|1:10 pm – 2:00 pm |
Windows to the Brain: Traumatic Brain Injury
in Time of War
Katherine H. Taber, PhD, FANPA
Research Health Scientist
W.G. "Bill" Hefner VAMC
Abstract: Traumatic brain injury (TBI) has been called the ‘signature injury’ of the wars in Iraq and Afghanistan. Historically, in times of war, TBI was present in 14-20% of surviving casualties. Improvements in both body armor and in-theatre medical care have greatly reduced mortality. Present estimates suggest that TBI may be present in more than half of soldiers evacuated for medical reasons. The incidence in soldiers that did not sustain injuries requiring evacuation has not yet been determined. Screening studies suggest that 15-20% have symptoms consistent with mild TBI.
TBI, particularly when mild, is a commonly under-diagnosed medical condition. It can result from many life events, including motor vehicle accidents, falls, assaults, sports-related accidents, and exposure to explosives. The linear and angular forces exerted on the brain by these events result in characteristic injury patterns. The forces associated with explosions are more complex. Their effects on the brain are not well understood and this is an area of active research. The nature, locations and neuroimaging appearance of the most common types of injury will be presented, as well as the present understanding of the progression of injury with time. Specific challenges in the identification of mild TBI will be discussed.
|2:00 pm – 2:50 pm |
New Advances in the Pathophysiology and Treatment
of Traumatic Brain Injury
W. Dalton Dietrich, III, PhD
Department of Neurological Surgery
The Miami Project to Cure Paralysis
University of Miami Miller School of Medicine
Abstract: Traumatic brain injury (TBI) is a prevalent, debilitating health problem occurring in 1.4 million people each year and disabling 5 million people in the United States. Although much is known about the pathophysiology of traumatic brain injury, research has not yielded a therapy that has passed Phase 3 clinical trials. It is known that brain trauma results in a variety of neuropathological events that are mediated by a number of injury mechanisms including excitotoxicity, free radical generation, apoptosis, and inflammatory cascades. The present lecture will summarize recent experimental evidence regarding novel cellular and molecular events that may be targeted for new therapeutic interventions. Specifically, the role of cyclic AMP signaling pathway and posttraumatic inflammatory cascades will be emphasized. Therapeutic hypothermia has recently been shown in experimental and clinical trials to promote improvement following TBI. Thus, mechanisms that are affected by mild cooling will also be discussed. Because cognitive dysfunction is an important consequence of mild, moderate and severe TBI, the effect of therapeutic hypothermia on hippocampal dependent learning and memory will be described. Finally, novel cellular transplantation strategies including the use of multineurotrophin transduced neural progenitor cells on improving behavioral outcome will be summarized. The lecture will attempt to emphasize this fast-moving field and how new findings may target both the civilian and military populations.
|3:10 pm - 4:00 pm||Novel Stem Cell Therapy for Brain Injury Repair|
Paul R. Sanberg, PhD, DSc
Distinguished University Professor, Department of Neurosurgery,
Director, Center of Excellence for Aging and Brain Repair
University of South Florida College of Medicine
Abstract: Stem cell therapy is a promising approach to the treatment of neurodegenerative diseases and brain injury that has been shown to be efficacious in many animal models. However, the use of embryonic tissue can limit the acceptability and wide spread application of the technique in certain countries. Alternative cell sources will be discussed that may be used to repair the brain and spinal cord, with a focus on adult stem and progenitor cells, including hNT Neurons, bone marrow and a focus on human umbilical cord blood (HUCB) derived cells. Human umbilical cord blood (hUCB) cells are a non-controversial source of stem cells and progenitor cells which appear to have a multipotent capacity. HUCB cells are capable of differentiating into neurons, glia, endothelial and other cell types. Moreover, these hematopoietic stem cells can engraft into specific sites of brain injury and disease following systemic or direct injection, and produce recovery of function in animals following stroke and other brain disorders, including brain trauma, spinal cord injury, and ALS. More importantly these cells provide neural repair through trophic and immunological mechanisms. Furthermore, hUCB cells are associated with a low incidence of severity of graft-versus-host (GVHD) diseases when given to cancer patients, and are easily obtained. This aspect is important for future clinical studies in brain repair since significant confounds of cell therapy include rejection by the recipient, and the viability of transplantable cells. With the ongoing discovery of novel cord blood based cell therapies, the applications for brain repair become increasingly promising.
Disclosure: Paul R. Sandberg is a Co-Founder of Saneron CCEL Therapeutics, Inc.