Grant: CIHR Fellowship

Traumatic brain injury (TBI) is one of the leading causes of death and disability around the world. Unfortunately, the treatment of TBI has failed to make significant strides in the past 25 years, with patients not having significantly improved recoveries. One cause of this may be dysfunctional cerebral autoregulation (CA). This is when the brain loses its ability to control its own blood flow after a TBI. Recent technological developments have allowed for the continuous monitoring of CA. This is important since the level of dysfunctional CA seems to be linked to how well patients recover after TBI. However, these methods require the placement of probes into the brain. This puts the patient at risk of further brain injury and limits these methods to the intensive care unit (ICU). There are methods that have been developed to non-invasively evaluate CA using a harmless form of light called near infrared light. The method, called near infrared spectroscopy (NIRS), may be a safer alternative to current methods. My research aims to test if NIRS based methods of measuring CA are a good alternative to current invasive methods in TBI. Our study is enrolling all TBI patients with invasive monitoring admitted to our ICU. As part of the study, we also measure NIRS based CA while they are in the ICU. At 3, 6, and 12 months after their injury we follow up with them and evaluate how they are recovering using standardized questionnaires. Also, because NIRS based measures of CA are non-invasive, we measure their level of CA dysfunction at that time. Using this data, we can compare the invasive measure of CA with NIRS based measures of CA to see if they are similar. We can also see if NIRS based measures of CA are able to predict how patients will do after a TBI. Finally, we will also be able to see how CA, measured by NIRS, recovers in the long term after TBI. This may lead to safer and more effective care for patients and give us insight into how the brain recovers from TBI.