CASBI is conducting a number of studies of the clinical, translational, and ethical issues surrounding severe brain injury. This work receives both government and private funding.
Our current research focuses on improving our understanding of mechanisms of recovery and on building a foundation of knowledge to develop strategies to encourage the recovery process. Our aim is to develop an understanding of the underlying pathophysiology of states of altered consciousness, such as vegetative state, minimally conscious state, and confusional state, which can result from severe brain injuries. Using traditional diagnostic neurophysiologic assessments, such as MRI, EEG, and PET, we aim to obtain measurements that can provide insight into an individual patient’s actual rate of recovery, and into the specific mechanisms of recovery in the severely injured brain. In conjunction with qualitative and quantitative behavioral assessments and sensory stimulation paradigms, this multimodal approach allows for a comprehensive overview of this cohort.
Our other studies aim to address the ethical questions that affect both the patients and families that are caring for this population. We seek a better understanding of the epidemiology of disorders of consciousness, as well as the experiences of family members of patients with disorders of consciousness. We hope to get a fuller narrative picture of how families deal with these situations, how physicians communicate with the families, how families make decisions, and how they perceive their situation in order to develop communication and management strategies that physicians could utilize in such cases. Additionally, we are interested in determining if there are any treatment differences for patients based on demographics, type of injury, and other contextual factors of the case that have ethical implications. We hope to gain a better understanding of the natural history and epidemiologic progression of disorders of consciousness that could inform our knowledge of practice patterns to foster the development of better diagnostic and prognostic tools to assist in the assessment and management of these patients. These studies employ surveys, structured and unstructured interviews, and longitudinal questionnaires. Together, these approaches can identify emerging themes that highlight barriers to care, policy concerns, and systems gaps.