Blasts and gaps: How a biomedical engineering doctoral student is solving gaps in treatment for blast-induced neurotrauma
After enduring a challenging experience, some people decide to use what they learned to improve the experience for others who may face it later. This is not an easy feat and takes a special type of person. Carly Norris is one of these people.
In 2011, Norris, originally from Mechanicsville, Virginia, endured a head trauma. The trauma was so severe that it affected every area of her life, and she was just a teenager. In addition, the diagnosis and treatment options were unclear – health care professionals wanted to help but they were not sure what to diagnose, what to prescribe as treatment, or how to address the resulting traumatic symptoms. Adjusting to a new normal – which included relearning speech and motor skills – without clear treatment or diagnoses illustrated to Norris the challenges and an obvious need for solutions for traumatic brain injuries. She discovered blast-induced traumatic brain injury during her first year at Virginia Tech.
“Blast-induced traumatic brain injury is serious, and yet people don’t always know they experienced a trauma,” said Norris, a doctoral student in the Virginia Tech–Wake Forest University School of Biomedical Engineering and Sciences, housed in the Department of Biomedical Engineering and Mechanics (BEAM). “The stresses and the strains on the brain tissue are different from blunt-force trauma, but the injuries can still be progressive and lead to prolonged deficits.”
According to the Defense and Veterans Brain Injury Center, nearly 400,000 military personnel have suffered a traumatic brain injury, one-third of whom experienced a blast event.
The pressure wave resulting from a blast or explosion can spread a long distance from the source. When this overpressure traverses over and through the body, a person’s organs, particularly the brain and lungs, are susceptible to injury. The pressure imposes strains on tissues and cells that can cause long-term deficits, especially if not addressed.
In the Traumatic Nerve Technologies (TNT) Lab, Norris examines each of the brain’s regions to determine which are more susceptible to blast-induced neurotrauma. She looks at which metabolites in the brain are most sensitive to those traumas, examining at what points in time and at what thresholds those metabolites change, and asks questions about what might be causing these changes.
“I knew I wanted to solve these complex problems, so I chose engineering,” said Norris.
Foundational engineering knowledge
During Norris’s first year at Virginia Tech, she attended a presentation on blast-induced trauma research by Pam VandeVord, N. Waldo Harrison Professor and principal investigator at the TNT Lab. Through VandeVord, Norris saw her opportunity to jump into the exact research she wanted to do. After declaring her general engineering major, Norris soon began research in the TNT Lab. The experience helped narrow her academic focus to biomechanics, and she decided to switch majors to engineering science and mechanics.
“I was fortunate to get to work on a lot of projects,” said Norris. “I looked at lung and brain polytrauma as a result of primary blast exposure. Majoring in engineering science and mechanics gave me the theory and the strong foundation in mechanics to apply to this research.”
After graduating from Virginia Tech with her bachelor’s degree in 2018, Norris began work on her master’s degree in biomedical engineering. Her interest in image analysis – being able to pull information from an image to better understand brain injuries – led her to research with Stephen LaConte, an associate professor for BEAM and at the Fralin Biomedical Research Institute at VTC.
Under LaConte’s guidance, Norris created a structural brain template to normalize MRI scans in a 3D space. The template allows researchers to investigate brain diagnostics using MRIs and also facilitates brain diagnostics in pre-clinical settings. In 2021, her research was published in Neuroimage.
Norris continued using image analysis during a summer internship at the Orthopaedic Research Laboratory at Virginia Commonwealth University under mentorship of Jennifer Wayne, now a BEAM professor and department head. Norris developed algorithms to train artificial intelligence to recognize pelvic features from CT scans. Doing so enables automatic diagnoses for patients with hip abnormalities.
Norris became vested in her work. After she graduated magna cum laude with her master’s degree in biomedical engineering in 2019, she felt compelled to continue.
“After creating the 3D brain template, I realized I wanted to use it, too,” Norris said. “I wanted to ask the additional questions this research brought up, I wanted to use my projects, and I wanted to see this through.”
Applying knowledge to solve complex problems
As Norris works toward her Ph.D., she will continue her research on blast-induced traumatic brain injury as a recipient of the David W. Francis and Lillian Francis Research Fellowship, granted to students conducting research that emphasizes longer, safer, and healthier lives.
“This is very personal to me and very important,” said Norris. “I want to solve this problem.”
Norris hopes to identify therapeutic targets and options for metabolic changes in the brain. To understand when the changes occur, she examines the body’s amino acids at various time intervals – four, 12, 24, and 48 hours after a blast. Quantifying these changes and understanding when pieces of the metabolic cycle are breaking down will help her identify recommendations to combat those changes.
In addition to looking at the effects of blast-induced neurotrauma, Norris is characterizing spinal cord injuries, impact injuries, the biomechanics of the brain tissue during a blast, and more.
“It can be so frustrating going to a doctor’s office and they tell you they don’t know,” Norris said. “They try, and they want to help, but they don’t know. We’re sending soldiers abroad with no way to help them when they’re back. I’ve talked to veterans, and I hear their frustrations. I want my research to help find those diagnoses and to create tools and treatments to help with the aftermath of brain injuries.”
As for conducting this research at Virginia Tech, Norris couldn’t be happier. She said it really does feel like home.
“It has been a great opportunity for me to stay at this school, to study what I love, and to be around family,” she said. “Everything aligned, and I couldn’t be more grateful.”
