TRACK-TBI Epileptogenesis Project
Abstract
Background: Post-traumatic epilepsy (PTE) is a common complication of traumatic brain injury (TBI), occurring in up to 20% of civilian patients and as many as 50% of military Service members who suffer severe brain trauma, and 3%-5% of those who suffer moderate TBI. Epilepsy resulting from brain trauma is often difficult to control with medical therapy and is the cause of epilepsy in approximately 5% of patients referred to specialized epilepsy centers. PTE can be the result of TBI of any severity, although the risk is much higher from severe TBI. PTE is often associated with cognitive and behavioral problems, which can be just as disabling as the seizures. This proposed longitudinal observational study is part of the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) initiative, a multi-institutional study funded by the National Institute of Neurological Disorders and Stroke and the Department of Defense (DoD) (RC2 NS069409, 2010-2011; U01 NS086090, 2013 – 2019; W81XWH-14-0176, 2014 - 2019) designed to characterize the acute and longer-term clinical, neuroimaging, and blood biomarker features of TBI. To date, TRACK-TBI has enrolled 2800 subjects with TBI at 18 Level 1 Trauma Centers in the US, across the age and injury spectrum. While TRACK-TBI collects detailed phenotypic information about the acute injury and hospital course, information about PTE is limited to a screening questionnaire administered at 6 and 12 months after injury. We propose to extend the follow-up period for TRACK-TBI participants from 1 year to 5 years. In addition, the follow-up period for a TRACK-TBI affiliated DoD-funded study, Spreading Depression-2 (SD-2), which complements TRACK-TBI by focusing on the most severe forms of TBI, will be extended from 6 months to 2 years. The proposed TRACK-TBI Epileptogenesis Project (TRACK-TBI EPI) is tightly aligned with several of the Fiscal Year 2018 Epilepsy Research Program Longitudinal Risk Factors Focus Areas. The proposed TRACK-TBI EPI study will: • Prospectively collect data regarding frequency and severity of late post-traumatic seizures, including the responsiveness of seizures to anti-epileptic treatment. • Prospectively collect data on co-morbidities of PTE, including depression, anxiety, headaches, memory problems, functional deficits, sleep disorders, and other major illnesses. • Prospectively collect data on latency between injury and PTE. The median duration from injury to onset of seizures is approximately 1 year, but there is a long tail. The ability to prospectively collect information up to 5 years after injury represents an opportunity unique to TRACK-TBI EPI. • Prospectively collect data on the association between PTE and mortality after TBI. Existing data indicate that PTE is associated with elevated mortality after TBI, but cause of death is imprecisely ascertained. • We will prospectively assess the effect of PTE on quality of life after TBI.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910861
Entities
People
- Ramon Diaz-Arrastia
Organizations
- United States Army
- University of Pennsylvania