PHILADELPHIA — Douglas H. Smith, MD, the Robert A. Groff Professor of Neurosurgery at the Perelman School of Medicine at the University of Pennsylvania, has received a $4-million, four-year PACT (PA Consortium on Traumatic Brain Injury) award from the Pennsylvania Department of Health to lead a multi-institution effort to transform the prevention, diagnosis, and treatment of traumatic brain injury.
In the United States, 2.5 million people suffer traumatic brain injuries every year, incurring an estimated in $60 billion in healthcare costs.
Under the grant, Smith, who is also director of Penn’s Center for Brain Injury and Repair, and colleagues from four other Pennsylvania institutions will seek to pinpoint underlying biological commonalities in brain-injury patients and evaluate tests for identifying physical causes and forecasting recovery paths in the spectrum of brain-injury cases. Traumatic brain injuries result from significant blows or jolts to the head from falls, contact sports, vehicular accidents, assaults, and a number of other incidents. Symptoms include headache, dizziness, nausea, blurred vision, confusion, loss of consciousness, and seizures. In severe cases, coma and death may result.
“Despite the large number of people who suffer traumatic brain injuries, diagnosis and treatment remain grossly inadequate,” Smith said. “Our study aims to address a major shortfall, which is an inability to precisely diagnose the type and severity of injury.”
Currently, researchers and caregivers use a simplified classificatory system, ranging from mild to severe. At the lower end of the spectrum, diagnoses are made based solely on clinical history and symptoms, with no attempt to identify underlying physical causes. The Penn-led study will seek, for the first time, to objectively stratify patients according to physical damage, not only symptoms. This will enable researchers to design clinical trials based on physical causes, leading to more refined treatment of patients. (Other than supportive care, there are no proven drug therapies, and consensus is lacking on rehabilitation strategies.)
The researchers will also engage in community outreach and education/prevention efforts, including grade school demonstrations, public seminars, and mentoring and training underrepresented undergraduate minorities to assist in the research effort as well as to have them consider careers in brain-injury research and clinical management.
To carry out their work, the researchers will conduct several activities. First, they will develop new diagnostic techniques and treatments for mild forms of injury by examining the clinical role of diffuse axonal injury severity, which causes damage to several parts of the brain (as opposed to one location). Second, they will assess diagnostic techniques, such as physical examinations and blood tests, to discover biomarkers (identifiers) in moderate to severe cases of traumatic brain injury. Third, they will evaluate the sensitivity of promising biomarkers and advanced neuroimaging techniques in animal models to detect the extent and severity of brain damage.
“By carrying out this array of activities, we are aiming to supply a set of objective criteria for diagnosing and treating brain-injury patients, something we simply don’t have today,” Smith said.
Demonstrating the big science and cross-state institution aspects of the program, Project Leaders include, Drs. Ramon Diaz-Arrastia, Ragini Verma, Randel Swanson and Victoria Johnson (Penn Medicine), Dr. David Meaney (Penn Engineering), Dr. Christina Master (Children’s Hospital of Philadelphia), Dr. John Whyte (Moss Rehab, Phila), Drs. C. Edward Dixon and Amy Wagner (Univ. Pittsburgh) and Dr. Adedoyi Adeyiga (Cheyney University).
Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System, which together form a $7.8 billion enterprise.
The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $425 million awarded in the 2018 fiscal year.
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