The objective of project A (Clinical) is to apply new technology toward obtaining a continous functional neurologic assessment of afferent and efferent pathways of the comatose patient utilizing non-invasive methods. These techniques will be employed to test the hypothesis that under pathologic conditions the response of the CNS to rapid stimulation will provide a sensitive measure of synaptic impairment to accomplish this aim, we will employ sensory and non-invasive magnetic motor stimulation to determine the sensitivity and specificity of the NS response to pseudorandom stimulation trains in head injured patients. Data obtained from a proposed laboratory study using animals (Part B) will assist us in developing strategies for application of magnetic stimulation of motor pathways in head injured patients. A second cond objective is to apply novel methods employing artificial intelligence techniques to automatically grade the evoked response. This will extend our development of fully automated methods for acquiring, processing, grading and displaying the results of these measures continously in an ICU setting. The information derived from these measures can then be used as diagnostic tools, available in real time, to provide a non-invasive measure of functional CNS integrity for optimizing therapeutic management of the severely head injured, comatose patient.

Project Start
Project End
Budget Start
Budget End
Support Year
18
Fiscal Year
1993
Total Cost
Indirect Cost
Name
Virginia Commonwealth University
Department
Type
DUNS #
City
Richmond
State
VA
Country
United States
Zip Code
23298
Kleindienst, Andrea; Dunbar, Jana G; Glisson, Renee et al. (2013) The role of vasopressin V1A receptors in cytotoxic brain edema formation following brain injury. Acta Neurochir (Wien) 155:151-64
Fazzina, Giovanna; Amorini, Angela M; Marmarou, Christina R et al. (2010) The protein kinase C activator phorbol myristate acetate decreases brain edema by aquaporin 4 downregulation after middle cerebral artery occlusion in the rat. J Neurotrauma 27:453-61
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Mazzeo, Anna Teresa; Brophy, Gretchen M; Gilman, Charlotte B et al. (2009) Safety and tolerability of cyclosporin a in severe traumatic brain injury patients: results from a prospective randomized trial. J Neurotrauma 26:2195-206
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Stiefel, Michael F; Tomita, Yoshiyuki; Marmarou, Anthony (2005) Secondary ischemia impairing the restoration of ion homeostasis following traumatic brain injury. J Neurosurg 103:707-14
Stiefel, Michael F; Marmarou, Anthony (2002) Cation dysfunction associated with cerebral ischemia followed by reperfusion: a comparison of microdialysis and ion-selective electrode methods. J Neurosurg 97:97-103
Yamamoto, M; Marmarou, C R; Stiefel, M F et al. (1999) Neuroprotective effect of hypothermia on neuronal injury in diffuse traumatic brain injury coupled with hypoxia and hypotension. J Neurotrauma 16:487-500
Barzo, P; Marmarou, A; Fatouros, P et al. (1997) MRI diffusion-weighted spectroscopy of reversible and irreversible ischemic injury following closed head injury. Acta Neurochir Suppl 70:115-8
Marmarou, A; Barzo, P; Fatouros, P et al. (1997) Traumatic brain swelling in head injured patients: brain edema or vascular engorgement? Acta Neurochir Suppl 70:68-70

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