Since the beginning of the project, each of the three WPs has made significant progress despite the severe challenges imposed by the pandemic. In the following, work performed as well as achievements related to each WP are listed:
WP1: The major achievement since the beginning of the project has been to setup the clinical infrastructure necessary to conduct the human study within NEUROPRECISE. In collaboration with the Dr. von Hauner’s Children’s Hospital, we founded the Concussion Clinic for children and adolescents that experience a mild traumatic brain injury in the Munich area. This infrastructure of clinical care at the highest level of medical excellence did not exist before. The Concussion Clinic is now led by an experienced pediatric neurologist, Dr. Michaela Bonfert, who is also study physician of NEUROPRECISE. We developed an interdisciplinary clinical pathway and organizational algorithm to be able to screen all incoming patients for inclusion and exclusion criteria. Further, we reached out to two Munich-based hospitals as well as to 15 large local pediatric practices, provided information material on mTBI in children and adolescents with the intention to receive transferred patients from these centers. The concussion Clinic now screens patients 5 days a week and is setup to clinically evaluate every eligible patient on the same day.
WP2: Setting up the newly installed MRI scanner dedicated to brain research in the building next door has been the major effort. As one of four managing directors, the PI Dr. Inga Koerte, is shaping excellence in research within this new neuroimaging core unit NICUM (Neuroimaging-Core-Unit-Munich:
https://www.mcn.uni-muenchen.de/aktuelles/nicum/index.html(odnośnik otworzy się w nowym oknie)). Originally, NICUM was supposed to provide personnel to perform the MRI in this study. However, due to financial constraints, NICUM no longer plans to offer this service. Therefore, the PI Dr. Koerte, developed a training curriculum for research assistants to be trained as MRI operators. The NEUROPRECISE team not only managed to train 8 MRI operators in a short period of time, secured additional funding to pay for these research assistants but most importantly serves as a hall mark for performing research studies within NICUM.
WP3: The animal project began in June 2020. After adequate training, the PhD student newly developed and validated a mild traumatic brain injury (mTBI) mouse model for the project. The juvenile model matches the human part of the study and consists of a modified weight-drop device that delivers mTBI to anesthetized adolescent mice without surgical incision, skull fracture, brain edema, or macroscopic brain damage. The unique feature of this model is that the impact produces a rotational acceleration of the head, which mimics the average patient mTBI. Most importantly, the model produces acute and chronic neurological deficits after mTBI. The Barnes Maze test demonstrates acute deficiencies in spatial memory formation in the mTBI mice. Moreover, we now include the novel automated IntelliCage testing paradigm which captures long-term behavioral deficits (4 months post-injury) in the mTBI mice, specifically drinking disinhibition. Further, we have planned the next step to begin progesterone monitoring following mTBI.
Another important task has been to ensuring stability throughout the pandemic. The constantly changing rules and regulations surrounding the COVID-19 pandemic along with the restrictions to enroll patients in our study have been both time and effort consuming. The PI along with the leadership team has put an emphasis und team building and continues education to provide stability and flexibility so that the team continuously operates on full speed.
