CIMIT Program: Traumatic Brain Injury (TBI) & Neurotrauma

What is TBI?

Traumatic brain injury occurs when the brain is physically injured, usually by a sudden force. With military members, such an injury may result from the force associated with a blast or explosion.

TBIs can also be caused by falls, motor vehicle accidents, assaults or any sudden blow to the head. The force may cause the brain to jolt backward and forward, hitting the skull and causing damage to the internal lining, tissues and blood vessels. This damage can result in internal bleeding, bruising or swelling of the brain. Because the damage is internal, there may be no visible head wound. TBI can range from mild to severe, depending on the circumstances of the injury. Some people who experience a TBI can recover completely without medical intervention. Others who experience a severe TBI may have permanent disability.

Any brain injury, whether mild, moderate, or severe, can temporarily or permanently diminish a person’s physical abilities, including motor function; impair thinking abilities, including memory and reasoning; affect sensation, including touch, taste and smell; interfere with emotional and behavioral well being; and impede language and communication abilities. It is important for anyone who may have a TBI to be evaluated by a physician at the earliest possible opportunity.

Traumatic Brain Injury (TBI) & Neurotrauma

ACCELERATING RECOVERY FROM BRAIN OR SPINAL CORD INJURY (NEUROTRAUMA) TO IMPROVE FUNCTIONAL OUTCOMES

Traumatic Brain Injury (TBI) has long challenged caregivers, who have limited options for determining prognosis and providing treatment. Recent prevalence of severe, moderate and mild TBI from military combat has increased the visibility of these issues.

TBI and spinal cord trauma are major causes of morbidity and mortality throughout the world. Associated bio-physical changes are difficult to directly measure. The pathophysiology of TBI occurs in stages over prolonged periods of time. Better methods for characterization can aid in tailoring interventions to achieve better outcomes.

CIMIT encourages novel approaches to treatment through functional and metabolic imaging and electromagnetic stimuli to localize treatment sites, measure progress, and identify the stages of recovery.

CIMIT’s TBI & Neurotrauma Program seeks to explore novel techniques, including systemic and focal pharmacologic regimens, applied energy from lasers and ultrasound, and neuro-technological techniques, as methods to determine the stages at which they may be best applied. This program leverages the innovations of CIMIT Neurotechnology, Traumatic Stress Disorders, and Trauma & Casualty Care Programs, recognizing that many patients suffer from combinations of conditions that require clinicians to draw on a range of specialty resources.

Projects
Forum/Events
News

FY11 TBI CIMIT-Funded Projects and Past Projects Relevant to TBI & Neurotrauma
PRINCIPAL INVESTIGATOR	INSTITUTION	YEAR	PROJECT TITLE
Alexander Lin	BWH	2011	Neurochemical and Multimodal Biomarkers for Chronic Traumatic Encephalopathy
Lauren O'Donnell	BWH	2011	Diagnosis of diffuse axonal injury using robust tract-based quantification of diffusion tensor imaging
Alvaro Pascual-Leone, MD, PhD	BIDMC	2011	Noninvasive, Physiologic Characterization of Cortical Plasticity After Mild Traumatic Brain Injury in Humans-392
Alexander Rotenberg	CHB	2011	A novel application of intranasal Huperzine A in treatment of traumatic brain injury
Michael Hamblin, PhD	MGH, CHB	2009	Trauma & Casualty Care: Transcranial NIR Light for Traumatic Brain Injury
Felipe, Fregni MD, PhD	BIDMC, Spaulding	2009	Image Guided Therapy: The Effect of Transcranial Direct Current Stimulation Combined with Arm Training Using Glove-ArMEO Robotic Device on Motor Recovery in Traumatic Brain Injury Survivors
Alvaro Pascual-Leone, MD	BIDMC	2007	Neurotechnology: Modularized, Portable, Transcranial Magnetic Stimulation (TMS) Device
Johannes de Boer, PhD	MGH	2007	Image Guided Therapy and Neurotechnology: Optical Detection of Neural Activity for Neurosurgical Repair
Alvaro Pascual-Leone, MD	BIDMC	2005	Image Guided Therapy: DSI-Guided TMS: A System to Improve Focal Precision of Transcranial Brain Stem

» View all CIMIT-Funded Projects.

Related Past CIMIT Forum and Events
EVENT	DATE	SPEAKERS	DETAIL
Forum	Nov. 10, 2009	Eric Bluman, MD, PhD: BWH, Foot and Ankle Center, Uniformed Services University of the Health Sciences, HMS COL Paul Pasquina, MD: US Army Medical Corps and Walter Reed Army Medical Center and National Naval Medical Center Matt Mikosz: Hanger, Inc. Henrik Malchau, MD, PhD: MGH and HMS Cathryn Sundback, ScD: MGH Lifei Guo, MD, PhD: BWH and HMS MODERATOR: Joseph S. Barr, Jr., MD: MGH and HMS	Care of the Wounded Warrior: Upper Extremity Injury
Forum	June 9, 2009	Albert “Skip” Rizzo, PhD: Research Scientist and Research Professor, Institute for Creative Technologies and Dept. of Psychiatry/ School of Gerontology, USC	Virtual Iraq/Afghanistan: Virtual Reality Exposure Therapy with Active Duty OIF/OEF Military Personnel with PTSD
Forum: Trauma and Critical Care	Jan. 27, 2009	Matthew J. Martin, MD, FACS: Trauma Medical Director, Associate Residency Director, Madigan Army Medical Center, Tacoma, Washington David King, MD: MAJ, MC, USAR, Attending Trauma Surgeon, Attending Emergency General Surgeon, Attending Intensive Care Surgeon and Clinical Instructor in Surgery, MGH, HMS	"The Golden Hour" in Modern Combat Trauma: Different Battlefields, Same Problems Continuity of Combat Casualty Care: The Case for Immediate Technological Improvement
Forum: Unraveling the Brain in Trauma and in Health	Sep. 16, 2008	Van Wedeen, MD: MGH, HMS Marilyn Kraus, MD: University of Illinois at Chicago	Mapping Brain Connectivity with Diffusion MRI The Role of Diffusion Tensor Imaging in Traumatic Brain Injury
Forum: Post-Traumatic Stress Disorder: Diagnosis & Therapy	Apr. 1, 2008	Ross Zafonte, DO: Spaulding Rehab Hospital; MGH; CIMIT Roger Pitman, MD: MGH	Traumatic Brain Injury Clinical Trials from the Past for the Future Neurological Soft Signs in Post-Traumatic Stress Disorder
Traumatic Brain Injury Symposium entitled: Clinical Management and Advanced Treatment for Closed Head Injury	Nov. 15, 2007	Ross Zafonte, DO: Spaulding Rehab Hospital; MGH; CIMIT Lee Schwamm, MD, MGH	Press release: CIMIT, TATRC co-host successful symposium on TBI
Forum: Researchers Focus on Shock and Recovery	Oct. 16, 2007	Carl Hauser, MD, FACE, FCCM; BIDMC, HMS Alfred Ayala, PhD; Rhode Island Hospital, Brown University Wolfgang Junger, PhD; BIDMC, HMS	Post-Resuscitation Injury - Translational Approaches to Cell Signaling in Shock and Resusciation • Neutrophil Calcium Signaling in Shock and Trauma • The Role of Systemic Immune Cell Signaling in Whole Body Ischemia/Reperfusion Injury • Autocrine Regulation of Immune Cell Function • Translational Application of Cell Signaling Biology to the Care of Sick Patients
CIMIT Summer Education Series 2007	Jul. 10, 2007	Christopher Moore, PhD; MIT Leigh Hochberg, MD, PhD; Brown University, VA, HMS, MGH	Neurotechnology: Translating Basic Discoveries into Clinical Promise • Deciphering Cortical Electrophysiological Signals and their Applications for Brain-Body Interfaces
Forum: Doctors Discuss Challenges of Traumatic Brain Injury	May 22, 2007	Lee Schwamm, MD; MGH, HMS, MIT Marc de Moya, MD; MGH, HMS Mel Glenn, MD; Spaulding	• Acute and Chronic Consequences of Traumatic Brain Injury • A New Model of Severe Traumatic Brain Injury
Forum: Researchers Discuss Advances in Battlefield Medicine	May 8, 2007	Col. Geoffrey Ling, MD, PhD; DARPA, Walter Reed, Johns Hopkins Michael Callahan, MD, BTN & H, MSPH; DARPA	• Trauma Care and Soldier Performance
Forum: Experts Discuss Mass Casualty Incident Response	Apr. 24, 2007	Sandy Bogucki, MD, PhD; Yale, US Dept. of Health & Human Services Sheri Markwardt Harvey Mudd	• Decoding Cortical Electrophysiology for the Detection of Seizures

Related Program News, Press Releases & Literature
ARTICLE TITLE		PUBLICATION	DATE
CIMIT Statement on the Launching of the Home Base Program – a non-profit partnership between the Red Sox Foundation and Massachusetts General Hospital		CIMIT Press Release	Sep. 9, 2009
Army’s S&T Efforts Aim to Protect Soldiers’ Minds		USAASC	Oct., 2008
CIMIT, TATRC co-host successful symposium on TBI		CIMIT Press Release	Nov. 15, 2007
A Shock Wave of Brain Injuries		Washingtonpost.com	Apr. 8, 2007
Made-for-the-military Products Put Brakes on Bleeding		CNN.com	Mar. 2, 2007
More in Massachusetts Get Drug for Stroke		Boston Globe	Oct. 20, 2006
	Brain Injury Medicine: Principles and Practice	Book By Nathan D. Zasler, Douglas I. Katz, Ross D. Zafonte	2006

Program Leaders

Ross Zafonte, DO

CIMIT RESPONSIBILITIES
Program Leader, Traumatic Brain Injury (TBI) & Neurotrauma

CIMIT Community

TBI Key Facts

TBI can disrupt normal brain functions that are critical for normal motor function, memory, attention, thinking, mood regulation and personality. Survivors of TBI frequently exhibit persistent functional impairments in movement and strength, cognition, memory, mood and personality. Morover, they are at risk for the development of epilepsy.

• 1.4 million people sustain a traumatic brain injury in the US each year

• Traumatic brain injury is more prevalent in the US than breast cancer, HIV/AIDS, multiple sclerosis, and spinal cord injuries