Neurotrauma & Traumatic Brain Injury
The goal of the Traumatic Brain Injury (TBI) Portfolio is to close military-relevant gaps in combat-related Traumatic Brain Injury (TBI) from the battlefield through acute hospitalization. Lines of effort include detection using identification and assessment of injuries requiring rapid triage and intervention in prolonged care scenarios, and treatment using strategies for early interventions to improve TBI outcomes and Warfighter readiness.
Within the Combat Casualty Care Research Program, there are major subdivisions which present very different forms of TBI. The goal of each is to increase understanding of the etiology of TBIs, in order to develop new treatments, diagnostic and monitoring capabilities and to arrive at evidence-based solutions sooner after injury. Penetrating TBI, closed head blunt or contact trauma, and blast injury (including blast overpressure) lead to Glasgow Coma Scale (GCS) scores between 3 and 15. Currently mild, moderate, and severe TBI classify injuries that are within the GCS but the TBI and trauma community agree that this classification ins antiquated and very much in need of updating which has been noted in the 2022 National Academies of Sciences, Engineering, and Medicine Consensus Study Report on TBI.
A challenge for TBI care in combat is that trauma intervention needs to start much sooner and not rely so much on the ability to evacuate the injured personnel; future combat is expected to have reduced capacity to rapidly evacuate casualties. Also, in some cases such as mTBI or concussion, the Warfighter is needed to return to combat sooner. CCCRP Neurotrauma leverages our interagency collaborations as well as academic and corporate partners to translate TBI solutions from discovery to clinical practice.
The discovery to clinical practice pipeline is outlined here:
- Identify disruptive technologies for prolonged pre-hospital interventions
- Gather biomarkers for diagnosis and prognosis
- Begin drug discovery and targeted therapeutics
- Identify solutions for TBI with polytrauma
- Notate clinical endpoints
- Clinical Development
- Phase 1 clinical trials for TBI treatment
- GMP manufacturing of trial drugs
- Prototype clinical development for TBI diagnosis and monitoring