Description: Dr. Erin Bigler, renowned specialist and BYU professor, is studying the validity of old practices against newer technologies for diagnosing traumatic brain injuries.
Start: August 23, 2013
End: May 21, 2016
- Sponsor: National Institutes of Health
- Principal Investigator: Erin Bigler
Each year within the United States, there are approximately 1.5 million cases of head injuries that warrant an emergency room visit. A “Traumatic Brain Injury” (TBI), happens when an external physical force is enacted on the skull and wounds the brain inside. Such a shock can result in brain tissue damage either at the place of impact or penetration, and on the opposite side as the organ strikes the bone plate. TBIs usually result from falls at home or on the playground, sports injuries, abuse or assault, vehicle crashes, and military wounds. Generally speaking, individuals age 0-4, 15-19, and 75+ sustain the majority of brain injuries. Males— who are twice as likely as females to receive a TBI—specifically are most at risk between the ages of 14 and 24.
It is alarming that adolescents and children are statistically receiving more neural damage because their brains do the most developing at that young age; therefore, TBIs can leave a more devastating impact. Ensuing symptoms can include: physical impairments in speech, vision, motor coordination, headaches, paralysis and seizures; cognitive impairments in short term memory, concentration, communication skills, and judgement; and finally, emotional impairments such as mood swings and mood control, depression and anxiety, and a lack of motivation. These post-concussive symptoms (PCS) also occur in adult TBI, but there is often a delayed manifestation in children, growing apparent only as the individual matures and learns new skill sets. Once discovered, doctors will try to form a therapy plan, but longer procrastination can lower future quality of life.
It is for this pediatric plight that specialists such as Dr. Bigler seek to minimize the consequences of TBIs. Dr. Erin Bigler is an internationally renowned authority on brain imaging, TBI and behavioral outcomes, autism, and Alzheimer’s disease. He has authored several books, written and co-written dozens of chapters in other books, and has hundreds of publications on the noted subjects. Some of his past work involved longitudinal studies identifying predictors and their prognostic accuracy, the impact of PCS after head injuries, and how the organization and development of the neural system can help doctors better read brain images.
Dr. Bigler’s research acknowledges existing, simple TBI tests for balance and mental status (ability to function emotionally, intellectually, and in personality). However, he and other specialists challenge their usage when more complex and costly methods, such as neuropsychological tests and neuroimaging, can better predict the brain’s condition and outcome. Neuropsychological tests assess how the brain is able to concentrate, remember and relay information, and solve problems. Neuroimaging employs technology to form a structural or functional image of the nervous system, typically a computerized tomography (CT) scan or magnetic resonance imaging (MRI). Bigler encourages these, as well as newer and more-sensitive types of MRI sequences, to gauge TBI severity. These new sequences include susceptibility weighted imaging (SWI) which tracks blood flow and hemorrhaging, and diffusion tensor imaging (DTI) which maps the molecular structure of tissues.
Advanced tools are especially pertinent to detecting PCS, which can be present without obvious and outward evidence. For example, children with mild TBI often describe feeling dizzy and having frequent, severe headaches. While some may see these as only mild symptoms, a special MRI scan could show a high level of damage to the neural site, allowing doctors to quickly form a plan of action.
Dr. Bigler’s study will answer important questions about neuropsychology and neuroadaptation after an injury, leading to a fuller understanding of TBI. Additionally, the medical field will come to distinguish factors that exaggerate post-concussive symptoms. These progressive developments in clinical science will certainly inform specialists as they treat and nurture post-concussive pediatric patients, and may lead to a large reprioritization of diagnostic methods. When measures can be taken to subdue and eliminate such debilitating effects, patients’ quality of life will improve. Especially in the case of children, anything that can be done to minimize developmental disruptions will have significant and positive academic, social, emotional, and physical consequences.