Head Injury

In head injury, we have documented fMRI connectivity in brain regions based on motor and cognitive tasks, providing endpoints that can be used as biomarkers of plasticity in interventional studies.  Rigorous evaluation of 1H MRS and diffusion tensor MRI, including test-retest reliability has been used both in healthy volunteers and TBI, with estimation of sample size in experimental medicine and Phase IIa studies. Applying monitoring of brain chemistry, oxygenation and intracranial pressure as part of standard care of patients with acute brain injury in neuro-critical care has shown relationships between monitored parameters and clinical outcome. This work continues to define the impact of specific therapy on cerebral chemistry. We have completed the NIHR-HTA funded RAIN study – a prospective validation of risk prediction models for adult patients with head injury – and applied this to evaluate the optimum location and comparative costs of neurocritical care. Data from the Trauma and Audit Research Network for 2013 show Cambridge achieving excellent performance of adjusted outcome measures. In multiple sclerosis, we have replicated our finding that serum IL-21 is a reliable biomarker for autoimmunity after alemtuzumab although not detectable using all commercially-available assays.

March 2014