esearch & Training

Our mission is to promote collaborative, translational research and clinical investigation of injuries to the brain and spinal cord. Our goals are to use basic discoveries to develop treatment strategies that can be evaluated for efficacy in animal models followed by testing in clinical trials, and then to disseminate information on the best treatments and practices to the community.

Translational Research

There is a unique opportunity for interactions between basic and clinical scientists at the Brain and Spinal Injury Center. The strong clinical training program in Neurotrauma at SFGH provides an excellent backdrop for basic investigations into the underlying mechanisms of CNS injury and development of treatments for both acute and chronic injuries. The interplay between bench and bedside research is kept at the forefront due to the frequent interactions between those treating injured individuals and those studying laboratory models of injury.

Research Themes

The breadth of research training and opportunities is reflected in the range of research themes under investigation at BASIC. These include:

• Traumatic Brain Injury (TBI)
• Spinal Cord Injury (SCI)
• Vascular Injury and Stroke
• Stem Cells and Transplants
• Neuroinflammation
• Combined Injury
  
• Recovery after CNS Injury
  

Clinical Research Projects

The researchers at BASIC have conducted numerous other smaller scale studies with the aim of improving the care and outcome of patients with traumatic brain injury, spinal cord injury and other neurosurgical disease processes.

SF-NETT Projects

SFGH has been awarded a National Institutes of Health (NIH) Neurological Emergencies Treatment Trials (NETT) network grant created to improve the immediate care and research of neuroemergencies with treatments delivered within minutes rather than hours of insult. NETT initiatives explore the narrow window of opportunity existing in the treatment of neurologic damage from pathologies including stroke, traumatic brain injury, seizures and meningitis. The San Francisco Principal Investigator is J. Claude Hemphill III, MD, MAS. A few trials currently under way in San Francisco today are the RAMPART, ALIAS 2, and PROTECT trials.

RAMPART- Rapid Administration of Medication prior to Arrival Trial-This is a national study comparing the effectiveness of seizure-stopping medicine delivered two different ways-via muscle injection or intravenously-to immediately stop the seizure activity of patients with continuous seizures, also known as status epilepticus. This study involves all emergency departments, ambulances and first responders in the city and county of San Francisco.

ALIAS 2-Albumin in Acute Stroke Part 2- The purpose of the ALIAS trial is to evaluate the effectiveness of high-dose, intravenous human serum albumin in ischemic stroke. Human serum albumin is a natural protein already in clinical use for a variety of indications. In animal laboratory studies, it has been shown to reduce the size of the infarction (amount of tissue death) in the brain and improve neurological function after a stroke. Evidence also suggests that albumin decreases or eliminates the brain swelling that may occur. These effects may reduce or prevent the brain damage resulting from a stroke in humans.

PROTECT III-ProTECT III is a research study designed to see if progesterone, a hormone normally found in our bodies, can reduce the amount of brain damage caused from a traumatic brain injury. Previous studies suggest that progesterone, given immediately after a TBI, may help treat brain injuries by reducing brain swelling and damage.

There is no specific drug treatment for traumatic brain injury. The reason for doing this study is to find out if progesterone is safe and if it works better than standard medical care alone in reducing the brain damage caused from a TBI. If progesterone helps brain injury patients get better, it will mean a big improvement in TBI treatment! This study may also help people with brain injury in the future by finding out whether a simple blood test drawn in the ER can help predict who will recover.

Further information on ProTECT III can be found at: www.protectiii.com

For further information on these and all of the NETT trials, please see:

Neurological Emergencies Treatment Trials

Neuro-Imaging Projects

SFGH is involved in several projects involving imaging as a means of determining severity of injury and long-term outcome.

THE POST-TRAUMATIC SYNDROME OF BLUNT HEAD INJURY: Noninvasive Neurochemical and Structural Assessment-This is a study of the relationship between symptoms experienced after traumatic brain injury and possible areas of damage in the brain after mild and moderate traumatic brain injury. This study is funded by the Department of Defense. The principal investigator is Grant Gauger, MD, PhD.

MAGNETOENCEPHALOGRAPHY AND HIGH-FIELD DIFFUSION TENSOR MAGNETIC RESONANCE IMAGING OF NEURAL FUNCTION AND CONNECTIVITY IN TRAMATIC BRAIN INJURY-This study utilizes MRI to determine if a relationship exists between memory and attention problems and corresponding areas of damage in the brain after traumatic brain injury. This is funded through a grant from UCSF. The principal investigator is Pratik Mukherjee, MD, PhD.

MACROSTRUCTURAL AND MICROSTRUCTURAL IMAGING BIOMARKERS OF TRAMAUTIC BRAIN INJURY-This study seeks to understand if a specific type of brain scan can predict recovery after a traumatic brain injury. As part of this study, blood is obtained to determine how genetic differences may affect a patient's recovery. Pratik Mukherjee, MD, PhD is the principal investigator.

 

Neurosurgery Projects

SFGH is also interested in how the individual patient responds to treatments and how their genetic make up contributes to their overall outcome.

INTRAOPERATIVE CT GUIDED ENDOSCOPIC SURGERY FOR INTRACEREBRAL HEMORRHAGE (ICES)- The purpose of this study is to determine if a minimally invasive surgical procedure is an effective therapy in the treatment of hemorrhage in the brain. This is a multi-center NIH funded clinical study. The principal investigator is Shirley Stiver, MD, PhD.

GENETIC MARKERS TO PREDICT RESPONSE IN TRAUMATIC BRAIN INJURYThe goal of this study is to learn more about the responses to treatment in patients who have suffered serious traumatic brain injury and how genetic differences may affect their recovery. The principal investigator is Geoffrey Manley, MD, PhD.

 

Laboratories located at the Brain and Spinal Injury Center at SFGH

Michael Beattie & Jacqueline Bresnahan, Principal Investigators
Laboratory for CNS Repair

John Fike, Principal Investigator
Brain Injury and Neurogenesis Laboratory

Claude Hemphill & Geoffrey Manley, Principal Investigators
Brain and Spinal Injury Center Clinical Research Core

Geoffrey Manley, Principal Investigator
Laboratory of Vascular Dynamics after Traumatic Brain Injury

Susanna Rosi, Principal Investigator
Chronic Neuroinflammation, Learning and Memory Laboratory

Shirley Stiver, Principal Investigator
Laboratory of Cerebral Angiogenesis in Neurological Injury and Disease

Affiliated Laboratory at Parnassus

Linda Noble, Principal Investigator
Laboratory of Injury and Repair Mechanisms in the CNS

Training

Many of the faculty at The Brain and Spinal Injury Center are affiliated with the Biomedical Sciences Graduate Program at UCSF. There are numerous opportunities for training in neurotrauma research for graduate students, post-doctoral fellows, residents and visiting scholars.

In addition, SFGH has collaborations with clinical training programs throughout the Bay Area in the areas of nursing, rehabilitation, social work and other trained professionals.

Useful Links

National Library of Medicine for current publications

UCSF Dept of Neurosurgery

UCSF Department of Neurology