The Pennsylvania Department of Health has awarded a $4 million, four-year grant to a consortium of five institutions led by Penn Medicine to rethink how traumatic brain injuries are diagnosed and eventually treated.
Douglas Smith, who directs Penn's Center for Brain Injury and Repair, will lead researchers from Penn, Children's Hospital of Philadelphia, Moss Rehab, the University of Pittsburgh, and Cheyney University.
The goal of the study will be to go beyond symptoms like headache, dizziness, or confusion, which are often used to classify brain injuries today, and begin to classify damage based on the type and extent of physical damage in the brain. This, Smith hopes, will lead to better clinical trials and treatments. Smith likened the effort to moving from the days when people were told they had "consumption" because of their symptoms to knowing that tuberculosis was caused by bacteria that can be targeted for treatment.
The money comes from the state's tobacco settlement funds, which it may use for such health-related purposes.
Concussion, Smith said, now has 30 different official definitions. "What we want to do is have a real diagnosis," he said. Brain injuries can be caused by bruising, bleeding or swelling, each of which might require different treatment.
The group will be evaluating different ways to measure brain injury, including markers in blood and neuroimaging that can reveal how injuries affect the ability of brain cells to communicate. They will be trying to figure out how to predict which people will not recover quickly from concussion — about 20 percent of patients — and why some people with severe brain injuries can recover and do well for years, then decline. The group will also investigate leakage of the blood-brain barrier and resulting inflammation after injury.