Science begins to track brain injuries and possible treatments

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Science begins to track brain injuries and possible treatments

BY TIM COLLIE
South Florida Sun-Sentinel
Victims of severe traumatic brain injury are lost in a land without maps - a land whose rugged interior is only now being charted. Over the past two decades, science has begun to map the human brain, peering into thoughts, actions, even intention.

But these are only trial expeditions. Their potential to alter the course of brain injury still lies far off.

The pictures they produce - neuroimaging that depicts brain activity in yellows, reds and greens - are akin to finding the first signs of life on the brain's gray lunar surface.The implications are huge. Tens of thousands of Americans lie in nursing homes in comas and other diminished states resulting from brain injury. Thousands more join them every year. But they are at the mercy of a medical establishment ill equipped to assess their needs and provide treatment, according to several recent studies.

The gap between the science and the treatment is growing. Few answers have emerged to bridge the chasm.

Scientists have only learned over the past two decades that the brain doesn't stop growing. It can even repair itself in a process that's still far from understood. The brain's vast neuronal net, it appears, can prune dying branches and grow new ones. It can shift tasks and issue orders to new areas of the brain. This is why people can relearn speech or motion with large sections of their brain damaged or missing. That's why after years, even decades, a rare handful of patients awake from comas.

"The brain isn't a black box anymore - we know a lot about what's going on now with head injuries in patients who are comatose for days or weeks," said Dalton Dietrich, a neurologist and scientific director at The Miami Project to Cure Paralysis. "We're way past the dark ages of brain and spinal cord injury [of] 20 years ago."

In the United States, an estimated 315,000 patients live with some disorder of consciousness, most as the result of traumatic brain injury. But defining their state - whether they're vegetative or "minimally conscious" - is still a matter of debate. Breakthroughs on the horizon might lead to something more profound-discovering, for example, if personalities exist somewhere inside damaged heads.

"How can you always say you have no possibility of bringing someone back? I don't think we can do that," said Daniel Liebl, associate professor of neurological surgery at the University of Miami's Miller School of Medicine. "Today is a new day. There is promise. ...There may be a breakthrough next week."

Every brain is unique. So is every brain injury. The organ itself is encased inside a skull and cannot be removed or replaced. The only sure way to determine many injuries is through autopsy.

Scientists at the University of Miami and elsewhere are looking for new breakthrough treatments:

Stem cells: These can be triggered to grow neuronal brain cells that would regenerate damaged tissue.

http://www.sun-sentinel.com/news/loc...,4297076.story