Update from Dr. Parikh 2/13/24
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On behalf of the R Adams Cowley Shock Trauma Center at the University of Maryland, I would like to thank you for your ongoing dedication to supporting our Neurocritical Care research program.
Over the past year we have made great progress in enrolling patients into several important studies including REACH (Recovery after Cerebral Hemorrhage), DISCOVERY (Determinants of Incident Stroke Cognitive Outcomes and Vascular Effects on RecoverY), RAISE (Randomized Therapy in Status Epilepticus), and we are launching as a site for the REACH-ICH study (Race/Ethnicity, Hypertension, and Prevention of VCID After Intracerebral Hemorrhage). Your contributions will enable us to continue to scale up our efforts in offering University of Maryland neurocritical care patients the option to be involved in multiple cutting-edge clinical trials and epidemiologic studies.
One new project I would like to highlight centers on improving our ability to detect signs of consciousness in ICU patients who are recovering from hemorrhagic stroke or brain injury. Prior studies have shown that a small proportion of patients who are unresponsive on standard bedside examinations, actually retain some degree of conscious awareness. Failure to detect signs of conscious awareness while in the hospital may limit access to rehabilitation services. We explored the safety and feasibility of mobilizing patients in a prolonged coma guided by the use of the JFK Coma Recovery Scale in the Neuro ICU. We were able to show that with a highly trained multidisciplinary team and a focus on restoring function, it is feasible and safe to deliver early neurorehabilitation to patients in a prolonged coma in the intensive care setting including vestibular and other stimulation therapies and may enhance access to inpatient rehabilitation to a particularly vulnerable patient population by improving our ability to demonstrate subtle signs of conscious awareness.
2/11/22 Video from Dr. Parikh
Update Information 3/2/21
Dr. Parikh has been conducting research in patients with both traumatic and non-traumatic brain injury and stroke. Here’s a recent editorial in which, Dr. Gunjan Parikh I was quoted regarding the Neurocritical Care Society’s Curing Coma Campaign: https://journals.lww.com/neurotodayonline/pages/articleviewer.aspx?year=2020&issue=10080&article=00005&type=Fulltext
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Also, we were just approved to begin enrolling patients here at U Maryland into the following important NIH-sponsored $39M study led by Mass General Hospital for which I am a clinical performance site investigator—DISCOVERY:
Update Information12/5/20
Research has been very limited, but we’ve been able to ramp up our enrollment into clinical trials in the last month or so. Also, I’m now one of two Maryland site investigators for a NIH-funded study “DISCOVERY” led by our colleagues in Massachusetts General Hospital. We’re just getting started with enrollment next week, and this study will yield results in 4-5 years after analysis of data from thousands of stroke patients is completed. Discoverystudy.org is the study website (the link doesn’t seem to be working today however). Here you will also find information on a grand initiative by our Neurocritical Care Society and my comments are in the latter half of this NeurologyToday article: https://journals.lww.com/neurotodayonline/pages/articleviewer.aspx?year=2020&issue=10080&article=00005&type=Fulltext .
As for research on traumatic brain injury, the NIH group I worked with several years ago continues to publish interesting, novel findings (here’s one: https://academic.oup.com/braincomms/article/2/2/fcaa143/5903386 ). In addition, I continue to work in Dr. Badjatia’s tbi research group whose central aim is to leverage continuous vital sign waveform data using novel ‘Big Data’ strategies to predict early on which tbi patients are at higher risk of experiencing neurologic decline during the first week of their ICU stay. The long term goal of this work is to create an early neurologic warning system that helps alert and guide clinicians at the bedside.
Message from Dr. Parikh night of Bull Roast February 14, 2020
Good Evening,
Thank you for the opportunity to say a few words during this wonderful annual gathering in memory of Kevin Temple.
Worldwide, more than 50 million people have a traumatic brain injury like Kevin’s each year, and it is estimated that half the world’s population will sustain one or more traumatic brain injuries over their lifetime. We have made astonishing advances in injury care over the past 20 years, allowing us to repair the most serious wounds. However, traumatic brain injury remains a major cause of death and disability. In order to unlock the mysteries of complex neurological disorders like traumatic brain injury, there is no substitute for studying human brain tissue.
Brain donation is important, now more than ever, as powerful new technologies allow researchers to examine microscopic changes that were previously undetectable. For example, two recent studies from the Center for Neuroscience and Regenerative Medicine, showed that military members exposed to blast injury and civilians exhibit distinct patterns of scarring that could account for the neuropsychiatric symptoms of TBI. We will similarly examine the true pattern of injury to axons and small blood vessels near the surface of the brain and through the brainstem—an area responsible for consciousness.
Each donated brain is a precious resource in neuroscience, with the potential to provide tissue to many scientists and help reach the next level of scientific breakthroughs. Yet, relative to donations of other organs for transplantation and research, brain donation is rare, which is what made your generosity and courage so remarkable. The more brain tissue is available for research, the faster science will advance toward a better understanding of how best to prevent, diagnose, and treat traumatic brain injury.
I am personally grateful to the Temple family for allowing us to advance our research program in its earliest stages. I hope that your family finds comfort in knowing that life-saving discoveries made possible by Kevin's tissue donation will provide hope for families affected by brain disease and will help to improve many lives in the future.
On behalf of the R Adams Cowley Shock Trauma Center at the University of Maryland, I would like to thank you for your dedication to supporting our Neurotrauma research program. I know your decision turned a mournful time into a source of comfort knowing that donation may turn sickness and injury into a second chance at life for others who will come through the doors of one of the busiest trauma centers in the United States.
Brain Donation Program
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“Brain donation is a valuable contribution to medical research, especially dealing with traumatic brain injury (TBI). Effective treatment of traumatic brain injury (TBI) remains one of the greatest unmet needs in public health. Each year in the United States, at least 1.7 million people suffer TBI; it is a contributing factor in a third of all injury-related US deaths. An estimated 3.2 to 5.3 million people live with the long-term physical, cognitive, and psychological health disabilities of TBI, with annual direct and indirect costs estimated at over $60 billion. Unfortunately, little is known about how the brain is damaged following a TBI. Through the gift of brain donation scientists will be able to conduct research on many aspects of TBI. By donating you are providing a gift to people who may suffer a TBI now and in the future.”
In addition here’s a link which explains the urgent need for brain donation across all neurologic diseases:
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https://neurobiobank.nih.gov/donors-research-discoveries/
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