neurosurgeon who co-authored a Journal of Neurosurgery report on it published today.

The report describes the case of Dan Stunkard, 33, of New Castle, who suffered a traumatic brain injury in 2010 after crashing his all-terrain vehicle while not wearing a helmet. He was comatose for about three weeks before waking up, then discovering he couldn't move his left arm or hand. A CT and other scans showed swelling and bleeding on the right side of Stunkard's brain.

The images, however, gave doctors little indication of what caused the swelling and bleeding. Using high-definition fiber-tracking four months later, doctors identified a lesion that explained why Stunkard had trouble moving his left leg, arm and hand.

"Patients after a traumatic brain injury have a very difficult time understanding their injury," Okonkwo said. "It's not like a broken bone where your arm is broken and we put a cast on it. For patients with a traumatic brain injury, we don't really have a test that can show them exactly what's wrong with their brain."

Doctors said the images showed some intact fibers in the region controlling Stunkard's left leg, which explained why he eventually recovered movement in his left leg and arm.

Stunkard, who is left-handed and has restricted use of his left hand and fingers because of nerve fibers beyond repair, told the Tribune-Review that fiber-tracking images could help target patient rehabilitation treatment where it's needed.

"I'm hoping it helps people in the future," he said.

Okonkwo hopes doctors eventually can use the technology soon after an injury. He said the technology would especially help the approximately 1.7 million people in the United States who suffer traumatic brain injuries every year.

"What happens now is, we wait well into the recovery phase for people to come back, and then we have to figure out what the problem is," Okonkwo said.

Pitt researchers expect to begin multiple studies of the technology in four to six months with other medical centers and military hospitals that treat brain injuries. Okonkwo said researchers are hopeful the technology could become a routine part of treatment in five to 10 years.

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