Current Projects

Trauma Outcomes Registry at Children’s Healthcare of Atlanta (TORCH)

Much of the management of TBI in children revolves around imaging and neurological examinations, and currently, there are no blood-based lab tests that can assist in diagnosing and treating TBIs in children. TORCH aims to reduce this gap by correlating the initial levels and trajectory of blood-based biomarkers within weeks of TBI-onset with the severity of brain injury in pediatric patients. Additionally, we aim to test the predictive value of blood-based biomarkers on functional outcomes within 12 months after pediatric TBI. This study involves the creation of the Trauma Outcome Registry or Biorepository at CHOA to integrate clinical, imaging, proteomic, genomic, and outcome biomarkers from subjects across the age and injury spectra providing analytic tools and resources to support current and future TBI research. 

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Transforming Research and Clinical Knowledge in TBI (TRACK-TBI)

PNL is collaborating with Track-TBI as one of their primary pediatric enrolling sites. Track-TBI has enrolled over 3.000 TBI patients across the injury spectra collecting neuroimaging, blood biospecimen, and clinical outcome assessments to advance basic and clinical science of TBI. The data collected will improve TBI classification, TBI outcome assessments, and create a database providing analytic tools and resources to support TBI research. Please see the Track-TBI website for additional information. Transforming Research and Clinical Knowledge in TBI | TRACK-TBI

GNIOS

This project is an international multi-center evaluation of surgical care and clinical outcomes for patients with central nervous system infections (CNS). We are one of many sites across the world collecting data on these patients. The primary objective is to describe the profile of patients presenting with CNS infections who require neurosurgical management across a wide range of geographic and socio-economic environments (including patient demographics, baseline clinical characteristics, indications for surgery, surgical procedure, radiology, and microbiological diagnosis).

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Four graphs showing plasma OPN and S100B concentrations across TBI severity groups at admission and over 72 hours.

Osteopontin as a Blood Biomarker in Severe Pediatric Traumatic Brain Injury

Current TBI management relies heavily on imaging and physical exams, which often lack the granularity to monitor real-time injury progression. This project investigates the use of blood-based biomarkers, specifically OPN, GFAP, and UCH-L1, to provide a more precise window into brain recovery. By testing the predictive value of plasma OPN and correlating biomarker levels within 72 hours of injury, we aim to assess the clinical severity and progression of pediatric TBI and develop laboratory tools that assist in acute triage, guide surgical interventions, and refine 6-month rehabilitation plans.

An Investigation of Pediatric Brain and Spinal Gunshot Wounds

This retrospective chart review study hopes to obtain clinical, laboratory and radiographic data to identify predictors of favorable clinical outcome in the pediatric intracranial and spinal gunshot wound population. We also aim to identify predictive clinical and radiographic data, epidemiologic trends and other data that would allow better management moving forward with pediatric brain and spinal gunshot wound treatment.

Line graph showing a rising monthly rate of firearm-related injury patients per 1,000 trauma visits from 2014 to 2023.
Four graphs showing plasma OPN and S100B concentrations across TBI severity groups at admission and over 72 hours.

Osteopontin as a Blood Biomarker for Neonatal Hypoxic Ischemic Encephalopathy

The current study is designed to collect preliminary data characterizing the association between concentrations of OPN in the blood and outcomes in neonates with HIE. Identification of biomarkers of brain injury in neonates will have several important future clinical applications: 1) to stratify patients by the severity of their HIE; 2) to better monitor the progression of brain injury-induced pathology and recovery; 3) to monitor the effects of therapy/intervention; and 4) to predict outcome more accurately after HIE. Our primary aims are as following: 1) Identify and address roadblocks to studying novel biomarkers in neonates with encephalopathy undergoing therapeutic hypothermia and 2) evaluate OPN in the pilot cohort as a potential blood biomarker for identifying brain injury and detecting infants that need adjuvant neuroprotective therapies.

Saliva Biomarkers for Pediatric Mild Traumatic Brain Injury

Diagnosing concussions in children often relies on subjective symptom reporting. This research aims to create a non-invasive "saliva test" for concussions, helping clinicians predict which children are at risk for a protracted recovery and requiring specialized follow-up. This project utilizes cutting-edge RNA analysis and mass spectrometry to identify objective biomarkers within saliva that can quickly diagnose mild TBI (mTBI) in the emergency department.

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