Speaker: Neurosurgeons can help usher in new era for TBI
SAN DIEGO — Neurosurgeons need to play a prominent role in traumatic brain injury research and treatment, according to a speaker at the Congress of Neurological Surgeons Annual Meeting, here.
Traumatic brain injury (TBI) is a major public health problem that is expanding due to sports-related and recreation-related concussion, military service personnel who have suffered mild TBIs during duty and elderly people with fall-related TBIs, Geoffrey Manley, MD, PhD, said.
“Besides back pain, it is the most common thing we see in our field,” Manley, who is at University of California, San Francisco (UCSF), said.
What makes this area more critical than ever and worthy of attention are the new connections that have been found between TBI and Alzheimer’s disease, post-traumatic epilepsy, Parkinson’s disease and chronic traumatic encephalopathy, he noted.
Traumatic brain injury today is treated similarly to how it was treated 100 years ago, with basically unchanged grading and outcomes scores and little treatment progress in this area, according to Manley.
“The bar is low. We have an opportunity to make a difference” and usher in a new era for brain injury, he said.
That new era may involve changes such as using MRI instead of CT, diagnosing TBI with proteomes and possibly using genomic findings to develop targeted treatments for patients in a manner similar to what is done in cancer treatment.
Manley discussed the Track-TBI study, a prospective, longitudinal precision medicine study based at UCSF, with which he is involved. It now includes 13 sites and more than 75 investigators and has enrolled 1,707 participants across the full spectrum of TBI to date. The intent is to enroll 3,000 participants, including controls, and follow their outcomes long term.
“The goals are to improve the diagnosis and classification. We need better ways to describe these people if [we] want targeted treatments,” Manley said.
He said a partnership is also underway with private organizations that have a stake in better TBI diagnosis and treatment. These include imaging and diagnostic companies, for example, as well as academic partners.
“We need to come together,” Manley said. – by Susan M. Rapp
Manley G. Paper #110. Presented at: Congress of Neurological Surgeons Annual Meeting; Sept. 24-28, 2016; San Diego.
Disclosure: Manley reports no relevant financial disclosures.