The Year in Biomedicine

Brain trauma among soldiers, a $5,000 genome, cellular switches, and insight into the brain's beauty.

Brain Injury in Iraq
In April, we ran a feature exploring the new epidemic of brain injuries in U.S. soldiers serving in Iraq and Afghanistan, and the scientists racing to understand the often invisible wounds. One of the central questions--still unanswered--is whether mild brain injuries, undetectable with traditional brain scans, have a long-term impact, especially if caused by repeated traumas. Scientists are making progress using new brain-imaging technologies to find and monitor these subtle injuries.

Hidden wounds: Scientists have developed new methods to measure subtle brain injuries not visible on traditional brain scans. Here, a version of MRI known as magnetic resonance spectroscopic imaging is used to measure the levels of two chemicals--NAA and choline--in the brains of brain-injury patients and healthy controls. In the images above, the redder the color, the higher the ratio of choline to NAA. Brain-injury patients (bottom three rows) have a higher ratio of choline to NAA than do healthy people (top row). Credit: Andrew Maudsley

Soon after the May issue of the magazine came out, President Bush signed into law the Traumatic Brain Injury (TBI) Act, which reauthorizes through 2011 federal programs in prevention, education, research, and community living for people with TBI. The U.S. Army beefed up screening requirements in June; all soldiers who experience dizziness or loss of consciousness from a blast, a fall, or some other trauma are to receive immediate medical attention. This is especially important because the impact of repeated mild TBI, which can be easy to shrug off and difficult to diagnose, is still unknown.

Story continues below

Ups and Downs for Personal-Genomics Companies
Startups offering genetic analysis directly to consumers, including 23andMe and Navigenics, have had a roller-coaster year. The Genetic Non-Discrimination Act, which prohibits genetic discrimination in employment or health insurance, passed after more than a decade of debate, removing a potential barrier to use. And retail genetic tests, specifically 23andMe's, were named Time magazine's best invention of the year. But it's unclear whether either action has helped sales. 23andMe drastically reduced the price of its analysis service in September, prompting speculation of poor sales. And both companies have declined to report sales figures.

Navigenics and 23andMe also had to contend with regulatory skirmishes in New York and California, two states with strict laws on diagnostic testing. In June, the California Department of Health sent 13 personal-genomics companies cease-and-desist letters pending proof that they were complying with state law, including clinical licensing for the laboratories performing tests and the requirement of a physician's order for all clinical tests. The state gave both companies the green light in August, but the regulatory future of personal genomics is still far from clear.