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Bridging the gap: SickKids researchers work to bring traumatic brain injury research to the bedside
Summary:
It’s the number 1 cause of death in children in Canada, yet there is still a long way to go before we fully understand how to translate research on traumatic brain injury into something we can use at the bedside.
It’s the number 1 cause of death in children in Canada, yet Dr. Jamie Hutchison, Research Director in Critical Care Medicine and Senior Scientist in Neurosciences & Mental Health at SickKids, says there is still a long way to go before we fully understand how to translate research on traumatic brain injury (TBI) into something we can use at the bedside.
“It’s as though there is a deep valley, with researchers at one end and the clinical setting at the other,” says Hutchison, “As researchers, we try to bridge that gap by determining new ways to identify, treat and prevent TBI. The valley is still deep, but that’s not to say there hasn’t been incredible progress through the years.”
In the huge spectrum of TBI, mild injuries, such as concussions, are the most common. In the past, when a child would present at a hospital following some sort of incident, the only technologies available to determine trauma to the brain were X-rays and computerized tomography (CT) scans, which would capture an image of the child’s brain. The trouble is that both methods are insensitive to brain injuries.
“In the past, it was extremely difficult to detect TBI unless the patient presented with more severe forms. Now, we can detect it by measuring brain structure and function using MRIs,” explains Hutchison, “In the future, we want to be able to immediately detect brain injury using blood tests when a patient arrives at the hospital following some sort of trauma.”
Hutchison’s research intends to do exactly that. Currently, when children arrive at the hospital with obvious injuries following trauma, such as a car accident, they undergo blood tests to check for abnormalities in every organ in the body – except the brain. There are no blood tests to detect how the brain is doing.
“We’re working to change that,” says Hutchison.
When blood is drawn, health-care professionals check for molecules in the blood that are released from the injured organ. Hutchison’s research team focuses on determining whether the brain releases its own molecules, and finding blood tests that will identify these brain-specific molecules.
The ability to bring this kind of change to clinical settings is not only crucial for detecting TBI, but to help detect and prevent secondary brain injury which might occur as a result of brain swelling following the initial trauma, as well as predicting the child’s recovery.
Now, with Brain Injury Awareness month upon us, Hutchison says education and prevention on TBI is key, especially dispelling the myth that young brains heal more easily from injuries. In fact, the younger a child is under the age of seven, the worse the outlook for recovery. Rates of mortality from TBI are higher in children below the age of three, and those who do survive often face severe psychological repercussions in later years, particularly with social interactions.
“Until we figure out just how to bridge the gap between the lab and the bedside, education and social support for new, young parents should be a priority,” says Hutchison. “Parents need to know exactly how easy it is to injure a child’s brain and how to care for children in their early stages of life. Children should always wear helmets when appropriate and should exercise caution to protect their still-developing brains. Right now, the best treatment for TBI is avoiding it altogether.”