Neuroimaging Outcome in Traumatic Brain Injury Patients Treated with Hypothermia

Lay Summary

Imaging Structural Outcomes of Hypothermia Treatment for Traumatic Brain Injury

The investigators will study traumatic brain injury patients using advanced imaging methods that reveal white matter damage and will assess the efficacy of hypothermia in preventing neurological damage in these patients.

Traumatic brain injury (TBI) is experienced by about 1.4 million people every year in the U.S. and is a leading cause of long-term disability in people age 40 or younger. There is no effective treatment. Key priorities for TBI include not only the development of better treatment strategies, but also of more sophisticated tools for evaluating these treatments.

In this study, investigators will use imaging to assess the utility of hypothermia treatment (HT) as a treatment for TBI. In HT, the body is cooled to 91 degrees Fahrenheit as soon as possible after injury, with the intent of slowing down the biochemical processes that lead to brain tissue death and malfunction.  Animal studies and small clinical trials have suggested that HT can prevent or lessen the neurological, cognitive, and behavioral consequences of TBI, and the investigators are currently testing this hypothesis in a large, NIH-funded clinical trial.  With Dana support, they will perform imaging studies on 24 patients and 12 uninjured “control” participants to compare markers of structural brain damage with functional outcomes.

They will use three imaging techniques (volumetric MRI, diffusion tensor imaging, and magnetization transfer imaging) that are more sensitive than conventional techniques to widespread, subtle changes in brain structure.  These techniques are particularly good for revealing damage to the brain’s “white matter,” the bundles of axons—long, cable-like fibers—that nerve cells use to communicate.  Diffuse damage to white matter is common in TBI and may contribute substantially to neurological deficits in these patients.  The investigators will determine whether HT is correlated with reduced white matter damage and will determine how these measures correlate with cognitive and behavioral outcomes in TBI patients.

Significance:  The work may lead to new the development of new “gold standards” for evaluating brain injury and recovery in TBI patients and provide one of the first treatments for lessening or preventing the frequently devastating effects of TBI.