Clinical Research is also supported by our core facilities. Each core has a team of highly skilled staff and state-of-the-art facilities that are utilized for core-driven, CNRM-funded, and collaborative research initiatives. See below for information about each of our clinical cores.
Acute Studies Core
Address TBI diagnosis and treatment in its earliest stage, recruit civilian study participants, and conduct acute studies at 3 trauma centers in the Washington D.C. area: NIH’s Clinical Center, Suburban Hospital, and Washington Hospital Center.
- Chiara Ricciardi, M., Bokkers, R. P. H., Butman, J. A., Hammoud, D. A., Pham, D. L., Warach, S., & Latour, L. L. (2017). Trauma-specific brain abnormalities in suspected mild traumatic brain injury patients identified in the first 48 hours after injury: A blinded magnetic resonance imaging comparative study including suspected acute minor stroke patients. Journal of Neurotrauma, 34(1), 23-30. doi:10.1089/neu.2015.4338 https://www.ncbi.nlm.nih.gov/pubmed/27215444
- Cota, M. R., Moses, A. D., Jikaria, N. R., Bittner, K. C., Diaz-Arrastia, R. R., Latour, L. L., & Turtzo, L. C. (2018). Discordance between Documented Criteria and Documented Diagnosis of Traumatic Brain Injury in the Emergency Department. Journal of Neurotrauma. doi:10.1089/neu.2018.5772 https://www.ncbi.nlm.nih.gov/pubmed/30351183
The Acute Studies Core is currently evaluating:
- The severity of new or worsened mood, sleep, and headache following acute TBI
- The association of persistent post TBI symptoms and disability
- Strategies for identifying patients in the emergency department who are at risk of developing these symptoms to assess the value added from imaging and blood-based biomarkers for treatment decision making
Process, receive, catalog, analyze, and store biosamples (primarily blood) from participating study sites in the Biospecimen Repository.
- Gill, J., Latour, L., Diaz-Arrastia, R., Motamedi, V., Turtzo, C., Shahim, P., . . . Jeromin, A. (2018). Glial fibrillary acidic protein elevations relate to neuroimaging abnormalities after mild TBI. Neurology, 91(15). doi:10.1212/wnl.0000000000006321 https://www.ncbi.nlm.nih.gov/pubmed/30209234
- Gill, J., Motamedi, V., Osier, N., Dell, K., Arcurio, L., Carr, W., . . . Yarnell, A. (2017). Moderate blast exposure results in increased IL-6 and TNFα in peripheral blood. Brain, Behavior, and Immunity, 65, 90-94. doi:10.1016/j.bbi.2017.02.015 https://www.ncbi.nlm.nih.gov/pubmed/28232173
The Biomarkers Core engages in studies involving Service Members that determine the mechanisms of TBI and blast-related exposures using methods including:
- Circular RNA and gene-activity
- High sensitivity protein assays to determine changes in the concentrations of low abundant proteins
Human Imaging and Image Processing Core
Collect, process, analyze, and store imaging data from participating studies. Develop novel algorithms and optimize existing image processing procedures for TBI imaging data.
- Roy S., Butman J.A., & Pham D.L. (2017). Robust skull stripping using multiple MR image contrasts insensitive to pathology. Neuroimage, 146:132–147, https://doi.org/10.1016/j.neuroimage.2016.11.017 https://www.ncbi.nlm.nih.gov/pubmed/27864083
- Roy, S., Wang, W., Carass, A., Prince, J. L., Butman, J. A., & Pham, D. L. (2014). PET Attenuation Correction Using Synthetic CT from Ultrashort Echo-Time MR Imaging. Journal of Nuclear Medicine, 55(12), 2071-2077. doi:10.2967/jnumed.114.143958 https://www.ncbi.nlm.nih.gov/pubmed/25413135
The Human Imaging and Image Processing Core is working to develop improved MRI acquisition and post-processing techniques for improved mapping and analysis of microhemorrhages resulting from TBI, and avoiding artifacts. In another project, core personnel are using novel tagged MRI sequences to acquire dense, three dimensional measurements of human brain motion during a mild acceleration.
Perform phenotyping services (e.g., assessments that test emotional, cognitive and physical functioning) for CNRM-funded and collaborative studies.
- Leary, J. B., Kim, G. Y., Bradley, C. L., Hussain, U. Z., Sacco, M., Bernad, M., . . . Chan, L. (2017). The Association of Cognitive Reserve in Chronic-Phase Functional and Neuropsychological Outcomes Following Traumatic Brain Injury. Journal of Head Trauma Rehabilitation, 1. doi:10.1097/htr.0000000000000329 https://www.ncbi.nlm.nih.gov/pubmed/28731870
- Reid, M. W., Miller, K. J., Lange, R. T., Cooper, D. B., Tate, D. F., Bailie, J., . . . Kennedy, J. E. (2014). A Multisite Study of the Relationships between Blast Exposures and Symptom Reporting in a Post-Deployment Active Duty Military Population with Mild Traumatic Brain Injury. Journal of Neurotrauma, 31(23), 1899-1906. doi:10.1089/neu.2014.3455https://www.ncbi.nlm.nih.gov/pubmed/25036531
The Phenotyping Core is conducting parallel civilian and military natural history studies to determine the phenotypic expression of the entire TBI spectrum.
Provide a streamlined, patient-centered study recruitment process that identifies, screens, and refers potential research participants for CNRM-funded and collaborative studies. To learn more about participation in CNRM-funded and collaborative studies, please visit www.cnrmstudies.org.
- Joshi, S., Dunbar, K., Taylor, P., Sullivan, K. L., Afzal, M. M., Song, C., . . . Roy, M. J. (2017). Streamlining Participant Recruitment for TBI and PTSD Research Studies. Military Medicine, 182(S1), 124-127. doi:10.7205/milmed-d-16-00282 https://www.ncbi.nlm.nih.gov/pubmed/28291463
- Pattinson, C.L., Shahim, P., Taylor, P., Dunbar, K., Guedes, V.A., Motamedi, V., Lai, C., Devoto, C., Peyer, J., Roy, M.J., Gill, J.M. Elevated Tau in Military Personnel Relates to Chronic Symptoms Following Traumatic Brain Injury. Journal of Head Trauma Rehabilitation (in press).
The Recruitment Core conducts cross sectional analyses of imaging, biomarker, symptom severity, and cognitive performance data on participants in a prospective cohort study, and longitudinally follows those participants.