Traumatic Brain Injury Model Systems (TBIMS)

Traumatic Brain Injury Model Systems (TBIMS)

Department of Health and Human Services
National Institute on Disability, Independent Living, and Rehabilitation Research

TBIMS is a multi-center collaborative project which aims to monitor and improve long term outcomes for individuals with traumatic brain injury through enrollment of survivors into a national database, multi-center “modular” projects, and several single center studies. TBIMS research is responsible for almost 500 peer-reviewed publications and has facilitated the development of TBI medical care guidelines, comprehensive diagnostic procedures, rehabilitation approaches, and more. Within the 16 TBIMS centers throughout the nation, exceptional rehabilitation additionally serves to improve injury treatment and outcomes for future patients.

The Spaulding-Harvard System was selected by the National Institute of Disability, Independent Living, and Rehabilitation Research (NIDILRR) to receive federal funding as a Traumatic Brain Injury Model System. Spaulding has become a national leader in TBI research and rehabilitation under the Model Systems program as a result of excellent clinical care, research contributions, and educational efforts. Led by Dr. Joseph T. Giacino, the Spaudling-Harvard TBIMS team continues to develop the Disorders of Consciousness (DoC) program for individualized care and strive towards improving patient rehabilitation through a numerous research projects.

These projects include:

  • Map-USA-statesEnrolling patients into the TBIMS National Database for collaborative data-mining and retrospective analysis

  • TBIMS Multicenter Modular Projects

    • “Internet Use and Online Social Participation among Individuals with TBI”
    • “Cognitive Testing (BTACT) in the TBI Model Systems”
    • “Statins and Outcome After TBI: An Observational Study”
    • “Development of an Extended Measure of Global Function to Support Clinical Trials Originating in Acute Rehabilitation”
    • “Understanding Cause of Death in the TBI Model Systems”
  • Spaulding-Harvard Site Specific Study

“Looking for Consciousness: A Novel Functional Neuroimaging Approach for Detection of Visual Cognition in Patients with Severe TBI and Disorders of Consciousness

3 to 4 in 10 persons with an acquired brain injury who are believed to be unconscious on bedside examination actually retain conscious awareness. Behavioral signs, considered the “gold standard” in the evaluation of level of consciousness, are often misleading as it is difficult to differentiate volitional from random behavior. Underlying sensory, motor, language and cognitive impairments frequently constrain behavioral responses and may contribute further to false negative judgments of consciousness. A growing literature suggests that neuroimaging, specifically functional magnetic resonance imaging (fMRI), techniques DrGteaching2LRmay be employed to investigate cognition in severely brain-injured individuals who lack the capacity for speech and active movement. In previous research, instead of asking the person to follow commands involving physical movement (i.e. “Move your hand” or “Say your name”), the person was asked to perform a cognitive task (i.e. “Imagine playing tennis” or “Silently, say the name of this object to yourself”). Neuroimaging is then used to determine if the cognitive tasks are being performed.

The objective of this study is to develop and test novel visually-based fMRI paradigms designed to covertly detect language comprehension and communication ability in healthy volunteers and patients diagnosed with the vegetative (VS), minimally conscious states (MCS), and post traumatic confusional state (PTCS).

For more information about the Spaulding-Harvard TBI Model System, please contact Joseph Ostrow at (617) 952-6305 or jostrow@partners.org.