Dr. Geoffrey Ling talks about DARPA's tiny blast gauge, which worn now by 11,000 soldiers, can quantify who is at risk for brain injury so that they can get screened and treated more quickly.
[Dr. Geoffrey Ling] We found a few things. Number one is that the pressure wave that's emanated by an explosive blast is in fact injurious once it gets above a certain threshold. And that certain threshold varies a little bit, but it's roughly about maybe 10 to 20 pounds per square inch. And once you get a threshold like that, then at about that point, your brain is going to start to not function entirely properly. Once it gets higher pressure loads, then cells start to die and even higher pressures, then other structures start to go. And in fact, it's the basis behind a very important DARPA effort, that was created by Dr. Jeff Rogers at DARPA, which is a blast gauge. In fact, what Dr. Rogers did was assemble really a team of expert engineers, and they built a little, itty, bitty gauge that you hang on your equipment or hang on your helmet, and what it does is it measures that pressure wave. And that's really important because absent a biomarker, let's have an environmental sensor, kind of like a dive watch. I've gone too deep. It doesn't mean you have the bends, but you're at risk. And that's what Dr. Rogers did, and that's a direct leveraging against data that we developed in the PREVENT program that led to the development of the blast gauge. And in fact, Dr. Rogers has been so successful with the blast gauge that 11,000 warfighters presently are wearing it right now—today— while they are on patrol out in Afghanistan. And that is being used really to help quantitatively identify who is at risk of a brain injury. Terrific. Let's take a scenario. There's a group of young Americans out on patrol, and they encounter an improvised explosive device, an IED. Boom! It goes off. Now, a few people tumble down. Fortunately, nobody is seriously injured. But you wonder, "Oh, have they been exposed to a point where some of them had a mild traumatic brain injury?" Generally, there's about 20 or 30 of these fellows and gals out on this patrol, so what you do is you go up and now what you can do instead of just arbitrarily wondering who did or who didn't, you can go up and look at Dr. Rogers' blast gauge and push a little button. If it shows up green, they were below that blast threshold, and they're fine. If it's yellow or red, they probably are at risk, and then the medic would come up and do a MACE exam. The MACE exam would then say if it's normal, they're fine. But if it's abnormal, it's time to go see the doc. So now if you can imagine the scenario, how quickly you can screen all of these soldiers for traumatic brain injury,. Instead of it being a half hour or hours, it's down to just a handful of minutes. And now you take the ones who are potentially hurt, and you send them to the doctor, and if they in fact have a concussion, they go into the Concussion Restoration Center, and they're taken off the line and given very systematic care. And what's that systematic care? Some brain exercises, rest, and a graduated reintroduction to their activities. We've found that is very successful. We get well over 98% of our soldiers back to duty within five days by using this approach. That's what I'm hoping that we'll be able to do for our young soccer players and football players and the like.
Posted on BrainLine January 15, 2013.
Geoffrey Ling, MD, PhD is a program manager at the Defense Advanced Research Projects Agency, where he has responsibility for a broad research portfolio. Dr. Ling is an authority on traumatic brain injury, especially as it pertains to the military.
Produced by Noel Gunther, Ashley Gilleland, and Erica Queen, BrainLine.