Study explores brain injury recovery

Originally Posted on The Triangle via UWIRE

Joshua Jacobs, an assistant professor in the School of Biomedical Engineering, Science and Health Systems, will join a $22.5 million, four-year research project titled “Restoring Active Memory,” in which he will explore the use of brain stimulation to help recover memories and cognitive abilities of people who have suffered a traumatic brain injury.

The research is funded by the Defense Advanced Research Projects Agency and is affiliated with President Barack Obama’s Brain Research through Advancing Innovative Neurotechnologies initiative.

Jacobs explained, “We are trying to make brain stimulators that people can use when they have poor memories or poor navigation abilities. You can implant these devices and they can help fix the patients’ brains by applying brain stimulation to bring them back to a normal level again.”

The study focuses on improving memory and spatial navigation abilities. Researchers are targeting a wide range of patients, but mainly people who have concussions and repeated brain injuries.

This large-scale project is a coordination between seven hospital sites: Thomas Jefferson University, the Hospital of the University of Pennsylvania, Dartmouth University, Emory University, the National Institutes of Health, the Mayo Clinic and the University of Washington. Jacobs is involved in the Thomas Jefferson University hospital site.

“My basic research program is on understanding the human brain’s memories and navigation,” Jacobs said. “And what I’m excited about is that this is an opportunity to directly help people by taking my research out of laboratory and also potentially into people’s lives. People suffer all the time from memory deficits, and they get disoriented when they try to navigate. I think what’s really exciting is that I can help people directly.”

Restoring Active Memory consists of two main components: clinical research and device development.

The clinical research phase, in which Jacobs is mostly involved, uses standard clinical recording and stimulation devices to record brain signals in real time as the patients perform different memory and cognitive tasks. Stimulations will be applied to different parts of the brain with typical types of electrical current, frequencies, amplitudes and spatial characteristics of brain regions.

“We looked at the performances when the stimulation is turned on compared to when the stimulation is turned off,” Jacobs said.

The basic recordings are obtained from patients who experience epilepsy.

“If the patient suffers from heavy epilepsy, they’ll have electrodes implanted in their brains to map their seizures. Most people who have epilepsy don’t have this, but in a severe case, these electrodes are implanted in their brains directly,” Jacobs explained.

He continued, “Once we have that, we’ll then use that information to try developing different actual devices.”

The second component, of which Jacobs is also a part, will center on developing the tangible device. The process will take place in collaboration with Metronics, a medical device manufacturer.

“There are several different kinds of memory tasks that we’re trying to improve in these patients. The three areas are episodic memory, which is memory for ‘What I did this morning, where I left my key this morning’; associate memory, which is memory for linking things together; and the third one is spatial memory. My focus is on the spatial memory component,” Jacobs said.

Patients who have electrodes in their brains are asked to play a virtual navigation video game. During the navigation task, the researchers try to understand what kind of stimulation can improve spatial memory. Such information will be used to help design the implanted device.

The proposal for the project was submitted in January and while the DARPA grant officially starts the week of July 21, the team has been working for the last two months.

Since the cynosure of the project is the human brain, muchcautiousness has been taken into consideration.

“We are very focused on ensuring patients’ safety,” Jacobs said. “We have a very regular protocol to make sure that whatever brain stimulation procedures we follow in the hospital, as well as with the implanted device, are safe.”

“We have a medical adviser team, and we have the institutional review board approval,” he continued. “So we’re very careful about patients’ safety. That’s a challenge and we have a pretty good plan for it.”

“The other challenge is that the human brain is a very complicated system, and our understanding of the human brain is [restricted]. We have preliminary data, but there’s a reason that this kind of device hasn’t been developed yet, which is that the brain is a challenging thing to record from and to manipulate,” he explained.

According to Jacobs, a distinguishing characteristic of this project is that it is a translational research; “The reason why DARPA was very interested in funding us is that we not only understand the brain, but to make a device also.”

“For a long time I thought my research would help people, but help people in years from now, in decades from now, and now it’s a chance to help people in just four years. And that’s really exciting,” Jacobs said.

According to Jacobs, everything about this type of project is useful because it will open doors to further understanding of the human brain.

“The more fundamental understanding we have on how the brain operates, [the more it] will help everybody move forward on new treatment for disorders, drugs, all kinds of things like that,” he said.

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