Last Update: 08/17/2006 Printer Friendly Printer Friendly   Email This Page Email This Page  

Traumatic Brain Injury (TBI) Clinical Trials Network

The TBI Clinical Trials Network is supported by the National Center for Medical Rehabilitation Research (NCMRR) During the past two decades, understanding of the pathophysiology of TBI has increased dramatically.  For instance, clinicians now recognize that not all neurologic damage occurs at the moment of injury, but rather that it evolves over the ensuing minutes, hours, and days.  A combination of early imaging in the emergency room, removal of extra-axial masses, support of blood pressure, ventilation, and monitoring of intracranial pressure is well-known to produce improved survival rates.  The role of aggressive follow-on intensive care treatment is equally well established.  In addition, a growing body of literature suggests that adjunctive pharmacological treatment facilitates behavioral management during the rehabilitation process and might result in better functional outcomes.  Despite these advances, researchers have much to learn about the underlying damage and pathophysiology of the deficits associated with TBI and the links among acute care, rehabilitation, and long-term patient outcomes.

To learn more, the NCMRR established a multi-center network of sites that are working together to design clinical intervention protocols and measures of outcome for TBI.  Through rigorous patient evaluation, using common protocols and interventions designed for multiple points of care—including the accident scene, emergency room, intensive care unit, rehabilitation and long-term follow-up—the NCMRR TBI Clinical Trials Network can study the required numbers of patients to provide answers more rapidly than individual centers acting alone.  This interdisciplinary research Network is designed to evaluate the relationship among acute care practice, rehabilitation strategies, and the long-term functional outcome of TBI patients—that is, to identify which intervention variables result in improvements in long-term outcomes. 

Taking advantage of the network model structure has allowed TBI research to progress toward a number of clinical research goals.  Specifically, the NCMRR wants to highlight two major achievements to date.  First, the TBI Network created a profile of its typical patient to determine the number of patients with different clinical features who might be eligible for future studies and to help estimate recruitment times necessary.  Second, Network researchers are developing clinical treatment guidelines and procedures for all points in the continuum of care, including TBI Clinical Trials Network Guidelines for surgical care, systems-based protocol for severe and moderate TBI patients, deep-vein thrombosis prophylaxis procedures, and rehabilitation guidelines for physical therapy, speech-language pathology, occupational therapy, and neuropsychology.