Developing and Validating Blood and Imaging BIOmarkers of AXonal Injury Following Traumatic Brain Injury
Condition: Traumatic Brain Injury
MeSH terms: Brain Injuries; Brain Injuries, Traumatic; Wounds and Injuries
Study type: Observational

Summary: 
      Observational longitudinal study assessing outcomes following moderate-severe traumatic brain
      injury (TBI).
    

Detailed description: 
      Traumatic brain injury (TBI) occurs when the brain is physically damaged, for example after a
      car crash. It is common and survivors often have major on-going problems. It is very
      difficult to predict how patients will do after TBI. One reason for this is that clinicians
      and researchers are unable to measure all the effects of TBI. An important factor is that the
      connections between nerve cells are damaged by the impact on the brain of an injury (axonal
      injury). This damage has been difficult to measure in the past, but new ways to scan the
      brain and more sensitive ways of picking up the effects of this injury in the blood could
      change this. In other parts of medicine tests of this type have had a dramatic effect on how
      clinicians treat patients. For example, the products of heart muscle damage that have leaked
      into the blood can be used identify a heart attack and guide treatment. Clinicians need
      similar tests to be available in TBI. This should be possible as the products of axonal
      injury also leak into the blood and researchers have a sensitive way to pick this up. An
      accurate test for axonal injury would guide treatment choices and allow clinicians to predict
      how patients will recover. The investigators have brought together an international team who
      have been working on different aspects of this problem for many years. Together the
      investigators will conduct a large study to identify the best measures of axonal injury. The
      investigators will carefully test whether these measures help predict outcomes and will study
      where the blood markers come from using a safe method to measure the effects of axonal injury
      directly from the brain. The work links into some large projects that have already started
      and will use a standard way to assess patients after their injury. This is important because
      it will allow researchers to share results across studies. The investigators hope the work
      will allow us to identify a blood marker for TBI that could be widely used to quickly
      identify the presence of axonal injury. The investigators will also show what brain imaging
      measure is best at picking up axonal injury and how best to combine the measures to best
      predict how patients recover. This will allow doctors to diagnose problems after TBI more
      accurately, choose the right treatments and give patients and their families accurate advice
      about what will happen after discharge from hospital.
    

Intervention name(s): MRI; Blood Sampling; Microdialysis; Neuropsychological tests; MRI (advanced)
Intervention type(s): Diagnostic Test; Diagnostic Test; Diagnostic Test; Diagnostic Test; Diagnostic Test
Intervention description(s): Magnetic Resonance Imaging; Sampling of serum; Monitoring of cerebral fluid protein levels; Battery of tests to assess cognitive function, patient outcomes; Advanced MRI
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        250 traumatic brain injury patients from ITU / major trauma ward.
      
Biospecimen description: 
      Blood and cerebral microdialysis samples collected during longitudinal study, where
      appropriate (as per protocol).