(soft music)
(snappy music)
So I have to tell you
that I have an invisible disability.
It is temporary and it is my shoulder,
so I've been having some shoulder problems, some range
of motion problems
for about a year or two if my wife were here,
she would say it's been going on for four or five years.
I keep telling her, we need a new mattress.
She says, "It's not the mattress, it's your shoulder,
Go see your doctor."
I did.
So my doctor did a little bit of testing
and he said, "Of course, well go get an MRI."
So this is my MRI.
And any radiologist in the room?
So what this shows is a little bit
of rotator cuff deterioration, no tears.
It's got a biceps tendon problem
and it's been causing pain
and that is really what the diagnosis was.
Sat down with the radiologist.
What do you think the radiologist recommended I should do?
Surgery, I didn't really wanna end up like this guy.
I've had friends, I've had family members
get the rotator cuff surgery, it's not fine, it's painful
and it takes six to 12 months to recover from.
So I went back to my doc
and he said, well, why don't you try stem cell therapy?
So stem cell therapy was done
at the Premier Stem Cell Institute in Loveland,
and this was just a week and a half ago.
What they did was they extracted stem cells from bone marrow
out of my hip and reinjected that into my shoulder
and it's actually starting to feel better.
It takes about three to six months for the stem cells
to start making new connective tissue,
but I didn't wanna end up doing this.
Proper diagnosis
led to a really good treatment solution, I think.
I'll be able to report more in about six months,
but so far, so good.
Diagnosis though, is one of the problems
that is starting to gain more awareness in the country.
The National Academy of Sciences
is one of the premier institutes in the US.
It was formed by an act of Congress.
It was signed into law by the president,
this president, and it's been around for over 150 years
and it is populated with members
of top tier universities around the country.
And the purpose of the academy is to advise the nation
on matters of science and technology and medicine
and help us all understand what the state of art is.
They recently came out
with a report called Improving Diagnosis in Healthcare.
When I say recently, this was just last month
that they came out with this report.
They had been working on this study
for the past couple of years.
Some of the highlights of the study indicate
that in a conservative estimate, 5% of us,
seeking outpatient care, will experience a diagnostic error.
Now you think about 5%.
Well, that doesn't seem like a very large number.
That number is actually 12 million people.
So if you think about if you were one of those 12 million...
Postmortem research shows that diagnostic errors contribute
to approximately 10% of patient deaths,
this is all in this report.
Diagnostic errors are the leading type
of paid medical malpractice claims.
The best estimates indicate
that every one of us will experience
a meaningful diagnostic error in our lifetime.
Now, we've had some speakers today talk about some
of the diagnoses that they went through
over and over and over,
hopefully finding the one that was correct.
We find this at CereScan in our own research.
What we have looked at is brain-related
misdiagnosis rates,
TBI is misdiagnosed up to 33% of the time.
Now, Jim was just talking about PTSD.
The symptoms between PTSD and TBI overlap tremendously.
So when you're presenting clinically,
you may not really know what the problem actually is.
It looks a lot alike in the clinic,
but they're actually very different disorders.
ADHD is overdiagnosed, 20% in high school boys.
Boys just tend to wiggle.
They tend to be active.
They tend to be overactive sometimes
and it gets misdiagnosed.
The resulting overmedication of boys in particular
is one of the problems that goes with this.
Bipolar disorder Up to 69% of the time.
If a person is pres presenting in the clinic as depressed,
oftentimes they are diagnosed with depression,
when in fact they may have bipolar
and they're simply on the depression side of that syndrome.
Parkinson's is misdiagnosed up to 25% of the time.
Today, the technology is such that we can give an up
or down diagnosis of Parkinson's using SPECT imaging.
Alzheimer's is misdiagnosed up to 30% of the time.
Frontotemporal dementia is not the same as Alzheimer's
and we heard about Alzheimer's earlier today.
These are two different types of dementia.
We can differentiate that at CereScan.
But this report was about improving diagnosis,
it didn't just get stuck in all the problems
and all the misdiagnosis rates.
It talked about how to go about trying to do that.
Improving the diagnostic process is not only possible,
it represents a moral imperative
and it's something
that the National Academy of Sciences
is pushing more and more today.
There are several recommendations in this report
to improve the utility of health information technology,
data and the diagnostic process.
Health IT, the data that goes with assessments
has the potential to improve diagnosis
and reduce these errors by facilitating timely
and easy access to information.
The mission at CereScan, the reason that we exist,
is to provide the most advanced,
comprehensive brain data analytics
for the purpose of improving diagnoses,
patient outcomes and science.
The struggle that we run into is this type of thing.
When medical doctors think about SPECT imaging,
they're thinking about the way it used to be.
We call this the blob, that's what it is.
You can't diagnose much by looking at this,
but this is what medical professionals,
what doctors think about
when they think about SPECT imaging today,
if they are not up on what's going on.
There is a saying that we have at CereScan,
and you've heard this before,
doctors tend to be down
on the things that they're not up on.
This is what our images look like.
Now, I'll tell you that this is my brain.
It's always a little bit precarious when I drag my brain
out in public like this.
One of the speakers earlier said that we need
to know our brains.
Well, I know my brain.
This was a scan from a couple of years ago
and the first thing to note
about this image is
that when you look at the color scale, gray is good.
Gray is within the normal range of this color palette.
Green is two standard deviations below normal in terms
of cerebral blood flow in that particular region.
Blue is three standard deviations.
Dark blue would be four, black would be five.
Red is actually two standard deviations
above normal in terms of blood flow
and that particular region.
So what we're looking for are patterns of blood flow
in a patient's brain.
Now, what you'll see here are the brain sits inside
of the skull and it has bony ridges.
When I was a kid, I was always hitting my head.
I had my head stitched up a couple of times.
I was in accidents.
I was a fairly typical boy doing boy things
and most boys growing up,
most of the men in this room have probably bumped their head
or knocked their head several times.
Everything that we do though is about data.
We generate nice pictures, but it's based on data.
No one's sitting there coloring the color palette.
This is being produced by data.
We look at normative data.
When we take a patient's images,
the data that we get from that goes through our software
and it's compared to normative databases.
We collect for every scan that we do, 262,000 data points.
It's a 64 by 64 by 64 matrix
of voxels in 3D space,
and it's all compared to normative data.
What we're doing is advanced neuroimaging
and neuro analytics.
So what we do is called qSPECT,
quantitative single photon emission computed tomography.
We also do PET/CT imaging,
this is nuclear medicine using radioisotopes.
Now, let me shift gears for a minute
and tell you about a study.
We know that the veterans that have served our country
have gone through quite a bit
and some of the data that has come out recently
is kind of astonishing.
Military suicides are at their highest rate,
more military deaths by suicide than in combat in 2012,
over 300,000 TBIs in the last 15 years among veterans.
The VA has put out data
that says that there are 22 suicides per day
among veterans in this country, think about that,
22 per day among veterans in this country.
We wanted to do a study
and part of the reason that we wanted to do a study is
that we're looking for things that can help
fix TBI can help reverse the brain damage that we see here,
so we did a study.
And this study was done,
we call it the Invisible Brain Injury Project.
It was funded by the Tug McGraw Foundation.
We partnered with Colorado Neurological Institute,
who provided oversight in this study.
They're a great partner.
They are a great community resource here in Denver
and in Colorado.
Do many, many research projects, it's a small study.
We only had 12 veterans in the study.
TBI, six weeks of treatment three times a week,
Monday, Wednesday, Friday usually, and 20 minutes a session.
When you do the math on that,
that is a total of six hours of treatment.
We wanted to look at the impact of this treatment
on TBI symptoms,
cognitive performance using neuropsych tests
and blood flow using qSPECT.
Again, I want you to think about this is my brain.
This is one of the soldiers that we worked with.
One of the patients, again, think about gray is good.
Dark blue is four standard deviations
below normal black is five standard deviations.
When you talk to this patient,
it was difficult for him to look you in the eye.
He had feelings of rage.
He looked like if you said the wrong thing,
he might explode all over you.
He was depressed.
He had all kinds of the normal symptoms
that we think about with TBI.
This was the treatment,
this is polychromatic light therapy, polychromatic,
because we're using two wavelengths of light here,
red light and near infrared.
Now, this looks a little bit kludgy,
again, this is a pilot study.
So we put together some pads and some devices
and the near infrared and the red lights are transcranial
and they bathe the brain in the light.
And what's happening here
is we are stimulating the production
of a molecule called nitric oxide.
Now, nitric oxide is in our bodies.
It's in the food that we eat.
It's in the medications that we take.
It's in aspirin, it's in morphine,
it's in that little blue pill that some men take for ED.
Nitric oxide is a vasodilator,
It opens up the blood vessels
and that's what's happening in in the brain.
It is opening up damaged blood vessels
in order to generate blood flow through the brain.
Neurons eat glucose
and they need oxygen to be able to metabolize that glucose.
The only thing that gets it there is blood.
You've got to have blood flow going in the brain,
that's what this is doing.
What happened?
These were the symptoms,
we had everyone do a symptoms checklist.
The blue was pre-treatment,
so you look at some of these things,
the first set are all physical kinds of symptoms, headache,
dizziness, sleep problems, et cetera.
The middle ones are really more psychological,
depression, irritability, things like that
and then the last group are really cognitive problems.
Everything went down, symptoms went down,
I'm reminding you that this is six weeks of treatment,
a total of six hours of exposure
to the polychromatic light therapy.
The only one that didn't really register was nausea,
but it never was seemed to be a problem,
at least among these 12 in the first place.
But all of these symptoms went down.
Now, these are self-reported symptoms.
You might say, well, there's placebo
and you can fake that sort of thing.
We also looked at neuropsychological test performance.
Basically looking at subscales
of the Wechsler Adult Intelligence Scale,
which is one of the IQ tests used today.
And what we saw is an improvement across the board
in cognitive performance, auditory learning,
the memory subscales, cognitive processing speed,
all of these got better
from pre-treatment to post-treatment.
So what happened to our one patient's brain?
So as I mentioned this particular one
and and this is kind of typical
of what we saw in this study was pretty messed up.
This is a lot of low blood flow in the brain.
So after six weeks of treatment,
this is what his brain looked like,
it's a remarkable difference.
And the only way that you can get to this sort of thing is
by looking at qSPECT and actually measuring this
and taking a look at blood flow in the brain.
One of the divisions that we have inside
of CereScan is CereLab
and what we're interested in is more research
along these lines.
So, for example, this is a GyroStim.
(GyroStim whooshing)
And what GyroStim is doing here
is basically stimulating the vestibular aspects of the brain
And the marketing on this particular device,
by the way, the inventor lives in Colorado Springs,
it's manufactured here in the state,
but it's sold around the world.
It is stimulating the vestibular
aspects and it's for balance.
Right now the claim is around balance training,
but he believes that this is a therapy
for traumatic brain injury as well.
We don't know. He's had some anecdotal evidence of that.
This is hyperbaric oxygen therapy tank.
There is evidence that HBOT
is doing tremendous things for TBI.
There's certain studies that show that it's very effective
and there's some that, in particular,
the military doesn't seem to think
that it works on military people,
but seems to work in civilians.
I don't quite get that,
but this is a therapy
that we're very interested in.
This is CVAC, cyclical variations and adaptive conditioning.
Essentially you get into this chamber, closes down,
there's a plexiglass thing so you can see out
and it takes you through pressure profiles between sea level
and about 22,000 feet,
up and down, not the whole way.
You might go up to 5,000 back down to two, up to seven,
back down to four, up and down, up and down.
It is for extreme athletes for conditioning,
but they also have found some evidence
that this could be a treatment for traumatic brain injury.
We don't know.
Neurofeedback is a very popular therapy today
for a variety of brain disorders.
We are talking with Denver Sports Recovery.
We had one
of the board certified neurofeedback therapist
from Denver Sports Recovery here today.
But this patient is moving things
using brainwaves in that video game.
Is this a treatment for traumatic brain injury?
Possibly, we don't know.
It doesn't have to be like this,
it doesn't have to be 22 suicides a day.
There actually, I think is a lot of hope
for where we're going, what CereScan is trying to do.
We wanna find out what works, what doesn't work,
and we wanna pursue those things, thank you.
(energetic music)
(soft music)