The Rehabilitation Research and Training Center (RRTC) on Community Integration of Persons with Traumatic Brain Injury at TIRR

Traumatic Brain Injury Model System

Research Projects Overview

The Traumatic Brain Injury (TBI) Model Systems program at the Brain Injury Research Center (BIRC) of TIRR Memorial Hermann is funded by the National Institute on Disability and Rehabilitation Research (NIDRR). The NIDRR TBI Model Systems program began in 1987 and is the largest research program on recovery from TBI in the world. The TBI Model Systems study database is the largest database on traumatic brain injury.

Goals and Quality Outcomes

The overall goal of the TBI Model Systems program is to conduct research aimed at improving quality of care and outcomes for patients recovering from TBI. Within the TBI Model Systems program, individuals with TBI who consent to participate in the study are followed for many years after their injuries. Some participants in the study have been followed for more than 18 years after their injury.

This program is designed, in part, to help us better understand what goes on in the long-term recovery of persons with TBI. In addition to the long-term follow-up that is conducted as part of the TBI Model Systems study, each center has additional research projects designed to address specific issues about TBI, including looking at how different treatments might help in improving recovery and community participation. However, since the TBI Model Systems program is a research program, these grants do not provide support for direct clinical care.

Historic Program

BIRC was one of the original TBI Model Systems sites and was continually funded until 2002. After a five-year interruption in funding, BIRC is again a part of the TBI Model Systems research program as of Oct. 1, 2007.

When the TBI Model Systems program was started in 1987, only five centers were funded to conduct the research. The TBI Model Systems program has grown and now consists of 14 centers around the United States. Texas is one of only two states to have two sites: the Texas TBI Model Systems of TIRR and the North Texas TBI Model Systems in Dallas. TIRR is one of only six sites nationwide to have both TBI and Spinal Cord Injury Model Systems programs.

Researching TBI Complications and Other issues

The TBI Model Systems program at TIRR will be led by Mark Sherer, Ph.D., principal investigator and director of research for TIRR, and Angelle Sander, Ph.D., and Margaret Struchen, Ph.D., co-directors of BIRC.

The TBI Model Systems grant award will provide $2.15 million to BIRC to fund research on TBI over the next five years. These funds will support three main activities. First, BIRC will contribute data on the natural history of TBI to the TBI Model Systems National Database. This database contains data on more than 7,500 persons with TBI from all of the TBI Model Systems sites.

Various analyses of this huge database have resulted in new discoveries regarding the time course of recovery after TBI, factors that predict recovery after TBI, medical complications seen in persons with TBI, effects of race and ethnicity on recovery after TBI and other issues. As participants in the TBI Model Systems program, Drs. Sherer, Sander, and Struchen will have access to this database to conduct investigations of TBI.

In addition to the National Database project, BIRC will investigate the effectiveness of a treatment designed to improve social communication after TBI. Social isolation and loneliness are major concerns of families and patients following TBI. One of the major factors that contribute to social isolation is thought to be the changes in social communication abilities that many people experience after a TBI. Changes in social communication skills also can affect a person’s ability to get and maintain a job and contribute to family stress.

Dr. Struchen will lead a study where participants with moderate or severe TBI will either receive the intervention to improve social communication right away or will be put on a wait-list to receive the treatment later. Participants have an equal chance of being assigned to either of those conditions. Then, we will look at whether those that received the treatment do better on social communication skills and will have better short-term outcomes than do those who were on the wait-list. This kind of study is called a randomized controlled trial. Improved social communication skills should lead to improved quality of life for persons with TBI and their families.

Other Research Projects

As part of BIRC’s TBI Model Systems research program, Dr. Sander will be leading a multi-center, collaborative research project on sexuality after TBI. Collaborating centers are the Mayo Clinic, Craig Hospital in Englewood, Colo., and Carolinas Rehab in Charlotte, N.C. The project will investigate how sexuality is affected by traumatic brain injury, both directly and indirectly.

Sexuality after TBI is an area that has not been extensively studied. During the observational component of the study, TBI patients and their partners will be interviewed. Based on the information gathered, an intervention will be developed to increase understanding of sexual changes after TBI, improve sexual satisfaction, and increase comfort in seeking assistance for sexual dysfunction after TBI. This intervention will be tested using a randomized controlled trial.

In addition to these research activities, BIRC will have activities designed to provide useful information to persons with TBI, family members and friends, and healthcare professionals who treat persons with TBI. One of these activities will be to publish four articles a year in the Brain Injury Association of Texas (BIATX) newsletter.

BIRC staff will also develop brochures on social communication and sexuality for persons with TBI, significant others, and healthcare professionals. BIRC staff will give presentations at meetings attended by persons with TBI and their significant others, such as the annual meeting of the BIATX.

The Traumatic Brain Injury (TBI) Model Systems program at TIRR, one of the premiere traumatic brain injury facilities in the world, will study patients with traumatic brain injury and traumatic head injury. The program will also study traumatic brain injury rehabilitation, traumatic brain injury rehab and head injury. Other portions of the program will include brain injury, research, communication and brain injury, sexuality and brain injury, and acquired brain injury, as well as focus on outcomes.