Traumatic brain injury: progress and challenges in prevention, clinical care, and research

doi:10.1016/S1474-4422(22)00309-X

Traumatic brain injury: progress and challenges in prevention, clinical care, and research

Ben-Gurion University of the Negev, Technion - Israel Institute of Technology

Research output: Contribution to journal › Review article › peer-review

Abstract

Traumatic brain injury (TBI) has the highest incidence of all common neurological disorders, and poses a substantial public health burden. TBI is increasingly documented not only as an acute condition but also as a chronic disease with long-term consequences, including an increased risk of late-onset neurodegeneration. The first Lancet Neurology Commission on TBI, published in 2017, called for a concerted effort to tackle the global health problem posed by TBI. Since then, funding agencies have supported research both in high-income countries (HICs) and in low-income and middle-income countries (LMICs).

Original language	American English
Pages (from-to)	1004-1060
Number of pages	57
Journal	The Lancet Neurology
Volume	21
Issue number	11
DOIs	https://doi.org/10.1016/S1474-4422(22)00309-X
State	Published - 1 Nov 2022

All Science Journal Classification (ASJC) codes

Clinical Neurology

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10.1016/S1474-4422(22)00309-X

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@article{16fbcb843ead4b3cb2bf1abe3830f25f,

title = "Traumatic brain injury: progress and challenges in prevention, clinical care, and research",

abstract = "Traumatic brain injury (TBI) has the highest incidence of all common neurological disorders, and poses a substantial public health burden. TBI is increasingly documented not only as an acute condition but also as a chronic disease with long-term consequences, including an increased risk of late-onset neurodegeneration. The first Lancet Neurology Commission on TBI, published in 2017, called for a concerted effort to tackle the global health problem posed by TBI. Since then, funding agencies have supported research both in high-income countries (HICs) and in low-income and middle-income countries (LMICs).",

author = "Maas, {Andrew I.R.} and Menon, {David K.} and Manley, {Geoffrey T.} and Mathew Abrams and Cecilia {\AA}kerlund and Nada Andelic and Marcel Aries and Tom Bashford and Bell, {Michael J.} and Bodien, {Yelena G.} and Brett, {Benjamin L.} and Andr{\'a}s B{\"u}ki and Chesnut, {Randall M.} and Giuseppe Citerio and David Clark and Betony Clasby and Cooper, {D. Jamie} and Endre Czeiter and Marek Czosnyka and Kristen Dams-O'Connor and {De Keyser}, V{\'e}ronique and Ramon Diaz-Arrastia and Ari Ercole and {Van Essen}, {Thomas A.} and Eanna Falvey and Ferguson, {Adam R.} and Anthony Figaji and Melinda Fitzgerald and Brandon Foreman and Dashiell Gantner and Guoyi Gao and Joseph Giacino and Benjamin Gravesteijn and Fabian Guiza and Deepak Gupta and Mark Gurnell and Haagsma, {Juanita A.} and Hammond, {Flora M.} and Gregory Hawryluk and Peter Hutchinson and {Van Der Jagt}, Mathieu and Sonia Jain and Swati Jain and Jiang, {Ji Yao} and Hope Kent and Angelos Kolias and Kompanje, {Erwin J.O.} and Fiona Lecky and Or Duek and Isaac Lazar and Lingsma, {Hester F.} and Menashe Zaaroor",

note = "Funding Information: We are enormously grateful to our patients with traumatic brain injury—the Commission's most important stakeholders, who have shared their experiences with us and taught us so much. We are deeply indebted to all researchers and study personnel not included in the author list or in the Group contributor list, who contributed to the data collection for the studies reported in this Commission. We acknowledge the support provided by the funding agencies joined in the InTBIR initiative: the Canadian Institutes of Health Research, the European Commission, the US National Institutes of Health-National Institute of Neurological Disorders and Stroke, One Mind, and the US Department of Defense. The Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) project received additional support from NeuroTrauma Sciences, USA; the Hannelore Kohl Stiftung, Germany; and Integra Life Sciences, USA. Synergistic funding for the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study was obtained through the TBI Endpoints Development award from the US Department of Defense. Additionally, DKM was supported through a Senior Investigator Award and funding for the Cambridge Biomedical Research Centre from the UK National Institute for Health and Care Research. Funding Information: No funding was provided specifically for this Commission paper; however, most authors are involved in the International Initiative for Traumatic Brain Injury Research (InTBIR) as a scientific participant or an investigator. This Commission would not have been possible without the indirect facilitation provided by the InTBIR network. AIRM declares consulting fees from PresSura Neuro, Integra Life Sciences, and NeuroTrauma Sciences. DKM reports research support, and educational and consulting fees from Lantmannen AB, GlaxoSmithKline, Calico, PresSura Neuro, NeuroTrauma Sciences, and Integra Neurosciences. GTM declares grants from the US National Institutes of Health-National Institute of Neurological Disorders and Stroke (grant U01NS086090), the US Department of Defense (grant W81XWH-14-2-0176, grant W81XWH-18-2-0042, and contract W81XWH-15-9-0001). MC reports licensing fees for ICM+ software from Cambridge Enterprise and was an honorary (unpaid) director for Medicam. PS reports licensing fees for ICM+ software from Cambridge Enterprise. MBS has in the past 3 years received consulting income from Acadia Pharmaceuticals, Aptinyx, atai Life Sciences, Boehringer Ingelheim, Bionomics, BioXcel Therapeutics, Clexio, Eisai, EmpowerPharm, Engrail Therapeutics, Janssen, Jazz Pharmaceuticals, and Roche/Genentech. MBS also has stock options in Oxeia Biopharmaceuticals and EpiVario and is paid for editorial work on Depression and Anxiety (Editor-in-Chief), Biological Psychiatry (Deputy Editor), and UpToDate (Co-Editor-in-Chief for Psychiatry). KKWW holds stock options in Gryphon Bio. All other authors declare no competing interests. Funding Information: Since publication of the 2017 Commission, much has changed in the field of TBI. Studies have provided new data on epidemiology and casemix of TBI in the hospital setting, and new insights regarding the effects of systems of care on TBI management and outcome. Clinical care has been informed by the results of a substantial body of research since that Commission, much of which was supported by the International TBI Research (InTBIR) initiative, a coalition of major funding bodies that came together in 2011 to support neurotrauma research. 4,5 Although there have been advances in the characterisation of TBI with the use of advanced neuroimaging, blood biomarkers, and genomics, these advances have not yet been fully translated into clinical care. However, there is increasing evidence that these advances will facilitate identification of patients with TBI who share specific disease mechanisms, treatment response characteristics, or prognosis, thus providing a basis for individualised management. Progress has also occurred in the prediction and characterisation of outcome following TBI, and although these advances are still being developed in research settings, their clinical application will likely occur over the next few years. Challenges remain, particularly in low-income and middle-income countries (LMICs), relating to prevention of TBI, access to care, and provision of clinical guidelines that can be implemented in resource-limited contexts. It is also crucial that we ensure equitable integration of researchers from LMICs in neurotrauma research. Disparities in care provision have also been identified in high-income countries (HICs). In the research context, developments both within the TBI field and insights into novel approaches to trial design from the COVID-19 pandemic have highlighted exciting new approaches and opportunities for generating evidence to support clinical care. Many of these new approaches are dependent on collaborative research and data-sharing, a process that can be constrained by regulatory requirements and facilitated by novel data analysis techniques.",

year = "2022",

month = nov,

day = "1",

doi = "10.1016/S1474-4422(22)00309-X",

language = "American English",

volume = "21",

pages = "1004--1060",

journal = "The Lancet Neurology",

issn = "1474-4422",

publisher = "Elsevier Ltd.",

number = "11",

}

TY - JOUR

T1 - Traumatic brain injury

T2 - progress and challenges in prevention, clinical care, and research

AU - Maas, Andrew I.R.

AU - Menon, David K.

AU - Manley, Geoffrey T.

AU - Abrams, Mathew

AU - Åkerlund, Cecilia

AU - Andelic, Nada

AU - Aries, Marcel

AU - Bashford, Tom

AU - Bell, Michael J.

AU - Bodien, Yelena G.

AU - Brett, Benjamin L.

AU - Büki, András

AU - Chesnut, Randall M.

AU - Citerio, Giuseppe

AU - Clark, David

AU - Clasby, Betony

AU - Cooper, D. Jamie

AU - Czeiter, Endre

AU - Czosnyka, Marek

AU - Dams-O'Connor, Kristen

AU - De Keyser, Véronique

AU - Diaz-Arrastia, Ramon

AU - Ercole, Ari

AU - Van Essen, Thomas A.

AU - Falvey, Eanna

AU - Ferguson, Adam R.

AU - Figaji, Anthony

AU - Fitzgerald, Melinda

AU - Foreman, Brandon

AU - Gantner, Dashiell

AU - Gao, Guoyi

AU - Giacino, Joseph

AU - Gravesteijn, Benjamin

AU - Guiza, Fabian

AU - Gupta, Deepak

AU - Gurnell, Mark

AU - Haagsma, Juanita A.

AU - Hammond, Flora M.

AU - Hawryluk, Gregory

AU - Hutchinson, Peter

AU - Van Der Jagt, Mathieu

AU - Jain, Sonia

AU - Jain, Swati

AU - Jiang, Ji Yao

AU - Kent, Hope

AU - Kolias, Angelos

AU - Kompanje, Erwin J.O.

AU - Lecky, Fiona

AU - Duek, Or

AU - Lazar, Isaac

AU - Lingsma, Hester F.

AU - Zaaroor, Menashe

N1 - Funding Information: We are enormously grateful to our patients with traumatic brain injury—the Commission's most important stakeholders, who have shared their experiences with us and taught us so much. We are deeply indebted to all researchers and study personnel not included in the author list or in the Group contributor list, who contributed to the data collection for the studies reported in this Commission. We acknowledge the support provided by the funding agencies joined in the InTBIR initiative: the Canadian Institutes of Health Research, the European Commission, the US National Institutes of Health-National Institute of Neurological Disorders and Stroke, One Mind, and the US Department of Defense. The Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) project received additional support from NeuroTrauma Sciences, USA; the Hannelore Kohl Stiftung, Germany; and Integra Life Sciences, USA. Synergistic funding for the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study was obtained through the TBI Endpoints Development award from the US Department of Defense. Additionally, DKM was supported through a Senior Investigator Award and funding for the Cambridge Biomedical Research Centre from the UK National Institute for Health and Care Research. Funding Information: No funding was provided specifically for this Commission paper; however, most authors are involved in the International Initiative for Traumatic Brain Injury Research (InTBIR) as a scientific participant or an investigator. This Commission would not have been possible without the indirect facilitation provided by the InTBIR network. AIRM declares consulting fees from PresSura Neuro, Integra Life Sciences, and NeuroTrauma Sciences. DKM reports research support, and educational and consulting fees from Lantmannen AB, GlaxoSmithKline, Calico, PresSura Neuro, NeuroTrauma Sciences, and Integra Neurosciences. GTM declares grants from the US National Institutes of Health-National Institute of Neurological Disorders and Stroke (grant U01NS086090), the US Department of Defense (grant W81XWH-14-2-0176, grant W81XWH-18-2-0042, and contract W81XWH-15-9-0001). MC reports licensing fees for ICM+ software from Cambridge Enterprise and was an honorary (unpaid) director for Medicam. PS reports licensing fees for ICM+ software from Cambridge Enterprise. MBS has in the past 3 years received consulting income from Acadia Pharmaceuticals, Aptinyx, atai Life Sciences, Boehringer Ingelheim, Bionomics, BioXcel Therapeutics, Clexio, Eisai, EmpowerPharm, Engrail Therapeutics, Janssen, Jazz Pharmaceuticals, and Roche/Genentech. MBS also has stock options in Oxeia Biopharmaceuticals and EpiVario and is paid for editorial work on Depression and Anxiety (Editor-in-Chief), Biological Psychiatry (Deputy Editor), and UpToDate (Co-Editor-in-Chief for Psychiatry). KKWW holds stock options in Gryphon Bio. All other authors declare no competing interests. Funding Information: Since publication of the 2017 Commission, much has changed in the field of TBI. Studies have provided new data on epidemiology and casemix of TBI in the hospital setting, and new insights regarding the effects of systems of care on TBI management and outcome. Clinical care has been informed by the results of a substantial body of research since that Commission, much of which was supported by the International TBI Research (InTBIR) initiative, a coalition of major funding bodies that came together in 2011 to support neurotrauma research. 4,5 Although there have been advances in the characterisation of TBI with the use of advanced neuroimaging, blood biomarkers, and genomics, these advances have not yet been fully translated into clinical care. However, there is increasing evidence that these advances will facilitate identification of patients with TBI who share specific disease mechanisms, treatment response characteristics, or prognosis, thus providing a basis for individualised management. Progress has also occurred in the prediction and characterisation of outcome following TBI, and although these advances are still being developed in research settings, their clinical application will likely occur over the next few years. Challenges remain, particularly in low-income and middle-income countries (LMICs), relating to prevention of TBI, access to care, and provision of clinical guidelines that can be implemented in resource-limited contexts. It is also crucial that we ensure equitable integration of researchers from LMICs in neurotrauma research. Disparities in care provision have also been identified in high-income countries (HICs). In the research context, developments both within the TBI field and insights into novel approaches to trial design from the COVID-19 pandemic have highlighted exciting new approaches and opportunities for generating evidence to support clinical care. Many of these new approaches are dependent on collaborative research and data-sharing, a process that can be constrained by regulatory requirements and facilitated by novel data analysis techniques.

PY - 2022/11/1

Y1 - 2022/11/1

N2 - Traumatic brain injury (TBI) has the highest incidence of all common neurological disorders, and poses a substantial public health burden. TBI is increasingly documented not only as an acute condition but also as a chronic disease with long-term consequences, including an increased risk of late-onset neurodegeneration. The first Lancet Neurology Commission on TBI, published in 2017, called for a concerted effort to tackle the global health problem posed by TBI. Since then, funding agencies have supported research both in high-income countries (HICs) and in low-income and middle-income countries (LMICs).

AB - Traumatic brain injury (TBI) has the highest incidence of all common neurological disorders, and poses a substantial public health burden. TBI is increasingly documented not only as an acute condition but also as a chronic disease with long-term consequences, including an increased risk of late-onset neurodegeneration. The first Lancet Neurology Commission on TBI, published in 2017, called for a concerted effort to tackle the global health problem posed by TBI. Since then, funding agencies have supported research both in high-income countries (HICs) and in low-income and middle-income countries (LMICs).

UR - http://www.scopus.com/inward/record.url?scp=85140080624&partnerID=8YFLogxK

U2 - 10.1016/S1474-4422(22)00309-X

DO - 10.1016/S1474-4422(22)00309-X

M3 - Review article

C2 - 36183712

SN - 1474-4422

VL - 21

SP - 1004

EP - 1060

JO - The Lancet Neurology

JF - The Lancet Neurology

IS - 11

ER -

Traumatic brain injury: progress and challenges in prevention, clinical care, and research

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