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May 17, 2011

Medical Center leads push for new approaches to brain injury

In the race to more accurately diagnose the severity of head injuries quickly and without a CT scan, a Medical Center expert has a leading role in two nationwide studies that are launching this spring.

The first project involves testing a small, handheld instrument that assesses the brain’s electrical activity and other functional data after a concussion. The device, originally designed for the military to use in the field, is designed to triage head injury severity in three minutes, in a setting such as the Emergency Medicine Department.

In the second project, researchers will begin collecting blood and other baseline brain function data from two diverse cohorts: healthy university athletes and brain-injured patients receiving intensive care treatment. Having a broad spectrum of data will provide Medical Center scientists and other researchers across the country the infrastructure to test or validate emerging laboratory findings. For example, the blood samples could be used to quickly confirm whether a newly identified protein is clinically useful for diagnosing head trauma.

“This is clinical-translational research at its best,” says Jeffery Bazarian, the principal investigator on both projects and an associate professor of emergency medicine, neurology, neurosurgery, and community and preventive medicine. “The problem today with traumatic brain injury research is that we make an interesting finding in the lab but we have no easy way to proceed to the next step. So, by setting up the infrastructure first, we are taking a faster, more rational approach to move the findings into the clinic and improve the care of our patients.”

Head injuries are a common and growing problem in the United States. Researchers estimate that more than 1.6 million sports-related head injuries alone occur each year, yet many of them are dismissed or misdiagnosed as mild concussions, until further damage occurs or symptoms become worse.

Unless the injury is severe enough that a physician suspects bleeding inside the brain, diagnosis is very difficult. Physicians routinely use a CT scan to rule out bleeding, but recent studies suggest the radiation doses in CT scans, particularly in children, might have future negative consequences that outweigh the benefits. Currently there is no other technology widely available to objectively assess brain injury.

The National Institutes of Health recently awarded Bazarian more than $870,000 to build the database. He will conduct the second study in collaboration with BrainScope Company Inc., a private firm that develops portable, noninvasive devices to triage head trauma patients at the initial point of care. BrainScope added the Medical Center as one of 10 clinical sites to test its system.

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