Our Fragile Brains

Traumatic brain injury represents one of the most significant application areas for neurotechnology. As we report in our conference report in this issue, there are about 300,000 cases of concussion caused by football alone each year in the U.S.—with about 47,000 of them classified as serious injuries. On top of that, approximately 1,300 children suffer severe or fatal head trauma in the U.S. each year as a result of shaken baby syndrome. And about 35,000 U.S. servicemembers have returned from Iraq or Afghanistan with traumatic brain injury. All told, there about 1.7 million cases of TBI in the U.S. each year, and there are more than 5 million Americans living with TBI-related disabilities.

TBI presents a twofold challenge to biomedical engineers: Understanding the biomechanics of head trauma so as to reduce and minimize the number of people who experience a severe head injury and devising therapies and treatment regimens to restore function to those living with TBI-related disabilities. We were encouraged with the level of understanding offered by Jonathan Forbes and colleagues at Vanderbilt University Medical Center and presented at the American Association of Neurological Surgeons Meeting this year. The team’s work offers insight to helmet manufacturers on ways to reduce the incidence of subdural hemorrhage caused by rotational acceleration.

We were also encouraged to learn that the U.S. Department of Defense has awarded a $2 million contract to Brain Plasticity Inc. to study the impact of brain training on treatment of TBI. BPI is a technology incubator that spun off of Michael Merzenich’s work on cortical plasticity at the University of California, San Francisco and the firm he founded, Posit Science Corp.

The grant will fund a two-year clinical trial of an internet-based program designed to improve cognitive function in people suffering from cognitive impairment following mild traumatic brain injuries as a result of active duty with the U.S. military. The award of this grant reflects the tremendous promise of brain-plasticity-based cognitive training technology, which has already shown to be effective in more than a dozen clinical trials in healthy aging, and is now entering clinical trials in schizophrenia and stroke rehabilitation.

Other neurotech firms looking at the market for treating TBI include Intelect Medical, which is developing a DBS therapy for individuals in a minimally conscious state as a result of severe head trauma, and Trifectas Medical, which is investigating the use of vagus nerve stimulation for treatment of TBI.

Although the market opportunity presented by TBI to the neurotech industry is promising, we hope that it will be a declining market in years ahead as we address the societal issues that lead to head trauma.

James Cavuoto
Editor and Publisher