NICHD is one of several federal agencies that support and conduct TBI research. The institute’s research portfolio includes projects on prevention, diagnostic and imaging tools, the biological and biochemical mechanisms of TBI, treatment methods, and therapeutic interventions. NICHD’s efforts also include research on TBI’s secondary symptoms and conditions, such as depression and reduced motor function.
Through the National Center for Medical Rehabilitation Research (NCMRR) within NICHD, the institute also helps to coordinate rehabilitation research strategies and activities, including efforts related to TBI, across NIH and other HHS agencies. The Pediatric Trauma and Critical Illness Branch (PTCIB), within NICHD’s Division of Extramural Research, supports research on the care of children with mild to life-threatening TBI across the continuum of care.
NICHD has a long history of supporting and conducting research on TBI, from mild forms to severe TBI-related disabilities, and on rehabilitation and recovery from TBI. Some of NICHD’s research goals related to TBI include:
- Exploring how certain proteins and enzymes are involved in brain injury and how certain genes may play a role in neural recovery
- Understanding the progression of and recovery from brain injury over time
- Improving diagnostic methods and tools to help identify TBI faster so that treatment can begin sooner
- Developing pharmacological treatments and other therapies to enhance recovery
- Mitigating risk for and treating secondary conditions associated with TBI, such as depression
- Addressing issues unique to specific groups, such as determining safe drug therapies for children with TBI and adapting TBI treatments for military personnel
- Developing methods and technologies for effectively measuring head impacts in sports, combat, and other settings
- Evaluating how individuals, families, and communities can best adapt to injuries and promote recovery
TBI can cause short- and long-term physical, cognitive, and emotional problems and is a leading cause of death and disability in children and adults. Understanding the full spectrum of TBI, its short- and long-term effects, and ways to treat or minimize those effects is an active area of research for NICHD.
Institute Activities and Advances
NICHD’s portfolio includes research to understand the mechanisms of TBI, improve prevention and diagnosis of TBI, evaluate treatments for TBI patients, and address secondary conditions of TBI, including its emotional and psychosocial effects.
TBI-related research falls into the purview of several NICHD components, each with a slightly different focus. A large portion of NICHD research on TBI is supported through the National Center for Medical Rehabilitation Research (NCMRR). In addition to its focus on understanding the mechanisms of injury and evaluating rehabilitation methods, NCMRR also helps coordinate rehabilitation research and activities across NIH.
The Pediatric Trauma and Critical Illness Branch (PTCIB), within NICHD’s Division of Extramural Research, supports research on care of children with mild to life-threatening TBI across the continuum of care, from pre-hospital to emergency care and in pediatric intensive care units.
Within the Division of Intramural Research (DIR), the Section on Quantitative Imaging and Tissue Sciences studies ways to evaluate TBI using imaging technology. Section researchers explore the microstructure and architectural organization of the brain to promote understanding of TBI mechanisms and possible interventions. The section also invents, develops, and implements novel quantitative in vivo methods for imaging tissues and organs. For more information about this work, read the section’s description in the DIR’s 2019 annual report.
Through these and other components and investigator-initiated projects, NICHD research on TBI has found that:
- Monitoring the brain’s electrical activity offers a way to identify children with TBI who are likely to suffer progressive brain damage.
- Anger self-management therapy helped TBI patients manage some aspects of problematic anger. (PMID: 28520666)
- The antidepressant sertraline was not superior to placebo for major depressive disorder in people with post-acute, complicated, mild to severe TBI. (PMID: 28520672)
- Mild TBI was associated with increased utilization of mental health services, but most of the services were received by children with previous mental health disorders. (PMID: 28159872)
- A biomarker in blood may help predict recovery time for sports concussions.
- People who had a TBI before age 25 were more than twice as likely to later be hospitalized for a psychiatric illness and were more likely to die prematurely than those who did not have a TBI before age 25. (PMID: 27552147)
- Women and girls with a concussion are more likely than men and boys with a concussion to also have a neck injury, according to an analysis of emergency department visits.
- One-third of children who suffered a concussion experienced symptoms such as headache, irritability, and fatigue up to a year later.
- Light can be used to measure activity in tissues like the brain.
- People with traumatic brain injuries are more susceptible to bone loss and bone fractures. (PMID: 30658394)
- PTCIB supports a portfolio of research on preventing, treating, and reducing all forms of child abuse, trauma, injury, and critical illness.
- NICHD-supported researchers developed a new blood test that can help identify bleeding in the infant brain.
- NICHD-supported researchers found that among children ages 8 to 12 years, those using booster seats were less likely to be injured in car crashes. (PMID: 28427953)
- Some preterm infants produce a substance that protects against brain injury.
- There are features from the flow of blood within the brain’s prefrontal cortex that are promising biomarkers in classifying subjects with TBI. (PMID: 27843695)
- Classifying TBI patients by their risk of rehospitalization can help anticipate and manage their healthcare needs over time.(PMID: 28115070)
- A dose of fentanyl and midazolam were unable to reduce episodic intracranial hypertension in severe pediatric TBI. (PMID: 26757162)
- Studies of motor learning-related changes in the brain can help advance the efficacy of neurorehabilitation. (PMID: 28137969)
- NIH study finds no significant link between brain injury and intravenous fluid treatment of pediatric diabetic ketoacidosis.
- Total healthcare costs related to mild TBI were higher for rural than urban children despite lower use of some health services. (PMID: 30507042)
Other Activities and Advances
- NICHD collaborated with leaders at NIH and other agencies to improve outcomes for people with TBI. The institute played a key role in the 1998 Consensus Development Conference on the Rehabilitation of Persons with Traumatic Brain Injury. In 2011, NICHD scientists were appointed to a blue-ribbon panel established to review medical rehabilitation research at NIH and identify promising research opportunities.
- The institute, through its Section on Quantitative Imaging and Tissue Sciences, is participating in a Center for Neuroscience and Regenerative Medicine (now the Military Traumatic Brain Injury Initiative) project to improve the accuracy and reproducibility of findings using diffusion tensor imaging in TBI research.
- The Medical Rehabilitation Research Resource Network is made up of six resource centers nationwide whose mission is to support rehabilitation researchers.
- In 2013, PTCIB held a workshop on abusive head trauma that built on a previous meeting held in 2002. Also in 2013, PTCIB and other guests participated in a podcast on preventing shaken baby syndrome.
- Learn more about NICHD-funded prevention projects, including TBI projects.