Traumatic Brain Injury Biomechanics, Prevention, and Treatment
Traumatic brain injury results in approximately 50,000 deaths and 80,000 permanently disable persons per year in the United States with an estimated cost of $76 billion per year. The clinical situation is quite dire as there are no drug treatments which target the underlying pathobiology of TBI. This profound need for improvements in the prevention and treatment of TBI is the driving force behind our research in the Neurotrauma and Repair Laboratory. Our long term goal is to understand the consequences of mechanical forces on the most complex system of the human body, the brain, and to develop strategies to mitigate and perhaps reverse these injurious effects. Our efforts explore the specific cellular, molecular, and metabolic effects of injury on brain cells in response to precisely controlled biomechanical stimuli. Our research program has three main focus areas:
- Improvement of prevention strategies through development of critical biomechanical data for the living brain
- Identification of novel treatment options by understanding the post-traumatic pathobiology in greater detail
- Engineering new research tools to enhance studies in the first two areas
Motivation
Traumatic brain injury (TBI) is a significant cause of death and disability throughout the world and is especially prevalent in the population under the age of 45. In the U.S. alone, about 1.7 million head injuries occur each year, of which about 300,000 require hospitalization. The majority are non-penetrating injuries caused by a combination of motor vehicle accidents, falls, and assaults. Annually, the result is 50,000 deaths and 80,000 survivors with life-long disability that significantly impacts their quality of life. Annual costs are estimated at $76 billion. The clinical situation is quite dire as there are no drug treatments which target the underlying pathobiology of TBI; current clinical treatments are either surgical to remove mass lesions (i.e. hemorrhages) or supportive to control intracranial pressure (i.e. craniectomy).
With the evolving nature of warfare, TBI due to blast is now a significant military health concern. The increased use of improvised explosive devices (IED) and the growing role of the US Military as peacekeepers have resulted in an increased incidence of blast-exposure. Combined with technological advances in body armor, US Military personnel are surviving blasts that would have been deadly just a few years ago. However, helmets were designed to stop shrapnel and were not designed to protect against blast-induced shock waves. The result is that since 2000, 357,048 US military personnel have sustained a TBI, the majority of which were due to blast. The effects of mild TBI (i.e. concussion) spontaneously resolve, but significant numbers of returning personnel are reporting debilitating and long-lasting symptoms. Understanding the biomechanics and physical mechanisms of this emerging injury is absolutely critical for designing effective equipment and therapies to reduce its devastating effects.