|(Rose Lincoln/Harvard University)|
Q. In your latest, just-published work you explained what traumatic brain injury (TBI) looks like at the cellular level. Can you explain what you found?
A. Maybe up until about an hour ago [when the research was published], the dogma in the field has been that TBI is due to tearing of the cell membrane, and that causes a neuron to die.
Q. But you showed that it actually has to do with pressure on the cells?
A. Imagine this blast wave is propagating through the head - like you’re thumping your Jell-O when you’re a kid. When it gets to these cells, the cells are stretched and compressed.
Q. And this deformation blocks off some of the blood flow to cells and breaks the connection between them and neighbor cells?
A. The membrane of a cell is kind of floppy - it’s like the skin on a hound dog. It’s not a very good conductor of mechanical energy. When an IED [improvised explosive device] goes off, and you have this blast, it’s coupling into the cells in some way. No one had looked at this. Also, these TBI patients are having something we hardly ever see in civilian TBI and that is the blood vessels within the brain are closing off. Sometimes it doesn’t happen until 10 to 15 days after the blast. Sometimes they don’t see it until six months after the blast.
Q. You were able to replicate this damage on brain cells in a lab dish?
A. We mimicked the explosion. We beat them a little bit with pressure pulses of like 100 milliseconds. We saw the same injuries the neuropathologists see in these cells when they do postmortems on these casualties.
Q. You already have a drug that works to counteract this damage - at least in a Petri dish - right?
A. When you’re in a fight you’re always trying to get a good shot on your opponent. We’ve got a good one.
Q. But won’t it take a decade or more to test the drug before it can be used to help injured service members?
A. Because we’re in combat, because my buddies are getting blown up, we can’t screw around and wait 10 to 15 years. I recommend that we move to animal studies immediately. I hope that the war is over before this comes to where it could help a patient. I’m afraid it won’t be, though.
Q. Does your research, though aimed at helping military personnel, also have implications for civilians?
A. Our vulnerability was all around us long before the first IED blew up. Shaken baby syndrome. Your favorite quarterback gets a concussion. Your cousin’s driving down the road and gets in an accident, snapping their head - all that’s TBI. The brain is not meant to be a mechanical organ - sloshed and smashed up against - that’s why you have a thick skull.
Q. As a soldier yourself, do you find this work more rewarding than your other research at Harvard’s School of Engineering and Applied Sciences, the Wyss Institute for Biologically Inspired Engineering, and the Harvard Stem Cell Institute?
A. I think the paper that came out today was probably the most important piece of work I’ve ever done.
Q. How do you think your military service has changed you?
A. You’re never going to walk through Harvard Square and see it the same way after you’ve tried to sort out some Third World village where someone wants to kill you. It’s not easy to turn this stuff off.
This interview has been edited and condensed. Karen Weintraub can be reached at Karen@KarenWeintraub.com.