After a brave five-year struggle with what was diagnosed as depression, Matthew Dahl took his own life at age 24. Bob and Linda were very close with their son and miss him beyond measure. “We are a team,” Matt would often say, and it was true.
When Matt was just five years old, he suffered a serious head injury after falling from a second-story window. He was rushed to Harborview Medical Center where he was put on life support. Shortly thereafter, he woke from his coma and for a long time everything seemed okay.
“His accident was devastating, but his recovery was miraculous,” says Bob.
However, at age 19, Matt began to struggle. He insisted something wasn’t right with his brain. All three of them thought there might be a link to his earlier head injury.
After his death, at his parents’ request, Dirk Keene, MD, PhD, director of the UW BRaIN Research Lab, accepted Matt’s brain for examination. It was at their first meeting with Dr. Keene that Bob and Linda were introduced to the term “traumatic brain injury” (TBI) and the concept of late onset symptoms of such injuries. At that meeting, they were not only impressed by Dr. Keene’s intelligence and passion for his work, but also by his compassion.
“He and his team are very sensitive to the fact that for each brain that comes to them for study, there has been the tragedy of a death and a grieving family. In our case, they’re not just working with a brain, they’re working with Matt’s brain,” says Bob.
The BRaIN Lab: at the forefront of brain research
The BRaIN Lab stands for the Biorepository and Integrated Neuropathology Lab. It sounds complex, but every word means a lot to Dr. Keene, associate professor of laboratory medicine and pathology at the UW School of Medicine and the Nancy and Buster Alvord Endowed Chair in Neuropathology.
The biorepository contains nearly 4,000 donor brains that Dr. Keene and his team study to better understand normal brain structure and function, and how that changes after injury, such as TBI, or with disease. They also share these tissues, always anonymized, with research partners around the globe to maximize the impact each donor has in the search for new treatments and cures.
The BRaIN Lab is known for continuously pushing the field forward with the latest innovations, often in collaboration with partners across the UW and the region. For example, Christine Mac Donald, PhD, professor of neurological surgery at the UW School of Medicine, and Lisa Keene, who runs the autopsy program for research and is married to Dr. Keene, have developed a way to take magnetic resonance imaging (MRI) of brain tissue. Their technique allows them to see injuries that a neuropathologist would not be able to identify.
And in collaboration with the Allen Institute for Brain Science, the BRaIN Lab has developed a novel way to slice and freeze brains so investigators can identify cell types that are most vulnerable to injury and disease. Investigators have also developed a technique to generate brain cells in a dish — or cell lines — from donated brains. This is a critical step for testing which new drugs and therapeutics will be effective at the individual, molecular level.
One of Dr. Keene’s personal goals is to bring TBI research up to speed with Alzheimer’s disease research. In fact, he hopes that Alzheimer’s can serve as a kind of roadmap for TBI – deepening our understanding of the degenerative changes that happen long after a traumatic brain injury has occurred.
Six months after Bob and Linda’s initial meeting with Dr. Keene, the examination of Matt’s brain was complete. Dr. Keene and his team had discovered a lot of disruption to Matt’s brain, including a few very serious contusions and evidence of old hemorrhage that resulted from the fall from the window that never completely went away. An MRI of Matt’s brain revealed injury deep into the white matter up to the front of his brain, areas of injury that a pathologist wouldn’t have seen.
Bob and Linda found this news validating; Matt knew there was something wrong with his brain, and now they had evidence. “What they said that day supported what Matt told us as he struggled those last five years of his life. Something was happening to his brain. He wasn’t getting better. It was more than depression,” says Linda.
More than anything, Bob and Linda hope that what BRaIN investigators learn from their son’s brain will help someone else’s child who may experience a TBI.
BRaIN Lab researchers share that goal as they search for answers to some of the most difficult questions in the field. “The brain doesn’t heal itself very well, and we don’t know why,” says Dr. Keene. “But we want to help it heal itself, and to do that, we need to understand how these injuries happen, how they progress and what can be done to prevent some of the long-term consequences.” Dr. Keene notes that he and his team are applying multiple cutting-edge techniques on Matt’s brain to try and better understand TBI, and, as with every donor brain, they are going to be learning from Matt for a long time.
A Path Forward
COVID has been a huge challenge for brain banks around the world, including the BRaIN Lab. However, Dr. Keene feels extremely proud that they have managed to stay open and not miss a single brain donation.
Currently, every donated brain is tested for COVID-19, and there are protections in place in case there is a positive. In fact, the BRaIN Lab is part of major efforts nationally to collect and study the effect of SARS-CoV-2 on the brain. Dr. Keene, says the pandemic has shown him how much support the BRaIN Lab has in the community.
Bob and Linda know all too well that support for TBI research is crucial, especially because a devastating accident can happen in an instant, without warning, to anyone. They have both pledged a significant matching gift to support the work of Dr. Keene and his team.
“We always thought that we could save Matthew, and we will be forever sad that we could not. But now what we can do is honor him. We believe strongly in the work that Dirk and his team are doing,” says Linda.
Dr. Keene feels a deep sense of gratitude to anyone who supports his work, and he stresses that donations of all sizes are welcome. And he feels a special sense of gratitude to Bob and Linda, to everyone who donated in Mathew’s memory and to Matt.
“We have so much work to do, and we can’t solve any diseases until we really understand the normal brain and what’s happening with a traumatic brain injury,” says Dr. Keene. “But we’re getting there. We’re seeing early results that are really encouraging.”