Novel Prediction of Recovery of Consciousness in Acute Traumatic Brain Injury
NINDS - National Institute of Neurological Disorders and Stroke
About This Grant
PROJECT SUMMARY/ABSTRACT Traumatic brain injury (TBI) is a major cause of death and disability in the U.S. and beyond. More than half of TBI deaths occur in the context of acute withdrawal of life-sustaining treatment (WLST). The decision to continue towards neurorehabilitation versus transition to WLST hinges on predictions of recovery. Predicting recovery, however, is challenging. Recovery predictions drive care decisions, but even seasoned clinicians cannot make reliable predictions. The stakes are high: surrogates overwhelmingly view a persistent vegetative state after severe TBI as worse than death. Yet, late recovery and functional independence may be possible for many. Among those who die after WLST, up to one third may have recovered to functional independence. Correctly identifying those patients in the intensive care unit could equate to up to 10,000 lives saved annually with good functional recovery by preventing premature WLST. We must move beyond prognostic uncertainty. A potential diagnostic tool is available: the injured brain’s response to anesthesia reveals its likelihood to recover, and this response is measurable with electroencephalography (EEG). Anesthesia can induce distinctive patterns of brain network reconfiguration. In patients with disorders of consciousness, detection of these brain network reconfigurations in response to propofol anesthesia may allow us to correctly identify patients with the capacity to recover consciousness. In our preliminary work, we quantified the reconfiguration of high-density EEG network hubs and directed functional connectivity before, during, and after propofol anesthesia to obtain an index of propofol-induced network reconfiguration. This index discriminated with high accuracy between patients who did or did not later regain consciousness. This work was limited to 10 patients with disorders of consciousness after acquired brain injury, of which 2 had acute TBI. This tool has the potential to apply to acute TBI patients. To address this evidence gap, this R21 proposes to enroll 30 unresponsive acute TBI patients from our intensive care unit, both isolated and polytrauma TBI, in a prospective study with two Specific Aims: (1) to develop a novel propofol-induced index to predict recovery of consciousness after acute TBI in the intensive care unit; and (2) to quantify the added value of this novel index for TBI prognostication. We will use high-density and clinical-grade EEG to measure the brain’s response to the neurophysiological perturbation of propofol anesthesia and then calculate the accuracy of this novel index to predict recovery of consciousness 6 months later. This project leverages our high-volume, high-acuity trauma center with a large pool of severe TBI patients. This interdisciplinary team science collaboration leverages the diverse skillsets of four female investigators: a trauma surgeon intensivist, a neurologist specializing in critical care EEG, a neuroscientist focused on recovery of consciousness, and an engineer focused on consciousness and neuroprognosis. Eventually, this pragmatic, bedside prognosticator for unresponsive, acute TBI patients may provide hope of recovery and prevent early inappropriate WLST.
Grant Summary
Novel Prediction of Recovery of Consciousness in Acute Traumatic Brain Injury is a NINDS - National Institute of Neurological Disorders and Stroke grant providing up to $263K for university, nonprofit, healthcare org. Applications are due 2028-03-31 (open). Check eligibility and apply with FindGrants.
Focus Areas
Eligibility
How to Apply
Up to $263K
2028-03-31
- 1Confirm your organization is eligible for Novel Prediction of Recovery of Consciousness in Acute Traumatic Brain Injury from NINDS - National Institute of Neurological Disorders and Stroke, checking organization type, location, and any population or project requirements.
- 2Gather the required documents and information, including your organization details, project plan, and budget figures.
- 3Draft your application narrative and budget addressing the funder's priorities and review criteria. FindGrants can draft each section for you to review and edit.
- 4Review every section against the requirements checklist, then export a submission-ready application pack and submit it to NINDS - National Institute of Neurological Disorders and Stroke before the deadline.
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Novel Prediction of Recovery of Consciousness in Acute Traumatic Brain Injury: Frequently Asked Questions
Who is eligible for the Novel Prediction of Recovery of Consciousness in Acute Traumatic Brain Injury?
Novel Prediction of Recovery of Consciousness in Acute Traumatic Brain Injury is offered by NINDS - National Institute of Neurological Disorders and Stroke and is generally open to university, nonprofit, healthcare org. It is open to organizations nationwide unless the funder specifies otherwise. Review the specific eligibility terms before applying, since funders set their own requirements around organization type, location, and the population or project being served.
How much funding does the Novel Prediction of Recovery of Consciousness in Acute Traumatic Brain Injury provide?
Novel Prediction of Recovery of Consciousness in Acute Traumatic Brain Injury provides up to $263K per award from NINDS - National Institute of Neurological Disorders and Stroke. Actual award sizes depend on the scope of your project, available program funds, and the number of applicants, so build a budget that reflects realistic, allowable costs rather than the maximum figure.
When is the Novel Prediction of Recovery of Consciousness in Acute Traumatic Brain Injury deadline?
Applications for Novel Prediction of Recovery of Consciousness in Acute Traumatic Brain Injury are due 2028-03-31 (open). Because deadlines can change, verify the date with the funder, NINDS - National Institute of Neurological Disorders and Stroke, and give yourself enough time to prepare a complete, competitive application before the close date.
How do you apply for the Novel Prediction of Recovery of Consciousness in Acute Traumatic Brain Injury?
To apply for Novel Prediction of Recovery of Consciousness in Acute Traumatic Brain Injury, confirm your eligibility, gather the required documents, and prepare a narrative and budget that address the funder's priorities. FindGrants guides you step by step and can draft each section, then exports a submission-ready application pack for this grant from NINDS - National Institute of Neurological Disorders and Stroke.