The International Initiative for Traumatic Brain Injury Research (InTBIR) 2024 General Assembly will be held in Bethesda, Maryland January 24 – 25, 2024. This meeting will take place immediately after the NINDS-sponsored TBI Reclassification Workshop, held in Bethesda from January 22 – 23, 2024.
All InTBIR members are welcome to attend at their own cost, but total numbers will be capped due to meeting facilities available, so if you do plan to attend in person, we suggest you apply early. However, this will be a hybrid meeting, so you will also be able to participate online.
We encourage submission of abstracts describing your research that fits with the InTBIR Mission (https://intbir.incf.org/about/mission), Abstracts will be graded for selection by the InTBIR Executive Committee, and selected abstracts will be expected to be displayed as posters for discussion during breaks. In addition, five posters will be selected for 3-minute flash presentations.
Registration for Assembly 2024 is closed.
This meeting has been made possible through support from the US National Institutes of Health, with additional support from the following industry partners. InTBIR is very grateful for this support – which enables us to plan for the future of research in TBI.
08:30 Coffee
08:40 Introduction
09:00 Report of working groups (10 mins each)
a) Observational and comparative effectiveness studies – Fitzgerald and Okonkwo
b) Clinical trials – Turgeon and Hutchinson
c) Biomarkers & genetics – Diaz-Arrastia and Wellington
d) Global health – Hutchinson, Gao, and Gardner
e) Special contexts – Gardner, Wellington, and Zemek
f) Imaging – Nasrallah, Zanier and Newcombe
g) Outcomes – Nelson, Manley, and Wilson
10:30-10:45 Coffee
h) Fundamental and Translational– Smith, Zanier, Loane and Wellington
i) Linkage with post-mortem studies – Smith, Stewart
j) Data science and harmonisation – Abrams, Mondello
k) Policy engagement – Manley, Menon
l) Website – Abrams, Diaz-Arrastia
11:45-12:45 Flash presentations (listed on the last tab)
12:45-13:30 Lunch and Poster Session
Working group breakout sessions
13.30-14.30 Breakout session1
Participants: Fitzgerald, Okonkwo, Turgeon, Hutchinson, Lingsma, Abrams, Gao, Gardner, van der Jagt
Remit: To discuss study designs, data collection and analysis approaches, including data science and harmonisation
Participants:Diaz-Arrastia, Wellington, Nasrallah, Newcombe, Zanier, Menon, Manley, Smith, Stewart, Nelson
Remit: Discuss plans for biomarker collection harmonization and analysis
14:30 -14:45 Coffee
14:45 - 15:45 Breakout session2
Participants:Wellington, Nasrallah, Newcombe, Zanier, Stewart, Smith, (Diaz-Arrastia), Okonkwo, Hutchinson, (Nelson)
Remit: To address elucidation of human TBI pathophysiology through bidirectional translation, including microdialysis and human post mortem studies
Participants:Menon, Manley, Fitzgerald, Gao, Gardner, Abrams, (Diaz-Arrastia), Turgeon, Lingsma, (Nelson)
Remit: Website, public engagement, engagement with funders and policymakers
15:45 General discussion
16:30 Keynote presentation
TBI Care as a Model for Health Care as a Whole - Dr. DON BERWICK
Donald M. Berwick is one of the leading scholars, teachers, and advocates in the world for the continual improvement of health care systems. He is a pediatrician, and a longstanding member of the faculty of Harvard Medical School. He founded and led the Institute for Healthcare Improvement, now the leading global nonprofit organization in its field. He was appointed by President Obama as administrator of the Centers for Medicare and Medicaid Services, where he served in 2010 and 2011. He has counseled governments, clinical leaders, and executives in dozens of nations. He is an elected Member of the National Academy of Medicine and the American Philosophical Society. He has received numerous awards, including the Heinz Award for Public Policy, the Award of Honor of the American Hospital Association, and the Gustav Leinhard Award from the Institute of Medicine. For his work with the British National Health Service, in 2005 Her Majesty Queen Elizabeth II appointed him Honourary Knight Commander of the British Empire, the highest honor awarded by the UK to a non-British subject.
17:30 Evening reception and discussion - The Bethesdan Hotel, Wisconsin Room, 2nd Floor
18:15 Close
09:00 Coffee and posters
09:45 Introduction to day 2
10:00 Keynote presentation
Improving global trauma outcomes through better emergency, critical, and operative care
Dr TERI REYNOLDS, Unit Head, Clinical Services and Systems - World Health Organization
Dr Teri Reynolds leads the Clinical Services and Systems Unit in the department of Integrated Health Services at the World Health Organization Headquarters in Geneva. The Clinical Services and Systems Unit brings together WHO’s work on integrated delivery channels -including primary care, emergency care, critical care and operative care- with cross-cutting efforts on effective organization and people’s movement across the health system. Dr Reynolds coordinated guidance on maintaining essential health services during the COVID-19 outbreak and previously led the emergency and trauma care programmes at WHO. She was previously Associate Professor and Director of Global Health for the Department of Emergency Medicine, University of California, San Francisco; chaired the Scientific Committee of the African Federation for Emergency Medicine; and directed the Emergency Medicine Residency and research programmes at Muhimbili National Hospital in Tanzania for several years. She is a member of the United States National Academy of Medicine.
10:45 Coffee
11:15 Interim update from reclassification conference
11:45 InTBIR summary and insights
12:15 Articulate a vision for stakeholders
13:00 Close
14:00 Funders meeting (only by invitation)
16:00 Close
Flash Presentations
John D. Arena, MD
University of Pennsylvania
Philadelphia, Pennsylvania, United States
“The Neuropathological Basis of Elevated Serum Neurofilament Light Following Experimental Concussion”
Parallel measurement of serum neurofilament light protein and neuropathologic assessment of a clinically-relevant gyrencephalic model of concussion.
Shubhayu Bhattacharyay
University of Cambridge
Cambridge, UK
“From big data to individual narratives: mapping the disease course of traumatic brain injury patients in intensive care”
We used a data-driven approach to understand the impact of events and treatments provided to ICU patients – both to understand how unfolding disease narrative dynamically modulates outcome expectations and to identify high-value targets for therapy.
Emily L Dennis, PhD
University of Utah
Salt Lake City, USA
“Regional volume differences in blast TBI with cognitive implications: a LIMBIC-CENC study”
Leveraging the multi-site LIMBIC-CENC sample, we sought to identify alterations in brain structure using tensor-based morphometry in individuals with blast-related TBI, and to determine if these alterations related to cognitive function.
Mahmoud El Baassiri MD
Johns Hopkins University School of Medicine
Baltimore, MD
“Ccr2 Dependent Monocytes Exacerbate Intestinal Inflammation and Modulate Gut Serotonergic Signaling Following Traumatic Brain Injury”
Our study reveals a critical role for Ccr2 +monocytes in modulating intestinal homeostasis after TBI. Ccr2 +monocytes aggravate intestinal pathology and alter gut-derived serotonergic signaling. Therefore, targeting Ccr2 +monocyte-dependent responses, including TLR4 signaling, provides a promising therapeutic potential to alleviate the deleterious sequelae of TBI in the gut.
Farzin Farahbakhsh, MD, MPH.
Sina Trauma and Surgery Research Center
Tehran
“Prognostic Value of Frailty for Outcome Following Traumatic Brain Injury (TBI): A Systematic Review and Meta-Analysis”
Frailty is a known predictor of negative health outcomes. However, the role of frailty in predicting outcomes following traumatic brain injury (TBI) is unclear. This systematic review aimed to evaluate the association between frailty and adverse outcomes in TBI patients.
Erica S. Kornblith, PhD
UCSF/SFVA
San Francisco CA
“12-month cognitive outcome after acute geriatric TBI not associated with U.S. Military Veteran status”
We examined 112 older male Veterans and 320 older male civilians (55+) who experienced an acute TBI and enrolled in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study cohort.Risk of poor cognitive outcome following TBI does not differ between older male Veterans and civilians, and mood and life satisfaction outcomes were worse for Veterans but impacted by injury severity and prior head injury.
Ana Mikolic
University of British Columbia
Vancouver, Canada
“Screening for psychological risk factors to improve outcome prediction after mild TBI”
We describe a brief tool for measuring psychological risk factors after mild TBI. We examine the predictive value of this tool for outcomes after mild TBI in two prospectively collected cohorts in two geographical locations (British Columbia, Canada and New Zealand). We also examine the additional predictive value above and beyond known predictors. We describe plans for further examination of this tool in new settings (concussion clinics in Ontario, Canada).
Giovanni Nattino, PhD
Istituto di Ricerche Farmacologiche Mario Negri IRCCS
Ranica (BG), Italy
“Effectiveness of Intracranial Pressure Monitoring on the 6-month GOS-E of Critically Ill Patients with Traumatic Brain Injury”
The detrimental effects of persistent elevations in intracranial pressure (ICP) on the outcomes of patients with traumatic brain injury (TBI) are well documented in the literature. However, the effectiveness of ICP monitoring is unclear as there is no consensus on how ICP measurements should be used to drive treatments. In this study, we aimed at evaluating the effectiveness of ICP monitoring on the 6-month outcome of TBI patients. To address this research question, we used the data from the CREACTIVE consortium, which promoted a large-scale, international, prospective cohort study on TBI. Eighty-three intensive care units (ICUs) from 7 countries joined the consortium and enrolled more than 8,000 TBI patients between 2014 and 2019. We selected the TBI patients satisfying the Brain Trauma Foundations (BTF) guidelines for ICP monitoring, resulting in a cohort of 1,448 patients. ICP-monitored patients (exposure group) were matched to non-monitored patients (control group) based on the propensity score. The primary outcome of the study was the 6-month functional recovery, which was measured by the Glasgow Outcome Scale Extended (GOS-E). Of the patients meeting the BTF guidelines on ICP monitoring, only 503 (34.7%) were monitored. In the matched cohort, which was perfectly balanced with respect to all of the considered variables, we observed more frequent medical interventions and worse 6-month GOS-E among the ICP-monitored patients as compared to nonmonitored ones (p-value: 0.005, death/vegetative state: 39.2% vs. 40.6%; severe disability: 33.2% vs. 25.4%; moderate disability: 15.7% vs. 14.9%; good recovery: 11.9% vs. 19.1%). These findings suggests that, in general practice, ICP monitoring causes excessive concern about the numerical value of the pressure, leading practitioners to apply overly generous, non-targeted use of medical therapies, with significant adverse effects. These results prompt reconsideration of current monitoring indications and management protocols.
Francesca Pischiutta, PhD
Istituto di Ricerche Farmacologiche Mario Negri
Milan, Italy
“Mesenchymal stromal cells for traumatic brain injury: a winning continuous dialogue between the lab and the clinic”
The poster will illustrate our study on mesenchymal stromal cells (MSC) for traumatic brain injury. The poster will include: 1) our preclinical evidence of MSC efficacy in TBI models; 2) the design of the ongoing phase II clinical trial “MATRIx” aimed at verifying the safety and the biological activity of intravenous administration of allogeneic bone marrow-derived MSCs to severe TBI patients, within 48 h of injury; 3) our aims at preclinical level to include age and sex as biological variables, and to assess the effect of MSCs in relation to injury severity, and the immune activation state
Sophie Richter, PhD, MD
Cambridge University
Cambridge, United Kingdom
“Predicting recovery in patients with mild traumatic brain injury and a normal CT using diffusion tensor imaging”
Prognostic study in mild TBI patients with a normal CT brain assessing if the addition of early diffusion tensor imaging data can improve existing models to predict functional recovery
Clio Rubinos
University of North Carolina
Chapel Hill
“Current Practice for continuous EEG monitoring in the critically ill patient: A Latin American Survey ”
This is a pilot survey based study aiming to evaluate the practice patterns and access to cEEG monitoring in critically ill patients in Latin America
Veronik Sicard, PhD
CHEO Research Institute
Ottawa, Canada
“Subject-Specific Abnormalities in Brain Perfusion in Youth with Concussion using Arterial Spin Labeling MRI”
This study compared the subject-specific abnormalities in brain perfusion measured with ASL-MRI and their association with symptoms at 72 hours and 4 weeks following acute concussion or orthopedic injury (OI) within youths aged 10-17.99. The number of hypoperfused clusters was significantly higher at 72 hours compared to 4 weeks in the concussion group. However, no association was found between HBI and abnormal perfusion volume within the concussion group at any visit. Further, no differences were observed in the number of abnormal perfusion clusters or volumes between symptomatic and asymptomatic concussed and OI youths.
Thomas Van Essen, MD PhD MSc
Leiden University Medical Center
Leiden, The Netherlands
“Personalizing neurosurgical care in traumatic brain injury”
The main aims of my future research are to determine the comparative effectiveness of 1) acute surgery compared to conservative treatment in ASDH, and 2) primary decompressive craniectomy compared to craniotomy in surgical evacuation of ASDH, specifically towards specific groups of patients.
HUSSEIN A. YAKUBU
KOMFO ANOKYE TEACHING HOSPITAL
KUMASI, GHANA
“Evaluating The Association Between Delays In Head CT And Mortality Among TBI Patients In The Ashanti Region Of Ghana”
This study quantifies the time delays to obtain brain CT imaging for patient with traumatic brain injury and determines the association with patient outcomes in terms of mortality. It also evaluates the common reasons contributing to delayed brain CT imaging
Neil SN Graham MRCP PhD
Imperial College London
London, UK
“Elevated plasma glial fibrillary acidic protein eight years after military traumatic brain injury in the Afghanistan war from 2003-2014: the ADVANCE TBI study”
Battlefield TBI is associated with significantly elevated plasma GFAP eight years after injury in the prospective UK ADVANCE cohort, suggesting ongoing post-injury astrogliosis.
Mehwish Anwer, MPhil, PhD
University of British Columbia, Vancouver, Canada
“Using the CHIMERA model and 3D brain analysis to investigate Traumatic Brain Injury pathophysiology”
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John D. Arena, MD
University of Pennsylvania, Philadelphia, Pennsylvania, United States
“The Neuropathological Basis of Elevated Serum Neurofilament Light Following Experimental Concussion”
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Shubhayu Bhattacharyay
University of Cambridge, Cambridge, UK
“From big data to individual narratives: mapping the disease course of traumatic brain injury patients in intensive care”
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Bernadette A. D'Alonzo, MPH
University of Pennsylvania, Philadelphia, USA
“No observed changes in reported post-concussion affective symptoms in the context of the COVID-19 pandemic among collegiate student-athletes”
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Emily L Dennis, PhD
University of Utah, Salt Lake City, USA
“Regional volume differences in blast TBI with cognitive implications: a LIMBIC-CENC study”
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Mahmoud El Baassiri MD
Johns Hopkins University School of Medicine, Baltimore, MD, USA
“Ccr2 Dependent Monocytes Exacerbate Intestinal Inflammation and Modulate Gut Serotonergic Signaling Following Traumatic Brain Injury”
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Farzin Farahbakhsh, MD, MPH.
Sina Trauma and Surgery Research Center, Tehran
“Prognostic Value of Frailty for Outcome Following Traumatic Brain Injury (TBI): A Systematic Review and Meta-Analysis”
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Farzin Farahbakhsh, MD, MPH.
Sina Trauma and Surgery Research Center, Tehran
"Traumatic Brain Injury Management: Insights from Iran"
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Neil SN Graham MRCP PhD
Imperial College London, London, UK
“Elevated plasma glial fibrillary acidic protein eight years after military traumatic brain injury in the Afghanistan war from 2003-2014: the ADVANCE TBI study”
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Kathryn Hendrick, MA
Canadian Traumatic Brain Injury Research Consortium, TORONTO, CANADA
“Groundbreaking Patient Advocacy- The Case for Classifying Moderate to Severe TBI as a Chronic Condition”
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Jamie S. Hutchison, MD
SickKids, Toronto, Canada
“A Canadian Biobank and Database for Traumatic Brain Injury in Children and Adults (CanTBI): A Prospective Multi-Center Study.”
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Erica S. Kornblith, PhD
UCSF/SFVA, San Francisco CA, USA
“12-month cognitive outcome after acute geriatric TBI not associated with U.S. Military Veteran status”
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Lucia M Li
Imperial College London, UK
“Hyperacute plasma VEGF-A levels post-TBI and its clinical associations”
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Ana Mikolić
University of British Columbia
“Screening for psychological risk factors to improve prediction after mild traumatic brain injury”
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Ethan Jacob Moyer
Moberg Analytics, Philadelphia, USA
“Advancing InTBIR’s Goals: A Platform for Large-scale Physiological Data Analytics”
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Giovanni Nattino, PhD
Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica (BG), Italy
“Effectiveness of Intracranial Pressure Monitoring on the 6-month GOS-E of Critically Ill Patients with Traumatic Brain Injury”
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Peter Ngum
University of Turku/Turku/Finland
“TBIview: A User-Friendly Machine Learning Tool for Neurotraumatology Research”
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Francesca Pischiutta, PhD
Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
“Mesenchymal stromal cells for traumatic brain injury: a winning continuous dialogue between the lab and the clinic”
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Sophie Richter, PhD, MD
Cambridge University, Cambridge, United Kingdom
“Predicting recovery in patients with mild traumatic brain injury and a normal CT using diffusion tensor imaging”
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Clio Rubinos
University of North Carolina, Chapel Hill, NC, USA
“Current Practice for continuous EEG monitoring in the critically ill patient: A Latin American Survey ”
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Jakob Seidlitz, PhD
Centile Bioscience/Philadelphia/USA
“Automated deep-learning segmentation for quantitative morphometrics of clinically acquired brain MRI and CT ”
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Veronik Sicard, PhD
CHEO Research Institute, Ottawa, Canada
“Subject-Specific Abnormalities in Brain Perfusion in Youth with Concussion using Arterial Spin Labeling MRI”
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Hailong Song, MBBS, PhD
University of Pennsylvania/Philadelphia/USA
“Concussion leads to widespread axonal sodium channel loss and disruption of the node of Ranvier”
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Aditya Swaro
University of British Columbia, Vancouver, Canada
“TBISeq: A Spatial Transcriptomics Web Portal into Traumatic Brain Injury of the Mouse Brain”
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Thomas Van Essen, MD PhD MSc
Leiden University Medical Center, Leiden, The Netherlands
“Personalizing neurosurgical care in traumatic brain injury”
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Hussein A. Yakubu
Komfo Anokye Teaching Hospital, Kumasi Ghana
“Evaluating The Association Between Delays In Head CT And Mortality Among TBI Patients In The Ashanti Region Of Ghana”
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