Located at Hennepin County Medical Center in Minneapolis, our lab runs under the supervision of Dr. Uzma Samadani and can focus on research that is best described in our mission statement:
"The goal of the Hennepin County Medical Center Brain Injury Research Lab is to classify, treat, and prevent brain injury, and improve brain health in the greater Minneapolis/St Paul community by creating innovative, sustainable solutions that can then be scaled to serve larger communities throughout the world."
From neck strengthening for concussion prevention, to validating novel TBI diagnostic tools, to stimulating nerves after sever spinal cord injuries, our research staff are involved in a number of exciting and possibly ground breaking studies. Below, you can read about each study currently being done in our lab.
Vagus Nerve Stimulation to Treat Mild to Moderate Traumatic Brain Injury (VNS)
The purpose of this single center, prospective, randomized (1:1) double blind, sham-controlled parallel- arm pilot study is to provide initial evidence of use of the non-invasive vagus nerve stimulator for treatment in patients recovering from moderate TBI to improve their clinical recovery. Vagus nerve stimulation is not currently used by clinicians as a therapeutic treatment for concussions or moderate traumatic brain injuries, but is implanted for treatment of medication resistant seizures. Study of the effects of this device is to provide initial evidence of use of the noninvasive vagus nerve stimulator to improve clinical recovery. This is an adjunct to the current standard of care from physical, occupational and speech therapists, guided by the Physical Medicine and Rehab department. The study aims to compare the safety and effectiveness of an active GammaCore treatment against sham treatment.
Check out more at the ClinicalTrials.gov site. Watch a VNS patiet's Testimonial Below.
Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK TBI)
NINDS-funded multicenter study that was designed to develop a database composed of biomarkers, DNA sequencing, imaging results, and extensive Outcome Assessment data for 3,000+ patients of all degrees of TBI across the country. The goal is that this database will provide a foundation for which further studies can be built to develop accurate and novel diagnostic, classification, and treatment modalities for TBI’s.
TRACK TBI- Friends Control
A control off-shoot of the NINDS-funded multicenter study TRACK- TBI. This study looks to enroll friends and family members of those suffering from TBIs to serve as a more accurate control subject for comparison of outcomes. The concept behind this is that those close to the injured subjects live similar lifestyles and in the case of certain family members, similar DNA. These controls undergo the same sequential series of testing and bio specimen collections as the TBI patients enrolled in TRACK-TBI. This data is then utilized as a comparison tool when assessing the outcomes and improvement, or lack thereof, in the TBI subjects data obtained over the year following their injury.
Traumatic Brain Injury Classification and Outcome Assessment
Current brain injury trials rely on outcome measures such as Glasgow Outcome Scale Extended, which capture global phenomena but fail to assess for subtle differences in outcome. Thus, 30 consecutive trials for brain injury therapeutics have failed. Sensitive outcome measures are needed to determine how well patients have recovered from brain injury in order to test therapeutics and prophylactics.
The goal of this study is to develop an objective, multi-modal classification scheme and outcome measure better than what exists for traumatic brain injury based on several measures: (1) blood-based biomarkers (indicates which cell types are damaged), (2) eye tracking (detects mass effect/elevated ICP and pathway disruption), and (3) Radiographic measures of CT and MRI (detect structural abnormalities), and (4) standardized outcome assessments.
Check out more at the ClinicalTrials.gov site. Watch a patient's testimony below.
Long Term Outcome of Traumatic Brain Injury
This study was originally conducted to compare the long term health outcomes of subjects involved in hyperbaric oxygen treatment after traumatic brain injury to subjects that did not have hyperbaric oxygen treatment after traumatic brain injury.
Recruitment for this portion of the study has concluded and now we have expanded our recruitment criteria. We are now enrolling subjects with a history of head trauma(s) and a genetically matched control. A primary focus of this expanded study is the chronic effects of repetitive head traumas sustained in sports.
"Effectiveness of a Neck–Strengthening Program for the Prevention or Mitigation of Sports Concussion Injuries in Student Athletes (TRAIN)
Concussion risk in sports has been a very hot topic in recent years. Especially with new findings about the dangers of multiple head traumas, and concerns about contact sports. Many efforts have been undergone to help reduce the risk of sports-related concussion. One, often unattended factor is the strength of a person's neck muscles Stronger necks have been shown to be correlated with lower concussion risk in student athletes. For this reason, Traumatic brain injury Reduction in Athletes by Neck strengthening (TRAIN), formerly Preventing COncussion by Neck Strengthening (PCONS), is studying the effectiveness of a simple neck strengthening program to reduce concussion risk in student athletes.
Subjects recruited from Twin Cities high schools will perfrom a simple, manual resistance nck strengthening routine twice a week over the course of the study. Their neck stength is measured at regular intervals, and concussion assessments are done anytime a subject is suspected of incurring head trauma. In this way, TRAIN hopes to show that neck strengthening results in fewer, and less severe, concussions in student athletes.
Prevalence and Severity of Work-Related Musculoskeletal Symptoms in Physicians
This IRB approved study evaluates the prevalence and severity of musculoskeletal symptoms in physicians and whether these symptoms are attributed to their career as a physician. It also assesses the feasibility and best targets of future interventional exercise or device trials to prevent neck and back pain in physicians. A short web-based survey was sent to physicians at Hennepin County Medical Center. Inclusion criteria includes any physicians with privileges at HCMC.
The E-STAND trial was made to formally test the use of epidural spinal cord stimulation for restoring volitional movement in the legs of patients who suffered spinal cord injury and have been unable to move either leg since injury. In addition, the trial was constructed to figure out how to choose stimulation settings that provide the largest improvement in movement.
The E-STAND trial is also hoping to begin to understand how epidural spinal cord stimulation in this patient population can affect blood pressure, heart function, urinary function, and some aspects of cognitive function.
Check out more at the ClinicalTrials.gov site.Watch an E=STAND patient's testimony below.
Eye tracking and Neurovision Rehabilitation of Oculomotor Dysfunction in Mild Traumatic Brain Injury
The purpose of this single center, longitudinal, pilot study is to provide evidence for the use of an eye tracking system as an objective tool to identify mild traumatic brain injury (mTBI) related oculomotor dysfunction (OMD) and predict the effectiveness of neurovision rehabilitation (NVR) of OMD. Eye tracking visual stimulus measurements will be compared to objective developmental optometrist (OD) diagnosis and assessments. It will be determined whether an eye tracking system can predict the presence or absence of mTBI related OMD and whether mTBI patients who have OMD based on the eye tracking system will respond positively to NVR. One hundred mTBI patients with OMD will be eye-tracked after each of their OD and NVR appointments at the Hennepin County Medical Center (HCMC) TBI Clinic.
Mild traumatic brain injury that alters brain function is a major public health concern of significant personal and societal burden. Mild traumatic brain injury patients may experience any or all of at least 20 symptoms, including vision changes, with some persisting for weeks to months and increasing the risk of comorbidities. Neurovision rehabilitation is essentially physical therapy for the eyes and improves the connection between the brain and the eyes. Prior research has found NVR to be very effective for patients with post-concussion visual dysfunctions. Patients with potential mTBI primarily present to the emergency department, primary care, or specialty clinic, where there lacks proper equipment, training, and time for a comprehensive vision examination. Additionally, identification and diagnosis of OMD is only conducted currently by a vision specialist or highly skilled TBI specialists. This leaves a majority of OMD patients with inappropriate diagnosis and inadequate treatment. Thus an objective, easily accessible tool to identify mTBI related OMD would greatly advance clinical care.
The goals of this research study are to improve objective, timely identification of mTBI related visual dysfunctions and assessment of the effectiveness of NVR. A positive outcome will greatly impact diagnosis and care of mTBI patients with vision dysfunction, as objective assessments will be more widely and readily available and NVR will be more utilized by the medical community. Overall post-mTBI functional outcomes will improve, significantly lessening this major public health concern affecting patients, families, communities, and society. The study launched in September 2017 and is expected to last a year.
Cortical Spreading Depolarization After Severe Traumatic Brain Injury
Despite advances that have been made in the care of patients after severe brain injury, TBI continues to confer a very high morbidity and mortality. The development of effective treatments to minimize the morbidity and mortality following TBI has been hindered due to a fundamental lack of understanding of the factors that contribute to secondary injury after the initial inciting traumatic event. By better understanding mechanisms of secondary brain injury after TBI, such as CSD, as well as methods for monitoring for pathologic events, there will be more opportunities to develop new treatments. Neurosurgeons at the University of Minnesota and Hennepin County Medical Center have partnered to begin a study to better understand cortical spreading depression following severe TBI.
The Football Decision: An Exploration into Every Parent’s Dilemma on Whether or Not to Let a Child Play Football
There have been increased concerns over the long-term consequences of traumatic brain injury (TBI) and concussion, which can often result from participation in contact sports. However, not much is known about the net risks and benefits of contact sports play. The purpose of this study is to examine whether individuals in careers that require high motor and cognitive function and leadership skills, such as neurosurgical and orthopedic department chairs, have higher rates of football and contact sports participation as well as having had concussion in their lifetimes. We also surveyed the opinions of these surgical department chairs along with neurotrauma-specialty scientists and physicians on bans or limits of youth contact sports compared to pediatricians who have published a statement that favors such bans or limits.
The Minnesota Healthy Brain Initiative
The Minnesota Healthy Brain Initiative is an effort to increase awareness regarding brain health and its maintenance as well as increasing awareness of the impact of alcohol on brain function. The acute and long-term effects of alcohol consumption on the human body are well documented in the literature. Alcohol affects the body in complex ways – creating neurological, oculomotor, and psychological deficits. The purpose of this work is to demonstrate that our eye tracking algorithm can distinguish between normal subjects and those who have consumed alcohol.
Subjects were recruited at the Minnesota State Fair in order to gather a large and diverse study population. Questionnaire based cognitive assessments were done as well as eye tracking at baseline. Those who expressed the possibility of drinking alcohol while at the fair were encouraged to come back for re-evaluation afterward. In this way, data was collected about eye tracking and cognition of average people visiting the Fair, as well as how alcohol affects both assessments.