Profiling the five Grand Challenge winners

Now that the chaos and excitement of Pitch Day is in the rear view mirror, we’d like to take some time to recognize and highlight the five proposals that won funding as a result of successful pitches to The Massey Foundation TBI Grand Challenge panel. Among our funded proposals were innovative pharmaceutical, device and technology solutions to the challenges posed by severe TBI.

The first proposal to gain funding is principally investigated by Daniel A. Lawrence, PhDGeoffrey G. Murphy, PhD, and Enming J. Su, PhD. The three investigators will seek to develop an intravenous formulation and treatment protocol of the drug. The proposal focuses on an intravenous formulation because, while effective, Imatinib has been proven successful in treatment of severe TBI, it is administered orally. The most severe TBI patients are often unconscious and therefore unable to swallow.

The second proposal to gain funding is principally investigated by Patrick Georgoff, MD and Hasan Alam, MD. The aim of this proposal is to gain a better understanding of how Valproic Adic (VPA) protects the brain following injury, so that the drug may be transitioned into use as an early treatment for TBI. The team anticipates developing blood markers, allowing them to determine which patients will respond to VPA. The team also hopes to be able to develop other targets for drug development as a result of their research.

The third proposal to gain funding is principally investigated by Rodney Daniels, MD and David R. Chesney, PhD. The aim of this proposal is to develop a digital external ventricular drain (EVD) system with integrated intracranial pressure (ICP) monitor and cerebrospinal fluid (CSF) flow monitor/pressure regulator. The EVD will have the capability to automatically adjust to changing patient positions and conditions, while quantifying the amount of CSF drainage and alerting the caregiver to changes in ICP of CSF drainage. These automations will ease the burden of care for TBI patients drastically.

The fourth proposal to gain funding is principally investigated by Kayvan Najarian, PhD and Craig A. Williamson, MD. The aim of this proposal is to develop a software technology that leverages algorithms to automatically detect and provide precise measurement of hematoma volume, brain compression and optic nerve diameter in brain CT scans of TBI patients with subdural hematoma. Patients with subdural hemorrhages (SDH) can need urgent surgical intervention. However, determining the severity of SDH from a CT scan is a challenge to both humans and machines, which shows the advantage of an algorithmic program.

The final proposal to gain funding is principally investigated by William Meurer, MD, MS. The aim of this proposal is to provide clinical evidence supporting the use of quantitative pupillometry to gain precise measurements of pupillary light reflex (PLR) as a reliable biomarker for TBI. Evidence suggests that quantitative measurements of PLR can reveal the presence of TBI, indicate its severity, estimate intracranial pressure and track brain recovery. If a reliable biomarker were established, it could be used by first responders to determine objectively whether or not a patient has suffered a severe TBI, and to assess its severity.

The winning proposals and the teams investigating show the true versatility and research ability of MCIRCC’s members. The investigators of these proposals hail from across U-M, and feature clinicians, engineers, research scientists, and others. Tackling the vast problems posed by TBI requires an integrated approach, one which is offered by the integrated nature of MCIRCC’s membership.

Additionally, each proposal outlined their potential usefulness in the often austere and high-pressure settings of combat casualty care. As was outlined frequently in the proposals, the burden of care even in the most favorable of settings is huge. That burden is multiplied in warzones, where caregivers are often forced to improvise, and are often miles away from a traditional hospital setting. Any innovation in care that can improve outcomes for TBI patients in military settings will undoubtedly do the same in civilian settings. However, the field of TBI care is surely ripe for innovation and these five proposals represent a step forward in improving outdated treatment methods.