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 The team of eight researchers, led by Vassilis Koliatsos, professor
of pathology, neurology and psychiatry and behavioral sciences at
the Johns Hopkins University School of Medicine, studied the brains
of five U.S. combat veterans and compared them to 24 other brains of
people who died from causes such as car accidents, drug overdoses
and heart attacks.
Koliatsos says the honeycomb pattern is unique to the combat
veterans' brains, and was found in the frontal lobe which controls
decision-making, reasoning and other executive functions.
"We typically think of traumatic brain injury as something that
happens when an external force comes against your skull," says
Koliatsos. But he says they may have found a new type of injury
unique to combat veterans exposed to an IED blast.
"In this particular case, the force is coming against your chest so
the blood gets squeezed. And as the blood gets squeezed, there's a
lot of back apple blood into the brain. And because there's a pulse
of over-pressure wave that happens (like this), the brain also
swells (like this). And when the brain swells, it pushes against
some of the fixed elements inside the skull," says Koliatsos,
explaining the distinctive honeycomb pattern found in critical brain
regions.
Koliatsos says this hidden brain injury may later play a role in a
veteran's psychological and social problems.
"And because of the way vasculature is organized in the brain, most
of this damage happens in the front of the brain - what we call the
frontal lobes. And that's very important because this is the site,
the center, of the executive functions of the brain. Functions that
allow you to put your life together, organize, plan ahead,
understand abstract. And you can imagine this can make your life
difficult," says Koliatsos.
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U.S. veteran Aragorn Thor Wold says studies like these are necessary
to better understand what happens in the field. Wold was a Navy
Corpsman who served with the marines in combat medicine for nine
years and was deployed twice to Iraq. He says his first deployment,
with the 3rd Battalion 25th marines, suffered the most casualties
than any other battalion in the war - 48 were killed in action and
over 350 wounded. Now a veterans advocate, Wold says many of them
are still dealing with the problems associated with PTSD.
"How can we differentiate TBI from PTSD. Is it an organic brain
injury. Is it an anxiety disorder, illness side, you know. There's a
lot of those questions floating around. So I won't say the holy
grail but a huge deal would be a biomarker."
And while there are many efforts in the industry to find a
biomarker, it is not presently available.
Koliatsos says it is difficult to gather many more combat veterans'
brains that have been exposed to an IED blast. So they are working
with engineers to do simulation research to mimic the brain's tissue
elements, to try to confirm the hypothesis that brain injury can
come from within the chest.
Going forward, Koliatsos says he hopes his research may contribute
to a different way of treating brain injuries, with medications that
stimulate frontal lobe function.
"If there is an executive disfunction, and disfunction of the front
of the brain, you may think of different medications," says
Koliatsos.
He says he would also like to see improved body gear in the military
that would give greater protection to the chest, and minimize the
impact of explosive blasts upon the brain.
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