Institute for NeuroImaging of Coma and Consciousness

Laboratory for NeuroImaging of Coma and Consciousness

Dr. Brian Edlow’s Laboratory for NeuroImaging of Coma and Consciousness (NICC) aims to improve acute care and long-term outcomes for patients with coma and other disorders of consciousness caused by traumatic brain injury.

Overview

NICC in the News: 2015

2014 NEWS

2013 NEWS

 

Investigating Traumatic Brain Injury

Our mission at the Laboratory for NeuroImaging of Coma and Consciousness (NICC) at Massachusetts General Hospital is to determine how patients recover consciousness after a severe traumatic brain injury and to promote the recovery process.

We use advanced structural and functional imaging techniques to identify brain networks whose connectivity is critical to the restoration of consciousness.

We believe the identification of these brain networks will allow clinicians to provide patients' families with more accurate prognoses and will ultimately enable the development of personalized treatments aimed at promoting recovery.

While the NICC’s mission is to improve outcomes for civilians and military personnel with traumatic brain injury, we also partner with other labs to study recovery of consciousness in patients with coma caused by cardiac arrest, hemorrhage and stroke.

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Group Members

Principal Investigator:

Brian L. Edlow, MD

Brian L. Edlow, MD
Associate Director, Massachusetts General Hospital Neurotechnology Trials Unit
Director, Mass General Critical Care Research Neuroimaging
Instructor of Neurology, Harvard Medical School
Affiliated Faculty, Athinoula A. Martinos Center for Biomedical Imaging
View Dr. Edlow's physician profile

Post-doctoral Research Fellow:

Camille Chatelle

Camille Chatelle, PhD
M.Sc., University of Brussels, Belgium
Ph.D., University of Liege, Belgium
Camille is also a member of Dr. Joseph Giancino's Neurorehabilitation Laboratory at Spaulding Rehabilitation Hospital

Clinical Fellow:

Saef Izzy, MD

Saef Izzy, MD 
Bachelor of Science, Baghdad College
University of Baghdad, College of Medicine
University of Massachusetts Medical School, Neurology Residency
Mass General/Brigham and Women's Hospital Neurocritical Care Fellowship

Research Assistants and Clinical Research Coordinators:

Allison Moreau

Allison Moreau
B.A., Wheaton College
Allison is also a member of Dr. Bruce Fischl's Laboratory for Computational Neuroimaging at the Mass General Athinoula A. Martinos Center for Biomedical Imaging.

Camille Spencer

Camille Spencer
B.S., Brown University

Lee Tirrell

Lee Tirrell
B.S, Northeastern University
M.Phil., University of Hong Kong
Lee is also a member of Dr. Bruce Fischl's Laboratory for Computational Neuroimaging at the Mass General Athinoula A. Martinos Center for Biomedical Imaging.

Ani Varjabedian

Ani Varjabedian
B.S., University of Maine
Ani is also a member of Dr. Bruce Fischl's Laboratory for Computational Neuroimaging at the Mass General Athinoula A. Martinos Center for Biomedical Imaging.

Research Projects

Ongoing Research Studies

Traumatic Coma RESPONSE Study

Traumatic Coma RESPONSE Study (REsting and Stimulus-based Paradigms to detect Organized NetworkS and predict Emergence of consciousness): an MRI and EEG study of brain network structure and function in patients with acute traumatic coma.

The primary goal of this multimodal neuroimaging study is to determine if acute, advanced MRI and EEG predict 6-month outcomes better than current clinical predictors. 

The secondary goal of this study is to identify longitudinal changes within brain networks that enable recovery of consciousness and communication.

Ex Vivo Connectomics of Traumatic Coma

Ex Vivo Connectomics of Traumatic Coma: a postmortem imaging and histopathological study of brain specimens from patients who have died after severe traumatic brain injury. 

The primary goal of this correlative histo-radiologic study is to identify the specific circuits within the brainstem ascending arousal network and cortical default mode network that are necessary and sufficient for recovery of consciousness after traumatic coma.

Secondary goals of this study include:

  • Validation of structural connectivity imaging (i.e. diffusion tractography) with “gold standard” histopatholgical data
  • Development of a multimodal autopsy protocol that integrates ex vivo radiologic and histopathological data to advance knowledge about the neuroanatomic basis of coma and consciousness

Harvard Ascending Arousal Network Atlas

The ascending arousal network (AAN) is a subcortical neural network that is critical to consciousness. To date, the majority of studies investigating AAN connectivity have utilized animal models. As a result, current knowledge about the structural and functional connectivity of the human AAN is limited and largely based upon extrapolations from animal data.  

We created an AAN atlas to facilitate research into the structural and functional connectivity of the human AAN. The study of AAN "connectomics" has the potential to increase knowledge about arousal physiology in the human brain, as well as arousal pathology in neurological diseases, such as coma and other disorders of consciousness.

In addition, the study of AAN connectomics may advance knowledge about reciprocal connectivity between this subcortical arousal network and cortically based awareness networks, such as the default mode network.

More information about the Harvard Ascending Arousal Network Atlas can be found at https://www.martinos.org/resources/aan-atlas. In addition, regions of interest for AAN nuclei in MNI152 space can be downloaded at this site.

Publications

Selected NICC Publications

Edlow BL, Takahashi E, Wu O, Benner T, Dai G, Bu L, Grant PE, Greer DM, Greenberg SM, Kinney HC, Folkerth RD. Neuroanatomic connectivity of the human ascending arousal system critical to consciousness and its disorders. Journal of Neuropathology and Experimental Neurology. 2012;71:531-546.  PMCID: PMC3387430.

Edlow BL, Wu O. Advanced neuroimaging in traumatic brain injury. Seminars in Neurology. 2012;32:372-398. PMCID: PMC3779469.

Edlow BL, Haynes RL, Takahashi E, Klein JP, Cummings P, Benner T, Greer DM, Greenberg SM, Wu O, Kinney HC*, Folkerth RD*. Disconnection of the ascending arousal system in traumatic coma. Journal of Neuropathology and Experimental Neurology. 2013;72:505-523. (*co-senior authors) PMCID: PMC3761353.

McNab JA*, Edlow BL*, Witzel T, Huang SY, Bhat H, Heberlein K, Feiweier T, Liu K, Keil B, Cohen-Adad J, Tisdall MD, Folkerth RD, Kinney HC, Wald LL. The Human Connectome Project and beyond: Initial applications of 300 mT/m gradientsNeuroImage. 2013;80:234-245. (*co-first authors) PMCID: PMC3812060.

Edlow BL*, Giacino JT*, Hirschberg RE, Gerrard J, Wu O**, Hochberg LR**. Unexpected recovery of function after severe traumatic brain injury: The limits of early neuroimaging-based outcome prediction. Neurocritical Care; 2013;19: 364-375. (*co-first authors, **co-senior authors) PMCID: PMC3902071.

Edlow BL, Giacino JT, Wu O. Functional MRI and outcome in traumatic coma. Current Neurology and Neuroscience Reports. 2013;13:375. PMCID: PMC3811121.

Edlow BL*, McNab JA*, Witzel T, Kinney HC. The structural connectome of the human central homeostatic network. Brain Connectivity. 2015; in press. (*co-first authors) PMCID pending.

Edlow BL, Copen WA, Izzy S, van der Kouwe A, Glenn MB, Greenberg SM, Greer DM, Wu O. Longitudinal diffusion tensor imaging detects recovery of fractional anisotropy within traumatic axonal injury lesions. Neurocritical Care. 2015; in press. PMCID pending.


Selected NICC Abstracts

Edlow BL, O’Connor KL, Chu CJ, Hirschberg RE, Kramer MA, Gupta R, Greenberg SM, Giacino JT, Wu O, Rosenthal ES. Differential RESPONSE to language, music, and motor imagery in early traumatic coma: Pilot results from the traumatic coma RESPONSE study. Neurocritical Care Society Meeting. Philadelphia, PA, 2013.

Edlow BL, O’Connor KL, Chu CJ, Hirschberg RE, Kramer MA, Gupta R, Greenberg SM, Giacino JT, Rosenthal ES, Wu O. Multimodal assessment of arousal networks in early traumatic coma: Pilot results from the traumatic coma RESPONSE study. Neurocritical Care Society Meeting. Philadelphia, PA, 2013.

Edlow BL, McNab JA, Witzel T, van der Kouwe A, Stevens A, Vinke L, Ebling M, Frosch MP, Schwamm LH, Greenberg SM, Wu O, Wald LL, Perl DP, Fischl B, Kinney HC, Folkerth RD. Integration of advanced imaging and histopathology to determine the neuroanatomic basis of traumatic coma and recovery of consciousness. British Neuropathological Society Meeting. London, England, 2014. Oral Presentation.

Spencer CA, Chatelle C, Chu C, O’Connor KL, Hirschberg R, Kramer MA, Greenberg SM, Wu O, Giacino JT, Edlow BL*, Rosenthal ES*. Fatigue in the neurological examination of patients recovering from acute traumatic coma as assessed by electrophysiology.  Neurocritical Care Society Meeting. Scottsdale, AZ, 2015.  (* co-senior authors).

Chatelle C, Spencer CA, Chu C, O’Connor KL, Hirschberg R, Kramer MA, Greenberg SM, Wu O, Giacino JT, Rosenthal ES*, Edlow BL*. Detecting language processing in ICU patients recovering from acute traumatic coma: A stimulus-based EEG study.  Neurocritical Care Society Meeting. Scottsdale, AZ, 2015. (*co-senior authors).

Izzy S, Mazwi N, Martinez S, Spencer C, Glenn M, Greenberg SM, Greer D, Wu O, Edlow BL. Gradient echo MRI to predict long-term functional outcomes after traumatic brain injury. Neurocritical Care Society Annual Meeting, Scottsdale, AZ, 2015.

Moreau A, Izzy S, van der Kouwe A, Stevens A, Varjabedian A, Tirrell L, Tisdall MD, Mareyam A, Wu O, Fischl B, Folkerth R, Edlow BL. In vivo MRI overestimates brainstem axonal injury in patients with severe traumatic brain injury. Massachusetts General Hospital Clinical Research Day. Boston, MA, 2015.

Mazwi, N, Izzy, S, Martinez, S, Spencer, C, Glenn, MB, Wu, Ona, Giacino, JT, Zaftone, RD, Edlow, BL. Location, location, location: Distribution of traumatic microbleeds predicts duration of post-traumatic amnesia.  International Brain Injury Association Annual Meeting, The Hague, Netherlands 2016. 

Contact

Contact Us

Brian L. Edlow, MD

Suite 300175 Cambridge St. Boston, MA 02114
  • Near Public Transit
  • Handicapped Accessible

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