International Traumatic Brain Injury Research Initiative (ITBIRI)

UCSF and collaborating investigators from ten universities with established neurotrauma clinical centers and research programs have an unprecedented opportunity to join forces and leverage their vast biomedical research talent and clinical trial expertise to tackle one of the greatest unmet needs in medicine and public health – traumatic brain injury (TBI). Progress will require a multidisciplinary and multi-institutional effort. Working together, research can be accelerated, more effectively translated, and outcomes can be improved. 

Building on the success of the TRACK-TBI pilot study, the overall goal of this study is to enroll an additional 3000 subjects and controls across the injury spectrum of concussion to coma. Expansion of this high quality knowledge information network which integrates clinical, imaging, proteomic, genomic, and outcome biomarkers will advance our understanding of TBI, identify more precise methods for early diagnosis of TBI, and improve prognostic models to identify individuals at risk for persistent cognitive and psychological heath disabilities. These deliverables will improve clinical trial design, lead to patient-specific treatments, and improve outcome for TBI.

We propose to use the existing TRACK-TBI infrastructure to create a multicenter research network including collaborators in the European Union and Canada. We will use validated methodology and protocols for clinical data collection, CT and MR imaging, biospecimen collection, and multivariate assessment of outcome. Importantly, we will create a well-curated database along with imaging repositories and biorepositories to create a data commons for legacy research with emerging technologies and the opportunity for long term follow up. Data analysis will focus on diagnostic models to create and new taxonomy of TBI and prognostic models for risk-adjustment and benchmarking of clinical care. Advance statistical tools, including multilevel modeling, multivariate analysis, and systems biology approaches will also be employed.

There is an urgent need to improve the precision of diagnosis and the taxonomy of TBI beyond the current crude categories of Mild, Moderate, and Severe. In order to do this, better diagnostic tools are needed. Improvement in clinical trials will require better prognostic models for risk-adjustment and more refined and sensitive outcome assessment. The proposed investigators and study sites have considerable expertise with clinical, imaging and biomarker studies of TBI.