Core-Funded Projects | NIHR SRMRC - Surgical Reconstruction and Microbiology Research Centre

Ophthalmic Assessment in Traumatic Brain Injury

webteam — Tue, 19 Oct 2021 14:56:30 +0000

Traumatic brain injury (TBI) is defined as an alteration to brain function or other evidence of brain pathology, caused by an external force. It is considered as a global health concern due to its high incidence and has shown to be one of the major causes of morbidity and mortality around the world. Globally, 10 million people are affected by TBI per year, with reported incidence rate of 106 per 100,000. By 2020, it is estimated that TBI may exceed other types of diseases as the major cause of death and disability.

Impact of TBI on the optic nerve results in a condition called traumatic optic neuropathy (TON). TON typically manifests with reductions in visual acuity, colour vision, pupil reactivity and visual field in the affected eye. Historic data suggests a prevalence of TON as 2% after TBI, whilst recent anecdotal data suggests that retinal and visual changes after TBI may be much more frequent, being present sub-clinically in many elite athletes after head injuries in sport.

This investigation aims to evaluate the structure of the retina and optic nerve head whilst assessing visual function of TBI patients longitudinally in order to detail the early changes indicative of TBI severity and prognostic of visual outcome in order to inform patient management.

OCCI

webteam — Tue, 19 Oct 2021 14:52:09 +0000

Perioperative cognitive disorders (POCD) is an umbrella term used to describe post-operative delirium, and longer term neurocognitive dysfunction after surgery. Delirium is an acute impairment of brain function associated with surgery and systemic illness. Delirium affects up to 50% of older people admitted to general hospitals for elective surgery, and is associated with increased postoperative mortality and patient distress. Longer term changes to a person’s brain function can also be observed up to 1 year after surgery and critical illness. How people develop delirium and postoperative neurocognitive dysfunction is poorly understood, but may be related to cerebral vascular inflammation and disruption of the blood-brain barrier.

We think that changes in cerebral blood flow may be responsible for the development of peri-operative cognitive disorders, and think that indirect measures of cerebral blood flow may be key both to predict, recognise and monitor POCD. By looking at patients with and without impairments in brain function before, during and after major surgery and critical illness, we aim to improve patient assessment during this time as well as our understanding of the mechanisms underlying POCD and the extent to which changes in cerebral blood flow during major surgery and critical illness affect long term brain function.

RECOS

brownda — Fri, 16 Aug 2019 22:03:02 +0000

Sport concussion, defined as “a brief period of loss of consciousness, memory loss or feeling dazed or confused following trauma to the head”, is a common cause of traumatic brain injury (TBI), and accounts for 10-25% of all recorded head injuries, worldwide. The majority of patients improve rapidly following a single concussion, but repeated concussion prolongs recovery times after each incident. Patients also experience a high incidence of cognitive and behavioural dysfunction, post-traumatic stress disorder and social isolation. Certain groups of patients, such as athletes and soldiers are at greater risk of repetitive concussion – potentially leading to a catastrophic form of brain injury known as second impact syndrome, thought to be due to the second insult occurring inside a window of metabolic vulnerability in the brain. Our researchers will look at a group of athletes from sports such as rugby, football, American football, Aussie rules, Gaelic football, cycling, gymnastics, equestrianism, alpine sports, motor racing, martial arts and ice hockey, recruited through University of Birmingham Sport (UoBSport). The aim is to study the window of brain vulnerability following single and repetitive concussion, with a view to guiding return-to-play policy.
As in phase I, researchers will carry on recruiting from a number of professional clubs (mainly, but not exclusively, from the Rugby Football Union premiership) participating in this study. Blood and saliva samples will be collected at the pitch-side by the club medics and then the athletes will attend our new ITM Imaging Centre for evaluation with computerised neuropsychometrics, medical evaluation and advanced neuroimaging. The samples will be used to functionalise, optimise and validate a point-of-care device being developed in collaboration with Swansea University and an industrial partner BIOVICI Diagnostics.

Golden Hour

brownda — Fri, 16 Aug 2019 21:28:53 +0000

We are the only site in Europe to analyse ultra-early biomarkers from patients who have suffered from Traumatic Brain Injuries (TBI) and severe major trauma. We work closely with our pre-hospital teams to take blood and saliva samples from patients within 1 hour of their injury so most samples are taken before the patient even arrives in hospital! These samples are then analysed by scientists in our partner organisation, the University of Birmingham, who look at markers of inflammation and changes in DNA. The outcome of this learning is to be able to identify people who will be at risk of a poor outcome further down the line and also to develop roadside or bedside tests which can diagnose conditions like concussion very quickly. This will then improve the treatments we can give and also patient outcome maybe even years into the future.