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Abbott, Hennepin County Medical Center and University of Minnesota Collaborate to Launch the Nation’s Largest, Single-Center Prospective Study on Concussion and Traumatic Brain Injury
Researchers at Hennepin County Medical Center (Minneapolis, Minn.) and the University of Minnesota are launching a study in collaboration with Abbott (NYSE: ABT) “to better identify the range of brain injuries among patients. Using multiple evaluation tools, including eye tracking, blood-based biomarkers, imaging and cognitive measures, scientists hope to develop a new standard approach to help classify brain injuries, including concussions, and provide the information needed to guide doctors’ treatment decisions.”
“We know that there are different types of brain damage that can occur after trauma, whether it’s a mild concussion or a severe injury,” said neurosurgeon Uzma Samadani, M.D., Ph.D., Rockswold Kaplan Endowed Chair for TBI Research at Hennepin County Medical Center (HCMC), associate professor at the University of Minnesotaand one of the lead investigators of the study. “Our goal with this study is to combine multiple assessment techniques to quickly assess the severity of brain injuries and enable clinicians to provide appropriate treatments.”
USING VARIOUS TOOLS TO ASSESS HEAD INJURY
Dr. Samadani’s prior work suggests that eye tracking may detect injury in the brain, which is not always visible in imaging such as a CT scan. In the study, researchers will use eye tracking, which involves a high-frequency camera to map the positions of the pupils as a person watches a video or TV.
“Data have shown a connection between brain injury and abnormal eye movements,” said Dr. Samadani. “With new high-resolution cameras, we can detect subtle differences in movement much more easily and objectively than in the past.”
The study will also employ blood-based biomarker evaluations, as research suggests that certain biomarkers could indicate brain injury. Beth McQuiston, M.D., medical director, Diagnostics, Abbott and co-sponsor of the study says, “When someone experiences a head injury like a concussion, specific protein biomarkers will be found in the blood. If the protein levels are higher than normal, that may show a brain injury has occurred and serve as a warning bell that further evaluation is needed.”
Abbott researchers are working on a test designed to detect the specific proteins in the blood associated with brain injury and help evaluate potential concussions. The test, which is currently in development, would be analyzed on Abbott’s i-STAT – a handheld, portable device that is used to perform a broad range of blood tests right at a person’s side.
Lastly, the Minnesota Spinal Cord Injury and Traumatic Brain Injury Research Grant Program will fund MRI imaging to be used in the study to look for finer structural issues that may not be visible in CT scans. Imaging studies will include MRI scans not typically performed on trauma patients and may help identify tiny areas of bleeding or other damage to the brain.
“Imaging tells us what the brain looks like, eye tracking tells us how well it’s working and blood-based biomarkers can tell us the nature of the damage,” said Thomas Bergman, M.D., study co-investigator and Chief of Neurosurgery at HCMC. “When we put all of this information together, we will have a better understanding about brain injury that will help us treat patients now and in the future.”
ADDITIONAL STUDY DETAILS
Researchers plan to screen 9,000 trauma patients and enroll at least 1,000 of them as part of the study. Patients could range from children to elderly adults, as well as people who are conscious to those in coma. Enrolled patients will be followed for up to one year, making the research the largest single-center, prospective study of TBI in the country.
Additional co-investigators on the study include: Dr. James Miner, Chief of Emergency Department at HCMC; Dr.Fred Apple, HCMC Laboratory Director; Dr. Chad Richardson, Chief of Trauma Surgery at HCMC; HCMC neurosurgeons Dr. Gaylan Rockswold and Dr. Walter Galicich; Dr. Dave Gilbertson, Co-Director of the Chronic Disease Research Group at the Minneapolis Medical Research Foundation and Dr. Sarah Rockswold, Director of the Brain Injury Center at HCMC.
By Brian Burnsed, of the NCAA
Nine schools have been added to the largest-ever study of concussion in sport.
The NCAA-Department of Defense Concussion Assessment, Research and Education Consortium study enters its third year this summer and now includes 30 institutions across the country. The nine new schools will begin baseline screening for all their student-athletes this summer.
More than 170 schools have inquired about taking part in the study.
All student-athletes at each of the participating institutions receive a comprehensive preseason evaluation for concussion and will be monitored in the event of an injury. Data collected at each school are evaluated by a team of researchers led by Steven Broglio, director of the University of Michigan’s NeuroTrauma Research Laboratory; Michael McCrea, director of brain injury research at the Medical College of Wisconsin; and Tom McAllister, chair of the Indiana University School of Medicine Department of Psychiatry.
The researchers have collected more than 25 million data points from 16,000 student-athletes at the 21 institutions already participating. After adding nine new testing sites, researchers estimate that more than 25,000 student-athletes will take part over the course of the three-year study.
“The important expansion of the CARE Consortium to include a diversity of Division I, Division II, Division III and historically black college and university participants further solidifies this study as a groundbreaking initiative,” said Brian Hainline, NCAA chief medical officer. “It is a remarkable collaborative and inclusive effort.”
The NCAA and DOD have dedicated $30 million to the concussion study and an initiative to spur culture change regarding concussion. Participating schools receive a portion of that funding to cover the cost of carrying out the research.
New participants in the CARE Consortium study
Bloomsburg University of Pennsylvania – Division II
University of Chicago – Division III
University of Miami (Florida) – Division I
University of North Georgia – Division II
University of Pennsylvania – Division I
Temple University – Division I
Wake Forest University – Division I
Wilmington College (Ohio) – Division III
Winston-Salem State University – Division II
The Krembil Neuroscience Centre’s Canadian Concussion Centre (CCC) announced this month that the analysis of the brain of former NHL player Todd Ewen did not show signs of chronic traumatic encephalopathy (CTE) – a neurodegenerative brain disorder that has been linked to multiple concussions.
“These results indicate that in some athletes, multiple concussions do not lead to the development of CTE,” said Dr. Lili-Naz Hazrati, a neuropathologist with the CCC research team who conducted the autopsy. “Our findings continue to show that concussions can affect the brain in different ways. This underlines the need to not only continue this research, but also be cautious about drawing any definitive conclusions about CTE until we have more data.”
Ewen was a 49-year-old retired professional hockey player who played for several teams in the NHL and sustained multiple concussions during his professional and amateur career. Although he suffered from memory loss, chronic body pain, diabetes and undiagnosed depression prior to his death – some symptoms which are known to result from having sustained repeated head injury – his brain showed no sign of CTE or any other neurodegenerative disease.
“Every time it was announced that a fellow player had CTE, Todd would say: ‘If they had CTE, I know I have CTE.’ He was terrified by the thought of a future living with a degenerative disease that could rob him of his quality of life, and cause him to be a burden to his family,” says Kelli Ewen, Todd’s widow who donated her husband’s brain to the CCC for analysis.
“We were very surprised by the results as we were sure Todd must have had CTE,” adds Mrs. Ewen. “We hope that anyone suffering from the effects of concussion takes heart that their symptoms are not an automatic diagnosis of CTE. Depression coupled with other disorders can have many of the same symptoms as CTE.”
The results support the need for more concussion research to determine the prevalence of CTE in the brains of former athletes. The Ewen analysis brings the total of brains analyzed to 20, with roughly half showing signs of CTE or the presence of another neurodegenerative disease.
“Although it is encouraging to see that not all athletes who sustain concussions will develop CTE, we still need to better understand this disease and the effects of concussions on the brain in order to figure out how to identify those who will develop CTE as well as help people like Todd Ewen who struggle with symptoms from head injuries,” says Dr. Carmela Tartaglia, a neurologist with the KNC’s Memory Clinic who is also a member of the CCC research team. “We are very grateful to the Ewen family for making this important contribution to research as it’s through these analyses that we hope to find answers.”
The CCC aims to recruit a total of 50 brain donations to its ongoing research project and welcomes the commitment of donation from current or former professional athletes. All donor information is kept private, except when the player or family consents to release their name.
For more information about brain donation, please visit www.solveconcussions.ca
The CCC, founded by Dr. Charles Tator, is one of few research projects in the world to examine the entire spectrum of concussion disorders from acute injury to chronic illness including brain degeneration. The team harnesses the expertise of several scientists and clinicians in brain injuries, imaging, genetics, neuropsychology and clinical care at the Krembil Neuroscience Centre and other brain research facilities to further our understanding of this common brain injury.