About 22 percent of all troops deployed in combat since 9/11 have suffered traumatic brain injury (TBI). Because such injuries are difficult to detect, and are sometimes confused – or entwined – with psychological injuries, the percentage may be much higher. For that reason, the Department of Defense awarded a $4.6 million grant in March to the New York-based Brain Trauma Foundation. The funding was received in September and is being used to develop an eye-tracking device that will help determine, within seconds, if a soldier has suffered TBI.
Dr. Jamshid Ghajar, president of the foundation and clinical professor of neurological surgery at Weill Cornell Medical College, is the principal investigator for the project. He spoke with The American Legion Magazine about the proposed device and its potential value in combat zones.
Q: What is the premise behind the device you're developing?
A: In a TBI, the brain rotates inside the skull and tears. The tears are on the network that allows you to pay attention. So I was trying to figure out a way to measure attention in real time. I decided to look at eye movements. If you look at the circuit in the brain responsible for you looking at something – like a dot going around in a circle – that is the same part of the brain responsible for paying attention.
So you put a high-speed camera on your eyes, and I can tell exactly where your eyes are and where the target is, and I can see the synchronization between your eyes and the target. But I can do it not once every couple of seconds; I can see that every one-1,000th of a second. I can average that over a 100th of a second ... That correlates with how well you pay attention, how well your memory is, and it correlates with how many tears the brain has as a result of the concussion. That is, essentially, what the military is funding me to do.
Q:What is your timeline for completion?
A: (The day after being awarded the grant, DoD) called us up and asked, "When can we get this?"
We said, "Well, it's a four-year grant. We're going to make a prototype and then test it out."
They said, "No, no, no. We want to have it within the year." They told us that of all the stuff that got funded, this is the only thing that's tangible and the only thing they'll see in the short run.
Q:Is it realistic to think you can develop it within the year?
A: We could. We have an engineering company called Foster-Miller that's based in Boston. They do a lot of military contracts – they make the robot that goes out and defuses bombs. I'm developing the software; they're doing the hardware. I asked them if we could do this within the year, and they said, "Yeah, but we're going to need everyone to work four times as hard." We put in an additional proposal to do that. We have to go somewhere else within the Army to look for that funding.
Q:Will soldiers be able to take this device with them on the battlefield?
A: I see this as something they would have on the front lines. It can be a pair of goggles you put on the soldier, and within 10 seconds you can detect whether they have brain trauma or not. It'll be like, green light means you're ready to go. Yellow light means you're compensating; you're about to deteriorate. A red light means you're really affected and shouldn't be in any position where you can injure yourself or others.
Q: Will this device have other uses?
A: In talking with the military, they said, "Wait a minute. If this detects how well you pay attention, I want to use this to tell me if someone is fatigued or tired, or isn't paying attention." That's a good use for it. You don't want to send someone into a war zone if they're not paying attention. It's a device that allows you to measure how well you pay attention, and you can do it in 30 seconds. I'm going to get it down to 10 seconds.
Q:Is detection only part of the equation?
A: I think a combination of diagnostic treatment, along with prevention, is going to be really important. If we can prevent rotational shearing, we won't have any brain injuries. (The military) realizes this is a problem, and they are tackling it and want to solve it.
Unfortunately, in the civilian sector, we've never had the funding for traumatic brain injuries. But now that we've had all these soldiers coming back with traumatic brain injuries, the money is available for research. What I would like to see is the research dollars being used for practical solutions. We want research that comes out with a product that helps veterans.