High definition fiber-tracking (HDFT), developed by a team led by Walter Schneider, Ph.D., professor of psychology and neurological surgery and a senior scientist at the University of Pittsburgh's Learning Research and Development Center, will be tested in a one-year study to see if it could become the first imaging technique to accurately and consistently aid in determining a diagnosis of concussion and injury prognosis.
The proposal, among 402 submitted internationally, was one of 15 winners expected to be announced at a news conference in New York City this morning. Micky Collins, Ph.D., executive and clinical director, and Anthony Kontos, Ph.D., assistant research director, both of the UPMC concussion program, were invited to participate in the announcement.
The project will study 50 or more athletes ages 13 to 28 who sustained a head injury within seven days of seeking care at the UPMC Sports Medicine Concussion Program. In addition to undergoing examination-room assessments, vestibular and ocular evaluations, and neurocognitive testing, patients will have an HDFT scan.
"We're excited to continue our leadership in finding new, safer ways to help people from all walks of life who suffer from the effects of concussions," Dr. Collins said. "Informative imaging studies could be a significant step forward for concussion evaluation and treatment."
There are billions of neural connections in 40 major fiber tracts in the human brain, comprising the information cables of the mind, Dr. Schneider explained. Conventional imaging is not able to show these cables or to pick up the subtle damage that can be caused by a mild traumatic brain injury. HDFT, however, uses advanced computational means to process data from sophisticated MRI machines, revealing these brain pathways and spots where the tracts might be disrupted.
"This imaging technology allows us to see fiber loss and tract breaks, which has not been possible before," Dr. Schneider noted. "HDFT could provide an objective way of identifying and quantifying damage, as well as a way to monitor healing. Concussion patients may find it a relief to be able to point to a specific cause for symptoms that otherwise might seem inexplicable."
"We also are interested to see if the HDFT imaging findings align with functional impairment and symptoms in patients," Dr. Kontos added. "For example, the HDFT findings might show that there is damage to a memory tract in the brain that corresponds to functional impairment in memory performance. Conceptually, as the athlete recovers we expect to see the evidence of this in both functional and HDFT findings. Ultimately, this combination of clinical and imaging information will allow clinicians to better assess and treat the individual effects of this injury."
The NFL partnered with GE to announce in March 2013 the launch of a four-year, $40 million Head Health Initiative with the aim of improving the diagnosis and treatment of concussion, spurring innovation among health care and academic experts, and benefitting the safety of athletes, military members and society in general.
"This challenge was a call to action to advance head health research and innovation," said Alan Gilbert, director, global government and NGO strategy, GE Healthymagination. "The breakthrough ideas submitted will help us better understand brain injuries and the brain overall. We are excited to work with the University of Pittsburgh and UPMC as it advances its work in high-definition fiber tracking that could help improve identification and diagnosis of concussion."
Drs. Kontos, Collins and Schneider are the principal investigators in the Pitt/UPMC project, which will involve dozens of others from the Schneider lab and the UPMC Concussion Program. They received a $300,000 grant with an option to apply for additional funding after the opening six months of the study.
"Because HDFT can detail broken tracts in the brain much the same way an X-ray can detail broken bones, this imaging technique could provide biomarkers for specific impairments and eventually help to develop more targeted and effective therapies and treatments," Dr. Kontos said. "X-rays, MRIs, functional MRIs . . . nothing has been shown yet to be clinically useful and consistent. This could be groundbreaking for the 1.7 million or more Americans who sustain concussions every year - far more than simply top-tier athletes."
Dr. Collins is a developer, co-owner and shareholder of ImPACT Applications, Inc. ImPACT, a computerized neurocognitive test battery designed to assess mild traumatic brain injury, will be used in the study.
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About UPMC Sports Medicine Concussion Program
The Concussion Program, the first of its kind when it opened its doors in 2000 at theUPMC Center for Sports Medicine, attracts concussion patients from across the sports spectrum: NHL, NFL, Major League Baseball, NASCAR, NCAA, amateurs, high-school athletes and younger, the casual athlete and the non-athlete. Some 15,000 patient visits a year, the most in the United States, are recorded at its four locations. The Concussion Program and its specialists have produced more than 130 published research projects, including 15 in 2012 alone, as the program continues to push the envelope for better evaluation, treatment and education of concussions.
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