Traumatic brain injury (TBI) is a leading cause of death and disability around the world. The social and economic burden of TBI is tremendous and the cost of TBI is estimated at $1 billion per year in Canada- $650 million in care and $580 million in lost productivity. Novel interventions aimed at TBI-linked molecular targets have been successful in limiting injury and improving neurologic recovery in animal models, thus providing compelling evidence that effective intervention is possible after injury. This study proposes to investigate traumatic microvascular injury (TMI) and specifically blood-brain barrier dysfunction (BBBD) as a candidate biomarker and therapeutic target in TBI.
Study Type
OBSERVATIONAL
Enrollment
2
Halifax Infirmary
Halifax, Nova Scotia, Canada
Change in brain volume with blood brain barrier dysfunction
Measurement of change in brain volume with BBBD and extent of permeability change as measured by DCE-MRI
Time frame: At < 4, 10 ± 2, and 90 ± 10 days post-injury
Change in serum biomarkers of blood brain barrier dysfunction
Measurement of change in serum biomarkers of BBBD / neural injury (vWF, BDNF, GFAP, S100β, sTau, and sNFL)
Time frame: At < 4, 10 ± 2, and 90 ± 10 days post-injury
Change in Glasgow Outcome Scale-Extended (GOS-E)
The GOS-E is intended to provide a general index of overall outcome that is sensitive to small but clinically relevant treatment effects in people who sustain TBI.
Time frame: At 10 ± 2 days, 90 ± 10 days, and 1 year post-injury
Change in Rivermead Post Concussion Symptom Questionnaire (RPSQ)
The RPSQ is a 16-item self-report measure administered to individual(s) who sustained a TBI in order to measure the severity of symptoms and assess progress.
Time frame: At 10 ± 2 days, 90 ± 10 days, and 1 year post-injury
Change in Patient-Reported Outcomes Measurement Information System (PROMIS)
PROMIS is a set of person-centered measures that evaluates and monitors domains such as physical, mental and social health in adults and children. For this study, we will utilize the following domains: depression, fatigue, and pain interference.
Time frame: At 10 ± 2 days, 90 ± 10 days, and 1 year post-injury
Change in post-traumatic epilepsy
Screening for post-traumatic epilepsy
Time frame: At 10 ± 2 days, 90 ± 10 days, 1 year, and 2 years post-injury
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