Examples of ongoing research studies currently supported by COBRAH are listed below.
Examining the Chronic Burden of Neuropsychiatric Illness in COVID-19 Patients (CONOS)
Many long-term factors that may continue to affect patients who have had COVID-19 are still unknown. COVID-19 is known as a respiratory illness that affects the lungs and causes inflammation throughout the body; however, the research team is trying to find out if there are any ill effects to the brain, either as a direct result of the infection, or as a result of the stressors surrounding the diagnosis and treatment of the disease. We are investigating if these factors may affect the things a person may experience after they recovered from the disease, for example, how they think, act, or feel. It is important to monitor patients not only during the infection, but after they recovered because they may experience depression, anxiety, and post-traumatic stress disorders, all of which are anticipated and treatable. Funder: Weston Brain Institute. Principal investigators: Cheryl Wellington, Mypinder Sekhon.
Investigating Head Impacts and Concussions in Ice Hockey
Concussions are a major concern in contact sports such as ice hockey. While the associated cumulative and repetitive impacts to the head over the course of a player’s career pose a serious threat to long-term neurological and mental health, the injury mechanisms of concussion are still poorly understood, resulting in ineffective prevention, diagnosis, and treatment. As a result, we propose an interdisciplinary approach of using head impact sensing, advanced imaging, and neurocognitive assessments, to better understand the effects of both concussions and subconcussive impacts in ice hockey players. Funder: CIHR. Principal investigators: Lyndia Wu, Paul van Donkelaar, Alexander Rauscher.
Offsetting Hippocampal Degeneration in Moderate to Severe TBI
The effects of moderate and severe TBI (m-sTBI) can be debilitating. Recent studies have shown evidence of hippocampal degeneration occurring across time, disputing the common assumption that the brain is stable across the chronic stages of injury. Progressive neurodegeneration of the hippocampus can have detrimental effects on functions essential for daily life, such as memory as spacial navigation. Our 16-week intervention utilises allocentric spatial navigation tasks to improve memory and counteract hippocampal neurodegeneration in a treatment arm, in comparison with a control arm. This intervention will be administered in combination with neuropsychological assessments, MR imaging, and the analysis of genomic variants at two time points. Principal investigator: Robin Green (University of Toronto).
Mobilizing early management of mental health complications after mild traumatic brain injury (M4)
Mental health problems such as depression and anxiety are common in the months following concussion. They can make concussion symptoms worse and magnify difficulties with daily activities, but often go unrecognized. In a cluster randomized trial, we are evaluating the effectiveness of a guideline implementation tool to support family doctors to screen and initiate treatment for mental health problems after concussion, and to education patients about the importance of mental health treatment and treatment options. See Clinicaltrials.gov for details. Funder: CIHR and the VGH+UBC Hospital Foundation. Principal investigator: Noah Silverberg.
Feasibility of multi-domain data acquisition in patients at risk for hypoxic-ischemic brain injury following cardiac arrest: a cohort study (ACQUIRE)
There are more than 350,000 out-of-hospital cardiac arrests per year in the US. Survival to hospital discharge remains low, with the majority of deaths being directly attributable to hypoxic-ischemic brain injury. The purpose is to assess the feasibility of collecting comprehensive data (physiologic, biomarker, and neuro-imaging) in the immediate post-cardiac arrest period and linking these to 6-month detailed neurocognitive outcomes. This will be a prospective cohort study of 20 patients admitted with cardiac arrest who remain comatosed following resuscitation. Funder: ZOLL Foundation. Principal investigator: Don Griesdale.
At-home Rehabilitation for Concussion (ARC)
Behavioural interventions may help people get better after concussion. These kinds of intervention programs involve learning what you can do to maximize your recovery. They do not involve medications or medical devices. It remains unclear how well behavioural interventions work and which kinds work best for which people. Therefore, the goal of our research study is to evaluate and compare different behavioural intervention programs for concussion. Each program will be delivered remotely, meaning that you can participate from your own home, using your smartphone, tablet, or computer. The study findings will help us understand how to provide effective, tailored remote concussion care. Principal investigators: Dr. Noah Silverberg (British Columbia), Dr. Chantel Debert (Alberta), and Dr. Mark Bayley (Ontario).
Evaluating neurological injury and outcomes in patients with respiratory failure undergoing extra corporeal membrane oxygenation (ECMO)
Increasingly, patients with respiratory failure secondary to acute respiratory distress syndrome can experience long-term neurological disabilities. The precise mechanisms underpinning these observations are unknown. Further, diagnostic tests to detect dysfunction in the brain during ICU care are lacking. Recently, some patients with acute respiratory distress are managed using a machine that externally provides oxygen in the blood and places it back in the body. This machine is termed extra corporal membrane oxygenation (ECMO), in addition to a ventilator (breathing machine). It is imperative to understand whether patients managed with ECMO demonstrate evidence of brain dysfunction versus those without. We will do this by analyzing blood markers and performing follow-up questions. Principal investigator: Mypinder Sehkon.