Posted December 30, 2015
Dr. Rao Gullapalli, Ph.D., University of Maryland, Baltimore

Traumatic Brain Injury (TBI) is a serious concern for many active military members and repeated exposure to blasts could result in TBI with long-term damage, a condition that has not been well understood. Dr. Rao Gullapalli, from the University of Maryland, recipient of an Intramural TBI Investigator-Initiated Research Award from the Combat Casualty Care and the Clinical and Rehabilitative Medicine Research Programs, set out to identify early markers of TBI that could be used to improve treatment and measure the efficacy of interventions. His group has applied a number of advanced imaging and spectroscopic techniques to strengthen our ability to assess and monitor TBI over time.

Dr. Gullapalli's lab is currently investigating an alternative implementation of magnetic resonance imaging known as diffusion kurtosis imaging (DKI). The investigators have found that DKI is a sensitive tracker of small neuronal changes associated with mild TBI (mTBI); these changes correlate well to cognitive changes observed as patients recover from TBI. The ultimate goal is to further develop DKI that can be readily used in the clinic to evaluate TBI throughout treatment.

The group also applied magnetic resonance spectroscopy imaging (MRSI) to analyze cellular metabolism in different regions of the brain. When compared with cognitive evaluation metrics, changes were found in cellular metabolism within particular white matter regions of the brain and are indicative of injury and can be used to predict a patient's cognitive outcome. Resting state functional connectivity is another brain metric; it measures correlated brain activity when a subject is not involved in an explicit activity. In mTBI patients, abnormal resting state functional connectivity was found between brain hemispheres and within thalamo-cortical networks. In the former case, these changes were related to post-concussive symptom severity.

Dr. Gullapalli hopes that with further refinement of these new techniques, clinicians will be better able to determine when a TBI patient may return to work or whether a positive treatment outcome is likely. Together, these new findings have the potential to greatly advance the ability to identify and monitor progression and improvement of TBI, thus improving the level of care we can offer our Service members.

Links:

Public and Technical Abstracts: Investigation of Prognostic Ability of Novel Imaging Markers for Traumatic Brain Injury (TBI)

Top of Page