Dr. Ramon Diaz-Arrastia
Associate Professor of Neurology

The North Texas Traumatic Brain Injury Model System (NT-TBIMS)

In 2002, The University of Texas Southwestern (UTSW) Medical Center and Baylor Institute for Rehabilitation (BIR) were awarded a five-year grant as a Model System of Care for Traumatic Brain Injury (TBI) by the National Institute on Disability and Rehabilitation Research (NIDRR). At that time, an alliance between the two largest hospitals in the North Texas region was formed to establish the North Texas Traumatic Brain Injury Research Center. This collaboration between Parkland Memorial Hospital (PMH), the areas largest level I trauma center, and Baylor University Medical Center (BUMC), the second largest level I trauma center in the region, accounts for 90% of the trauma patients treated in the region. Due to its central location and reputation for excellence, BUMC and the UTSW affiliated hospitals serve a large catchment area including north Texas, west Texas, the panhandle of Texas, and the surrounding counties of Oklahoma, Arkansas, and Louisiana.
The majority of TBI patients who are admitted to PMH and BUMC require inpatient rehabilitation. They obtain such care at one of the three collaborating North Texas Traumatic Brain Injury rehabilitation units: Baylor Institute for Rehabilitation, the inpatient rehabilitation ward at PMH, or the inpatient rehabilitation ward at Zale-Lipshy University Hospital (ZLUH). The North Texas Traumatic Brain Injury Model System (NT-TBIMS) pools the efforts and talents of individuals from the Departments of Neurosurgery, Neurology, Physical Medicine and Rehabilitation, Psychiatry (Neuropsychiatry), and Neuroradiology of the two leading medical institutions in the North Texas region.
The NT-TBIMS centers will be responsible for gathering and submitting data to the national TBIMS database as well as conducting numerous research studies. The information added to the national database supports data from thousands of people with TBI throughout the United States. This database is used to study the factors that predict recovery and outcomes of TBI. The NT-TBIMS is currently conducting research on "Genetic factors in outcome after traumatic brain injury", "Evaluation of cognitive impairment after traumatic brain injury using functional MRI", "A prospective, observational study of screening and prophylaxis of deep vein thrombosis in survivors of traumatic brain injury during inpatient rehabilitation", "Video-EEG evaluation of motor behaviors in TBI survivors", "Delayed cognitive deterioration in TBI survivors", "Comparison of FSE and GOSE outcome measures 6-months after TBI Genetics of Traumatic Brain Injury", and "Rivastigmine for persistent cognitive deficits in long-term TBI survivors (Novartis Protocol No. CENA713BUS1)". Through our research we hope to learn more about TBI and about the issues and concerns of people with TBI. Our goal is to improve the outcome and quality of life for people who have brain injuries and for those who are caring for the person with a TBI. More information on the national database and the published articles based upon it may be found at the TBIMS national web site: www.tbindc.org.

The Traumatic Brain Injury Clinical Trials (TBI- CT) Network

In 2003, the North Texas TBI Research Center was selected as one of eight sites to be a member of the Traumatic Brain Injury Clinical Trials Network. The National Institute of Child and Human Development (NICHD) Traumatic Brain Injury Clinical Trials Network consists of a team of academic clinical centers and a data coordinating center, as well as the National Institute of Child Health and Human Development. The eight clinical centers have agreed to investigate problems in traumatic brain injury in a collaborative manner. The clinical centers represent premier institutions in TBI medicine with track records of excellence in clinical research. The Data Coordinating Center (DCC) for the Network is the Columbia University Department of Biostatistics. The data coordinating center was selected on the basis of their experience with the coordination of multi-center clinical trials, and with proven expertise in study design, data management, and biostatistical analysis.
The TBI-CT Network is designed to conduct clinical studies to improve the outcomes for individuals with TBI. The major aims of the Network are to reduce the rates of death, vegetative states, and cognitive dysfunction after moderate to severe TBI, as well as to evaluate acute and rehabilitative interventions for efficacy, safety, and cost-effectiveness. The TBI-CT Network is an efficient and cost-effective organization serving as a major source of evidence-based trauma and rehabilitative medicine through the conduct of multi-center clinical studies in TBI and through the dissemination of research results. Several research projects are currently proposed and will be initiated within the coming months.