A leading cause of disability in the United States is a neurological event such as stroke, head injury or drug abuse. Regardless of the cause, the brain is often quickly and irreversibly damaged. UC researchers, funded by a $9 million grant from the National Institutes of Health, will study point-of-care technologies to assist the diagnosis and treatment of patients with neurologic emergencies. The result is the "Point-of-Care Center for Emerging Neuro Technologies." This five-year award is renewable for five years.
"It is estimated that one million brain cells die every minute during an ischemic stroke," says Fred Beyette, associate professor of electrical and computer engineering and principal investigator (PI) for the project. "It's said that 'time is brain' during a neurologic emergency. Point-of-care information is critical for preventing patient brain damage, dysfunction and death. Thus, there is a critical need for developing improved and rapid diagnostic information for the patient experiencing neurologic emergencies."
"The UC center is dedicated to the development of technologies that will dramatically improve the care and health of the neurologic patient by providing fast and reliable information about the biological events occurring in this patient population," says Joseph Clark, professor of neurology in UC's College of Medicine and co-principal investigator (Co-PI) of the overall grant.
From Invention to Intervention
"The focus of the Point-of-Care Center will be to nurture the development of technologies to improve the diagnosis of and response to neurodiseases and neurodisorders using point-of-care devices, whether at the bedside or in the operating room -- wherever diagnosis or treatment is needed," says Beyette. The NIH grant is intended to stimulate business in the community as well. The center will be structured to take ideas from conception to development of a prototype ready for clinical testing. Some of the factors that these new technologies will address include fast results in a package that is size-appropriate for the location.
For example, consider a patient with a persistent headache, lasting 18 to 20 hours. The patient has tried over-the-counter medications to no avail and is now experiencing nausea and visual impairment. Is it sinusitis" Migraine" Or perhaps a hemorrhagic stroke" Current technology takes hours to indicate the source of the problem. The improved point-of-care technologies could take a matter of one or two minutes. If the source is a migraine, then the patient would be referred to a general practitioner. If it's meningitis, then a spinal tap is called for. However, if it's an acute rupture of an artery in the brain, a CT scan is usually performed but is not effective after 12 hours following the event. A spinal tap would be called for -- but the information is often unreliable.
"When a patient comes to an emergency room with a headache, blood and urine samples are routinely drawn. Spinal fluid tests are rarely used because of the minimal return on chemical information," says Clark. Current protocol would dictate sending the sample out for a biochemical assay, taking three to four hours. "If the problem is a subarachnoid hemorrhage, it's going to rupture again. But in doing the spinal tap, more blood might be introduced by the tap itself, making diagnosis difficult."
To address this, an instrument in development now is the size of a shoebox, into which the spinal fluid is introduced. Within three minutes, the instrument can distinguish hemoglobin and bilirubin (which indicates the breakdown of hemoglobin) from blood cells that might be present because of the procedure itself.
Beyette and Clark say that the center will be ramping up activities over the coming weeks and will soon be issuing a national call for proposals.
"Winning this award speaks very highly of the quality of our team and the outstanding level of innovation that we are bringing to the diagnosis and treatment of neurologic-based diseases and disorders," says Beyette.