Brain’s activity, health in coma focus of WashU study

Researchers at Washington University in St. Louis are developing a new method that will help them determine the state of the brain in patients in a coma and has the potential to lead to new treatments.

ShiNung Ching, assistant professor of electrical & systems engineering in the School of Engineering & Applied Science, and Terrance Kummer, MD, assistant professor of neurology in the School of Medicine, have received a two-year, $403,625 grant from the National Institute of Neurological Disorders and Stroke of the National Institutes of Health to develop this method, termed Network Reachability Analysis (NetRA).

When a patient is in a coma, often after a traumatic brain injury (TBI), his or her brain is not functioning — its electrical activity is disrupted — which can lead to long-term disability. Physicians and researchers are looking to improve treatment and outcomes of patients, but need a better understanding of what causes coma.

"We have specific treatments for types of coma, but often struggle to identify the root cause," Kummer said. "We're hoping to better understand these causes by analyzing their electrical effects on the brain."

Ching and Kummer plan to take bedside electroencephalogram (EEG) recordings from patients diagnosed with coma in the Neurology/Neurosurgery Intensive Care Unit at Barnes-Jewish Hospital in St. Louis, then create mathematical models with their NetRA to determine the causes of the coma.

"The No. 1 priority in the ICU is to treat patients and make them better," Ching says. "In the process, we have unprecedented access to the activity that occurs in the human brain. This is a great opportunity for us to develop our methods, and hopefully, generate new insights into how the brain emerges from coma. What we're trying to do with our NetRA method is to understand the capacity of the brain to recover. In other words, after an injury, how does the brain shut itself off, can it turn back 'on,' and does this progression depend on the type of injury?"

Ching and Kummer say this work would provide greater knowledge of the brain's dynamics during coma, which may assist in diagnosis but provide new insights as well.

"We believe our development of this new EEG analysis method, NetRA, as well as our exploration of EEG as a comprehensive, quantitative diagnostic tool for coma, is highly innovative and will provide the foundation for additional lines of research," Ching said.

In addition, Ching and Kummer each received a one-year grant from the Barnes-Jewish Hospital Foundation and the Washington University Institute of Clinical and Translational Sciences Clinical and Translational Funding Program for related work. Their proposals were among the 23 funded through the program, supported by the Clinical and Translational Science Award program of the National Center for Advancing Translational Sciences (grant number UL1 TR000448), which provides members of the ICTS with funds to advance medical knowledge that can improve human health.

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