The National Institutes of Health is awarding $18.8 million over 5 years to support worldwide research on concussion and traumatic brain injury. The NIH award, part of one of the largest international research collaborations ever coordinated by funding agencies, will be administered through University of California San Francisco (UCSF) and includes
McGowan Institute for Regenerative Medicine
affiliated faculty member David Okonkwo, MD, PhD (pictured), assistant professor with the Department of Neurological Surgery, University of Pittsburgh Medical Center, director of Neurotrauma and of the Spinal Deformity Program, clinical director of the Brain Trauma Research Center, and associate director of the Center for Injury Research and Control. Dr. Okonkwo will serve as the principal investigator for the University of Pittsburgh in the award.
The award supports a team of U.S. researchers at more than 20 institutions throughout the country who are participating in the International Traumatic Brain Injury (InTBIR) Initiative, a collaborative effort of the European Commission, the Canadian Institutes of Health Research (CIHR), the National Institutes of Health (NIH), and the U.S. Department of Defense (DOD).
Although the potential long-term harms due to concussions and blows to the head have gained more attention recently – due in part to media coverage of the experiences of athletes and of soldiers returning from the Middle East – traumatic brain injuries, or TBI, that results from automobile crashes or other common accidents impacts many more people.
The U.S. Centers for Disease Control and Prevention estimates that 2 percent of the U.S. population now lives with TBI-caused disabilities, at an annual cost of about $77 billion.
In the work funded by the NIH grant – which also is supported by contributions from the private sector and from the nonprofit One Mind for Research – the researchers aim to refine and improve diagnosis and treatment of TBI, which often has insidious health effects, but which frequently is undiagnosed, misdiagnosed, inadequately understood, and undertreated, according to UCSF neurosurgeon Geoffrey Manley, MD, PhD, a principal investigator for the grant who will serve as the U.S. research team’s primary liaison to the NIH, and the chief of neurosurgery at the UCSF-affiliated San Francisco General Hospital, a Level-1 trauma center.
New Approach to Lead to Patient-Specific Treatments
The new NIH award funds a continuation and expansion of TRACK-TBI. Among the goals is the creation of a widely accessible, comprehensive “TBI information commons” to integrate clinical, imaging, proteomic, genomic, and outcome biomarkers from subjects across the age and injury spectra. Another goal is to establish the value of biomarkers that will improve classification of TBI and better optimize selection and assignment of patients for clinical trials.
The researchers also aim to evaluate measures to assess patient outcomes across all phases of recovery and at all levels of TBI severity, to determine which tests, treatments, and services are effective and appropriate – depending on the nature of TBI in particular patients.
In addition to Drs. Manley and Okonkwo, principal investigators for the newly funded project include Pratik Mukherjee, MD, PhD, UCSF; Claudia Robertson, MD, Baylor College of Medicine; Joseph Giacino, PhD, Harvard University; Ramon Diaz-Arrastia, MD, PhD, Uniformed Services University of the Health Sciences; and Nancy Temkin, PhD, University of Washington. Each of these leading experts has worked in the TBI field for 2 decades or more.
International Funding and Collaboration
TRACK-TBI clinical enrollment sites throughout the United States will enroll 3,000 patients across the spectrum of mild to severe brain injuries. Clinical, imaging, proteomic, genomic, and clinical outcome databases will be linked into a shared platform that will promote a model for collaboration among scientists within InTBIR and elsewhere.
In addition to the U.S. award, the European Commission, the executive body of the European Union, has awarded €35.2 million (estimated $47,563,417) to fund the Collaborative European NeuroTrauma Effectiveness-TBI (CENTER-TBI) consortium, also part of the InTBIR. This project will collect data in over 5,000 patients across Europe, where 38 scientific institutes and more than 60 hospitals will participate.
In Canada, CIHR and its national partners also have made a multimillion dollar investment in TBI research, the details of which will be formally announced in the near future.
The InTBIR Scientific Advisory Committee met in Vancouver, British Columbia, and awardees from all three jurisdictions (EU, USA, Canada) now are aligning efforts to share resources and collaborate on strategies for achieving the InTBIR goals.
Illustration: McGowan Institute for Regenerative Medicine.
University of California, San Francisco News (10/22/13)
Pittsburgh Post-Gazette (10/22/13)
Bio: Dr. David Okonkwo