A High-Definition Fiber Tracking Report for Patients With Traumatic Brain Injury and Their Doctors

Abstract

We have developed a tablet-based application, the High-Definition Fiber Tracking Report App, to enable clinicians and patients in research studies to see and understand damage from Traumatic Brain Injury (TBI) by viewing 2-dimensional and 3-dimensional images of their brain, with a focus on white matter tracts with quantitative metrics. The goal is to visualize white matter fiber tract injury like bone fractures; that is, to make the "invisible wounds of TBI" understandable for patients. Using mobile computing technology (iPad), imaging data for individual patients can be downloaded remotely within hours of a magnetic resonance imaging brain scan. Clinicians and patients can view the data in the form of images of each tract, rotating animations of the tracts, 3-dimensional models, and graphics. A growing number of tracts can be examined for asymmetry, gaps in streamline coverage, reduced arborization (branching), streamline volume, and standard quantitative metrics (e.g., Fractional Anisotropy (FA)). Novice users can learn to effectively navigate and interact with the application (explain the figures and graphs representing normal and injured brain tracts) within 15 minutes of simple orientation with high accuracy (96%). The architecture supports extensive graphics, configurable reports, provides an easy-to-use, attractive interface with a smooth user experience, and allows for securely serving cases from a database. Patients and clinicians have described the application as providing dramatic benefits in understanding their TBI and improving their lives.

Telemedicine and mHealth odyssey: a journey from the battlefield to academia

“…Participants then depart Pittsburgh with a customized mobile TBI Toolkit, which includes: iPad with preloaded applications (e.g., Breathe2Relax for relaxation with diaphragmatic breathing; an object locator app), activity monitor, sleep kit, and object finders, along with targeted interventions (e.g., cognitive rehabilitation, specific sleep treatment, vestibular exercises, ocular-motor program). An app developed in the research group is used with the clinician team to present neuroimaging of the patients scans on a mobile device 17 . Clinical coaches provide telemedicine support and work with treatment providers for coordination of care.…”