Silent public health epidemic: Local study on traumatic brain injury

It has been a long, slow recovery for Teresa Moore, of Blacksburg. In May 2009, she fell in her basement. 

“I was standing on top of my dryer shimming up the wood flooring to get rid of the squeaks and I just stepped back and fell right on the concrete but luckily there's a pad and my head hit and my shoulder. My head just bounced and I was just so stunned and I couldn't move or talk or anything,” said Moore.

She says she went to the doctor a week later and was diagnosed with a concussion. Two years later there are still side effects. 

“I didn't realize I had it that bad. You can't have a conversation, you can't think, you can't remember anything.  You get so confused,” says Moore. 

“In many cases, people will have a mild head injury and people around them will tell them to ‘Shake it off, you'll be okay in a little while.’  And they seem fine a day or a week later.  But often what will happen after a period of time, one will start to see changes in behavior that will be directly related to TBI,” says Dr. Michael Friedlander, the Virginia Tech Carilion Research Institute executive director.

Doctors call traumatic brain injury a silent public health epidemic. 

“This could happen to any one of us at any time, and so we all have a potential reason to be interested in this” says Dr. Stephen LaConte, an assistant professor at the Virginia Tech Carilion Research Institute. 

TBI is caused by any number of things: car accidents, falling, violence or sports. Dr. Friedlander says every year, about 1.5 million Americans are diagnosed with TBI. The effects can be permanent like trouble controlling emotions, memory loss, changes in the way your brain works, or worse. 

“Amongst children, from about birth to age 14 in the U.S., TBI is the leading cause of death, and the leading cause of disability of children,” says Dr. Friedlander. 

He says it is hard to accurately diagnose a TBI, because current, widely used tests and surveys are not precise enough.  But using a new study, doctors hope to develop new procedures. 

“What we'd like to do is use (an) MRI to see how the brain heals from concussions.  And in special cases, where people aren't recovering from those concussions, we'd really like to study that as well,” says Dr. LaConte, who is recruiting study participants from the Carilion Emergency Room.  “What we'd like to do is get them within the first ten days of their injury, but then follow up with them throughout the year seeing them every couple months.”

Study participants go into an FMRI, a functional MRI.  It looks like what you'd see in a hospital, but has special equipment inside, enabling the person to watch a screen and play games against the computer and real people. 

The person in the fMRI, having their brain imaged, can actually see in almost real-time what their own brain is doing while performing a certain task.  Researchers can see how the brain reacts while we make decisions, and how we react to specific situations, feelings and functions. 

“(In) The grand scheme, we'd like to understand better how the brain heals naturally, and capitalize on that mechanism, and help those out where they're having problems,” says LaConte. 

Problems Teresa Moore wishes she could've avoided. 

“One false step and you know you can spend the next year in agonizing pain.  The stigma alone costs people their jobs, they can’t get a job they can’t ace that interview. There's a lot of things that go on when you're kind of muddled in the head” says Moore.