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The Military's PREVENT Program

The Military's PREVENT Program

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[Dr. Geoffrey Ling] So we initiated a program called PREVENT, Preventing Violent Explosive Neurotrauma, the goal of which was to understand the basic fundamental mechanisms of traumatic brain injury as they pertain to the theater of war, which is primarily explosive blast injury. So, we've been finding a number of things. From the basic science standpoint, we have been able to identify and characterize the spectrum of the disease. All diseases have a spectrum, and what I mean by that is they have a mild form, a moderate form, and a very severe form. In traumatic brain injury, a lot of the focus, of course, for a long time has been on the moderate-to-severe forms, the type that is so severe that a patient might need neurosurgical intervention, might need to be in an intensive care unit, might be in a coma, but really what was not as well appreciated was the mild form, and, in fact, many people even questioned whether or not there was a mild form, but, of course, it certainly goes to follow that if there is a moderate and severe there must be a mild. So we were able to, in this program, actually identify what constitutes a mild traumatic brain injury from a biochemical and mechanistic level. We find that mild traumatic brain injury, at least in the context of explosive blasts, is a recoverable condition, which I think that we would all accept as even true for sports-related mild traumatic brain injury. What we found for explosive blasts, anyway, is that, in fact, it was driven largely by inflammation. So what is that? Imagine striking your hand with a hammer by accident. You strike it not very hard, but hard enough that it hurts, and you shake your hand a little bit. Maybe it gets a little red, a little swollen, but the bones are intact, the muscle's intact, the skin's intact. So what really happened? What happened is that the tissue got perturbed, and the body reacted to it, a process called inflammation. It's a way of limiting the amount of injury, and inflammation in itself is a process, a natural process of restoration, and your body gets inflamed, so when you strike your head or your brain gets injured, you have an inflammatory process, and it turns out that mild traumatic brain injury is primarily an inflammatory process, less so than actual tissue destruction. However, once you get up to the moderate and severe, you actually start getting tissue destruction, and that's why those conditions are far more serious. So it's very important to be able to define the spectrum of the disease, and that, I think, was one of the big things that had happened.

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Dr. Geoffrey Ling describes PREVENT, an initiative to define and better understand the spectrum of injury — from the more inflamation-driven injury of mild TBI to the tissue destruction of severe TBI.

See more videos with Dr. Geoffrey Ling>>


Produced by Noel Gunther, Ashley Gilleland, and Erica Queen, BrainLine.

Geoffrey Ling, MD, PhD, Col. (Ret.)Geoffrey Ling, MD, PhD, Col. (Ret.), 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.

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Comments [1]

Every chemical explosion produces a broadband electromagnetic pulse (EMP).

The magnitude of the EMP is directly related to the mass of the explosive material. Kevlar helmets provide no protection from an EMP. Researchers are studying the effects of nearby explosions on brain tissue but they are not considering the EMP contribution.

Dec 2nd, 2016 2:32pm


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