WBIC acute brain injury collaborative grant

Lead Research Organisation: University of Cambridge
Department Name: Wolfson Brain Imaging Centre

Abstract

We use state-of-the-art scanners, and chemical analysis to help us understand what happens when our brains are damaged by accidents, become diseased and decline as we grow older. In order to make new discoveries we must also develop the scanners and the chemistry we do, and as we develop our tools we use these to help us understand better what is happening when we have problems with our brains. Our work will help develop new treatments and medicines which we hope will enable us to treat brain injuries and diseases more effectively.

Technical Summary

The proposed programme will be based at the Wolfson Brain Imaging Centre (WBIC) a component unit of the university Department of Clinical Neurosciences, based at Addenbrooke?s hospital, Cambridge. The centre is a purpose-built facility for structural and functional brain imaging and uniquely in the UK, has both a state-of-the-art positron emission tomography (PET) and MRI imaging facilities. The objective of the programme is to build on this range of multi-modality technology that has been developed at this centre in the last 10 years linked on the original research mission of the WBIC to advance the care of the critically ill patient following acute brain injury from initial ictus through recovery from coma and rehabilitation to final outcome. We aim to develop range of novel PET radiopharmaceuticals, MRI and MRS, microdialysis and proteomics methods designed to advance and enhance the objectives two associated MRC programmes proposals.

Publications

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Achard S (2007) Efficiency and cost of economical brain functional networks. in PLoS computational biology

 
Description Clinical Leads
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
Impact JPC is clinical lead for Critical Care & DKM is clinical lead for Anaesthesia within the West Anglian Comprehensive Local Research Network. Both are representatives on the National Speciality Groups.
 
Description Demographics and Clinical Assessment Working Group
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact Professor of Anaesthesia is member of Demographics and Clinical Assessment Working Group which participated in the NIH/NINDS initiative developing develop common data elements for TBI. The overall process leading to the workshop and the subsequent recommendations by the working groups are published in the Archives of Physical Medicine and Rehabilitation. (http://www.commondataelements.ninds.nih.gov/TBI.aspx
URL http://www.springerlink.com/content/u028t28013214524/
 
Description Faculty of Intensive Care Medicine, and academic training
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
Impact In June 2010, the creation of the Faculty of ICM which will henceforth represent the device for setting standards through education and training.
 
Description Guidelines for clinical trials in TBI
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description Guidelines on application of Mental Health Capacity Act in critical care contexts.
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact This document has completed a period of consultation and is being finalised as Guidance for UK ICUs by the Intensive Care Society (UK)
 
Description House of Lords Pandemic influenza enquiry
Geographic Reach National 
Policy Influence Type Gave evidence to a government review
URL http://books.google.co.uk/books?id=gttFlHWv4FgC&pg=PA61&lpg=PA61&dq=Menon+pandemic+flu&source=bl&ots...
 
Description London/GMEC PET Centre Feasibilty Working Group
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Membership of a guideline committee
 
Description MHRA MRC NCRI Group on Regulatory Issues in PET Research
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
 
Description MRC PET Neuroscience postdoctoral tarining award: August 2009
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
 
Description Membership of NIHR Integrated Academic Training review panel
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
Impact The scheme is intended to provede research exposure and experience for academically gifted medical and dental trainees with potential to be independant researchers of the future.
 
Description NCRI PET Steering Committee
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
 
Guideline Title Head injury: assessment and early management
Description NICE Guidelines for the management of TBI
Geographic Reach National 
Policy Influence Type Citation in clinical guidelines
Impact DKM was a member on the group revising NICE Guidelines for the management of TBI (Triage, assessment, investigation and early management of head injury in infants, children and adults. http://www.nice.org.uk/CG056; 2007). PJAH was a member of the updating committee 2014
URL http://www.nice.org.uk/CG176
 
Description National guidelines for the implementation of the Mental Capacity Act in Intensive Care Units
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact National guidelines for the implementation of the Mental Capacity Act in Intensive Care Units (see: http://www.ics.ac.uk/intensive_care_professional/standards_and_guidelines/mental_capacity_act)
URL http://www.ics.ac.uk/intensive_care_professional/standards_and_guidelines/mental_capacity_act
 
Description Neurosurgical Representative on the current NICE Committee revising the NICE guidelines for the early management of head injury in adults and children (due to be published published in 2013/4)
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact Head injury guidelines
 
Description SMART
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
Impact The Division of Anaesthesia, University of Cambridge organises the SMART (Scientific Methods and Research Training) course for clinical trainees. This course is open to all trainees in Anaesthesia in the UK
 
Description international panel on guidelines for the intensive care management of subarachnoid haemorrhage
Geographic Reach Multiple continents/international 
Policy Influence Type Membership of a guideline committee
Impact Professor of Anaesthesia is a member of international panel on guidelines for the intensive care management of subarachnoid haemorrhage (http://www.springerlink.com/content/u028t28013214524/)
URL http://www.springerlink.com/content/u028t28013214524/
 
Description Brain Injury and Repair Theme
Amount £541,696 (GBP)
Funding ID RG64341 
Organisation National Institute for Health Research 
Department NIHR Cambridge Biomedical Research Centre
Sector Public
Country United Kingdom
Start 04/2012 
End 03/2017
 
Description British Journal of Anaesthesia/Royal College of Anaesthetists project grant: Imaging
Amount £52,856 (GBP)
Organisation The Royal College of Anaesthetists 
Sector Academic/University
Country United Kingdom
Start  
 
Description Cambridge PET Neurochemist Programme
Amount £745,000 (GBP)
Funding ID G0900903 
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start  
 
Description Cerebral Energy Metabolism in Injured and Uninjured Brain
Amount £504,688 (GBP)
Funding ID G1002277 
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start  
 
Description Cerebral Energy Metabolism in Injured and Uninjured Brain.
Amount £504,688 (GBP)
Funding ID G1002277 
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start  
 
Description Developing the WTCRF in Cambridge: Magnetic Resonance Spectroscopy an da Nutrition Resource & Appetite Laboratory.
Amount £2,782,604 (GBP)
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start  
 
Description EU Fellowship for Dr Jeroen Hermanides €
Amount € 97,727 (EUR)
Organisation European Commission 
Sector Public
Country European Union (EU)
Start  
 
Description EU Framework 7
Amount £422,817 (GBP)
Organisation European Commission 
Department Seventh Framework Programme (FP7)
Sector Public
Country European Union (EU)
Start 02/2011 
End 01/2014
 
Description Evelyn Trust - Cognitive dysfunction after head injury: neuroanatomical correlates
Amount £120,400 (GBP)
Organisation The Evelyn Trust 
Sector Charity/Non Profit
Country United Kingdom
Start  
 
Description Evelyn Trust - Role of inflammation and neovasculatirsation in expansion of small AAA.
Amount £72,000 (GBP)
Organisation The Evelyn Trust 
Sector Charity/Non Profit
Country United Kingdom
Start  
 
Description Fellowship
Amount £143,419 (GBP)
Organisation National Institute of Academic Anaesthesia 
Sector Learned Society
Country United Kingdom
Start  
 
Description Imaging Theme co-applicant
Amount £6,700,000 (GBP)
Organisation National Institute for Health Research 
Department NIHR Cambridge Biomedical Research Centre
Sector Public
Country United Kingdom
Start  
 
Description Imaging inflammation in atherosclerosis: An integrated multimodality approach
Amount £1,139,380 (GBP)
Funding ID RG/10/007/28300 
Organisation British Heart Foundation (BHF) 
Sector Charity/Non Profit
Country United Kingdom
Start  
 
Description Imaging inflammation in atherosclerosis: an integrated multimodality approach
Amount £591,252 (GBP)
Funding ID RG/10/007/28300 
Organisation British Heart Foundation (BHF) 
Sector Charity/Non Profit
Country United Kingdom
Start  
 
Description Imaging mechanisms of energy failure following head injury.
Amount £220,000 (GBP)
Funding ID 093267 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start  
 
Description Imaging the surviving penumbra and recovery after stroke
Amount £843,000 (GBP)
Funding ID G0500874 
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start  
 
Description Interrogating energy metabolism in human brain using 13C microdialysis and magnetic resonance spectroscopy
Amount £475,000 (GBP)
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start  
 
Description Lang Fellowship, Research Fellowship
Amount £40,000 (GBP)
Organisation Royal College of Surgeons of England 
Sector Learned Society
Country United Kingdom
Start  
 
Description MICA: Detecting ictogenicity and epileptogenesis
Amount £1,635,366 (GBP)
Funding ID MR/L013215/1 
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start 04/2014 
End 03/2019
 
Description MICA: Training and Novel Probes Programme in PET Neurochemistry - PET Call
Amount £1,016,892 (GBP)
Funding ID MR/K02308X/1 
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start 12/2013 
End 11/2017
 
Description MRC/RCS Clinical Research Training Fellowship
Amount £105,224 (GBP)
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start  
 
Description MRC/RCS Clinical Research Training Fellowship
Amount £100,000 (GBP)
Organisation Royal College of Surgeons of England 
Sector Learned Society
Country United Kingdom
Start  
 
Description Multi-level patient-specific artery and athero-genesis model for outcome prediction, decision support treatment, and virtual hands-on training.
Amount £425,753 (GBP)
Funding ID 224297 
Organisation European Commission 
Sector Public
Country European Union (EU)
Start  
 
Description NIHR BRC
Amount £1,892,000 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 04/2017 
 
Description NIHR Brain Injury MedTech Co-operative
Amount £1,250,000 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 01/2018 
End 12/2022
 
Description NIHR Clinician Scientist Award
Amount £940,146 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start  
 
Description NIHR Global Health
Amount £1,800,000 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 08/2017 
End 07/2020
 
Description NIHR HTC
Amount £5,200 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 08/2017 
 
Description NIHR, Biomedical Research Unit in Dementia Capital Funding
Amount £1,537,000 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start  
 
Description Neurobiological correlates of trait impulsifvity an ddrug abuse vulnerability
Amount £1,134,962 (GBP)
Funding ID G0701500 
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start  
 
Description New drugs for addiction: focus on attenuating core behavioural component of heroin, cocaine and alcohol addiction and relapse prevention.
Amount £1,774,000 (GBP)
Funding ID G1000018 
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start  
 
Description Novel Mitochondria-targeted PET probe
Amount £82,500 (GBP)
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start  
 
Description RESCUEicp
Amount £1,116,980 (GBP)
Funding ID G0601025 
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start  
 
Description Research Fellowship
Amount £46,014 (GBP)
Organisation Royal College of Surgeons of England 
Sector Learned Society
Country United Kingdom
Start  
 
Description Risk Adjustment in Neurocritical Care (RAIN)/Health Technology Agency
Amount £617,028 (GBP)
Funding ID HTA/07/37/29 
Organisation National Institute for Health Research 
Department Health Technology Assessment Programme (HTA)
Sector Public
Country United Kingdom
Start  
 
Description Sleep and circadian rhythms in moderate and severe traumatic brain injury
Amount £420,000 (GBP)
Organisation Canadian Institutes of Health Research 
Sector Public
Country Canada
Start  
 
Description Stroke Association
Amount £139,500 (GBP)
Funding ID TSA2011/08 
Organisation Stroke Association 
Sector Charity/Non Profit
Country United Kingdom
Start  
 
Description Surgical Research Fellowship
Amount £50,000 (GBP)
Organisation Royal College of Surgeons of England 
Sector Learned Society
Country United Kingdom
Start  
 
Description The British Oxygen Professorship: Imaging anaesthetic action in the brain.
Amount £320,943 (GBP)
Organisation The Royal College of Anaesthetists 
Sector Academic/University
Country United Kingdom
Start  
 
Description The Evelyn Trust. Cognitive disfunction after head injury:Neuroanatomical correlates and drug therapy/Evelyn Trust
Amount £120,400 (GBP)
Organisation The Evelyn Trust 
Sector Charity/Non Profit
Country United Kingdom
Start  
 
Description The HIF system in traumatic brain injury.
Amount £188,599 (GBP)
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start  
 
Description Towards a biomechanics-based vulnerability assessment tool for carotid atherosclerotic plaque: mechanical property testing and MRI-based computaional modelling
Amount £193,818 (GBP)
Funding ID PG/11/74/29100 
Organisation British Heart Foundation (BHF) 
Sector Charity/Non Profit
Country United Kingdom
Start  
 
Description Vegetative State
Amount $500,000 (USD)
Organisation James S. McDonnell Foundation 
Sector Charity/Non Profit
Country United States
Start 08/2013 
End 07/2017
 
Title CAD&CAM for MRE 
Description In the process of developing the MRE method we have introduced computer added design software (SpaceClaim) combined with manufacturing on a 3D printer (HP Designjet 3D). This allows for assessment of structure strength and design flaws before manufacturing, considerably reducing the costs of manufacturing 
Type Of Material Improvements to research infrastructure 
Year Produced 2012 
Provided To Others? Yes  
Impact We managed to design and manufacture actuation devices used for MRE and disseminate them across our partners 
 
Title In-line MRE analysis 
Description This is an add-on to the image acquisition sequence that allows the calculation of elastograms at the point of acquisition without the need of additional materials of knowledge. 
Type Of Material Data analysis technique 
Year Produced 2012 
Provided To Others? Yes  
Impact The tool allows non-expert operators to acquire MRE data and assess data quality. This makes this a valuable clinical tool 
 
Title MICL 
Description Establishment of the Molecular Imaging Chemistry Laboratory at Forvie Site, Cambridge Biomedical Campus, Cambridge (2008): a dedicated facility for the development, synthesis and evaluation of novel imaging probes. 
Type Of Material Improvements to research infrastructure 
Year Produced 2013 
Provided To Others? Yes  
Impact Major new grants to support dementia initiative 
 
Title Microfluidic methods for PET radiopharmaceuticals 
Description Development of microfluidic methods for the preparation of PET radiopharmaceuticals 
Type Of Material Technology assay or reagent 
Provided To Others? No  
Impact TBD 
 
Title Novel 11C-METHIONINE PET for pituitary micro adenomas 
Description Functioning pituitary micro adenomas can be very difficult to identify on conventional MR scanning. Dr Mark Gurnell, Dr Franklin AIgbirhio and Professor Pickard in collaboration with colleagues have developed a PET imaging technique based on 11C-Methionine based on an initial contribution of £10000 from JDP's Senior Investigator Award.The Cambridge Pituitary MDT Clinic now attracts tertiary referrals from throughout the UK and abroad for this technique. Oral/pleanry presentations have been given in San Francisco, Sydney and Munich. 3 major papers are in preparation. 
Type Of Material Model of mechanisms or symptoms - human 
Provided To Others? No  
Impact A very difficult group of patients with refractory functioning pituitary micoadenomas are now being offered highly selective endoscopic re-do pituitary operations thereby improving outcomes and reducing the need for expensive and ineffective drug therapies. 
 
Title Pneumatic Actuator for MRE 
Description This actuator consists of an loudspeaker connected to a drum-like element via a plastic tube. This is used for mechanical excitation of tissue. The device does not require additional filtering in the MR environment, is portable and versatile. 
Type Of Material Improvements to research infrastructure 
Year Produced 2012 
Provided To Others? Yes  
Impact The device is a complement to the existing equipment and has the advantage of being portable. This opens the opportunity to easily disseminate the method to other research partners worldwide. 
 
Title UK Neurocritical Care Network (NCCNet) 
Description DKM is the Research and Project Lead for the UK Neurocritical Care Network (NCCNet), a collaborative of 20 plus critical care units involved in the care of neurological patients. This provides the infrastructure for clinical research and trials 
Type Of Material Improvements to research infrastructure 
Year Produced 2007 
Provided To Others? Yes  
Impact as per above 
 
Title functional MR and EEG paradigms for assessment of covert awareness 
Description Study of patients in low awareness states requires the development of psychological paradigms that can be applied in brain scanners including PET and MR. 
Type Of Material Physiological assessment or outcome measure 
Year Produced 2006 
Provided To Others? Yes  
Impact Major papers in Science, NEJM and worldwide publicity 
 
Title Outcome Registry, Intervention and Operation Network (ORION) 
Description ORION is a generic, cloud-based and temporally-specific application developed by Dr Alexis Joannides (Clinical Lecturer in Neurosurgery) as part of the NIHR Brain Injury HTC that allows secure and controlled access to structured healthcare information across multiple sites. It forms the basis for the NIHR Brain Injury HTC information hub and includes: National Prospective Databases - UK CSF Shunt Registry, Vestibular SChwannoma Registry and the DH-funded Children's Epilepsy Surgery Service Service tools - Major Trauma Rehabilitation Prescription, Neuroscience Emergency Referrrals, Ward tai list, NF-2 quality of life collection Studies and audits - Melatools-Q, EPIPEG, Neurooncology Quality of life (recent Innovate UK DAMSEL award), Chronic subdural hamatoma audit, Impaired consciousness Research database. 
Type Of Material Data handling & control 
Year Produced 2013 
Provided To Others? Yes  
Impact The UK shunt Registry was established some 20 years ago and now includes over 70,000 operations and 35,000 patients. It has been an invaluable authoritative and independent source of data for the MDA (now MHRA), neurosurgery units and for research (e.g. case control study of antibiotic impregnated shunt catheters). 
 
Title UK shunt registry 
Description The UK shunt registry was establish some 20 years ago and now includes data on over 70,000 hydrocephalus shunt operations in over 35,000 patients. 
Type Of Material Database/Collection of data 
Provided To Others? No  
Impact Annual reports have confirmed that there are no neurosurgery units where the cumulative failure rate for shunts nor infection rates are persistent outliers. Case control studies have demonstrated the efficacy of antibiotic shunt catheters. The registry has been able to provide the data on which to power hydrocephalus shunt RCTs/ 
 
Description 13C-labelled microdialysis 
Organisation University of Calgary
Department Section of Neurosurgery
Country Canada 
Sector Academic/University 
PI Contribution 13C labelling studies of brain metabolism using microdialysis in traumatic brain injury patients.
Collaborator Contribution Our collaborator has visited us in Cambridge on a Visiting Fellowship (awarded by the Canadian Institute of Health Research). The collaboration is ongoing and our collaborator is a Co-investigator on a current MRC Research Grant (PI: Peter Hutchinson, G1002277 ID 98489).
Impact Publication: Gallagher CN, Carpenter KL, Grice P, Howe DJ, Mason A, Timofeev I, Menon DK, Kirkpatrick PJ, Pickard JD, Sutherland GR, Hutchinson PJ. The human brain utilizes lactate via the tricarboxylic acid cycle: a 13C-labelled microdialysis and high-resolution nuclear magnetic resonance study. Brain. 2009 Oct;132(Pt 10):2839-2849. PubMed PMID: 19700417.
Start Year 2006
 
Description 13C-labelled microdialysis 
Organisation University of Calgary
Country Canada 
Sector Academic/University 
PI Contribution Division of nNeurosurgery (University of Cambridge) hosted Dr Clare Gallagher for a visitnig fellowship, funded by the Canadian Institure of Health Research.
Collaborator Contribution Our collaborator has visited us in Cambridge on a Visting Fellowship (awarded by the CAnadian Institute of Health Research). The collaboration is ongoing and our collaborator is a Co-investigator on a current MRC Research Grant (PI: Peter Hutchinson, G1002277 ID 98489).
Impact PMID: 19700417
Start Year 2006
 
Description Altered States of Consciousness - International Collaborations 
Organisation Cornell University
Country United States 
Sector Academic/University 
PI Contribution Pickard JD: Collaobrations with S Laureys (Liege Belgium) and N Schiff (Cornell, New York); national working parties on Vegetative State (Royal College of Physcicians) and Brain Death (Royal College of anaesthetists); liason with the Official Solicitor.
Impact See publications lists and new grants.
 
Description Altered States of Consciousness - International Collaborations 
Organisation Royal College of Physicians of London
Country United Kingdom 
Sector Academic/University 
PI Contribution Pickard JD: Collaobrations with S Laureys (Liege Belgium) and N Schiff (Cornell, New York); national working parties on Vegetative State (Royal College of Physcicians) and Brain Death (Royal College of anaesthetists); liason with the Official Solicitor.
Impact See publications lists and new grants.
 
Description Altered States of Consciousness - International Collaborations 
Organisation The Royal College of Anaesthetists
Country United Kingdom 
Sector Academic/University 
PI Contribution Pickard JD: Collaobrations with S Laureys (Liege Belgium) and N Schiff (Cornell, New York); national working parties on Vegetative State (Royal College of Physcicians) and Brain Death (Royal College of anaesthetists); liason with the Official Solicitor.
Impact See publications lists and new grants.
 
Description Altered States of Consciousness - International Collaborations 
Organisation University of Liege
Country Belgium 
Sector Academic/University 
PI Contribution Pickard JD: Collaobrations with S Laureys (Liege Belgium) and N Schiff (Cornell, New York); national working parties on Vegetative State (Royal College of Physcicians) and Brain Death (Royal College of anaesthetists); liason with the Official Solicitor.
Impact See publications lists and new grants.
 
Description Altered States of Consciousness - International Collaborations 
Organisation University of Melbourne
Country Australia 
Sector Academic/University 
PI Contribution Pickard JD: Collaborations with S Laureys (Liege Belgium) and N Schiff (Cornell, New York); national working parties on Vegetative State (Royal College of Physcicians) and Brain Death (Royal College of anaesthetists); liason with the Official Solicitor
Impact See publications lists and new grants.
 
Description Application of PET in addiction research 
Organisation University of Cambridge
Department Department of Psychology
Country United Kingdom 
Sector Academic/University 
PI Contribution Application of PET in addiction research.
Impact n/a
Start Year 2010
 
Description British Neurosurgical Trainee Research Collaborative 
Organisation Society of British Neurological Surgeons
Country United Kingdom 
Sector Learned Society 
PI Contribution AK and PH led the efforts to establish the British Neurosurgical Trainee Research Collaborative. The BNTRC is a research network for trainees which will aim to develop, run and support neurosurgical trials.
Collaborator Contribution The SBNS has very generously supported this initiative since its inception.
Impact PMID: 22583319
Start Year 2012
 
Description British Neurotrauma Group 
Organisation Society of British Neurological Surgeons
Country United Kingdom 
Sector Learned Society 
PI Contribution Initiative to set up a special-interest group within the Society of British Neurological Surgeons
Collaborator Contribution Increasing understanding of the issues surrounding decompressive craniectomy in head injury
Impact The first academic meeting of the group took place in 2010 (October). The meeting was attended by neurosurgeons, neurorehabilitation consultants, endocrinologists, neurologists and specialist nurses.
Start Year 2008
 
Description Delica Inc, Shenzhen, China - transcranial Doppler ultrasound company in China 
Organisation Shenzhen Delica Medical Equipment Co., Ltd.
PI Contribution Integration of Cambridge based ICM+ software platform into Delica TC devices.
Collaborator Contribution Delica Inc are a major manufacturer and distributor of TCD equipment in China which affords an excellent platform for iCM+ software through whioch to promote clinical trials.
Impact early stage development
Start Year 2016
 
Description Development and application of microfluidics 
Organisation Advion BioSciences
Country United States 
Sector Private 
PI Contribution Development and application of microfuidics methods in the preparation of PET radiopharmaceuticals
Impact tba
Start Year 2008
 
Description Development of novel fluorination method 
Organisation Newcastle University
Department School of Chemistry
Country United Kingdom 
Sector Academic/University 
PI Contribution Development of novel fluorination method using iodonium compounds
Impact tba
Start Year 2009
 
Description ERASMUS Exchange Programme 
Organisation University of Groningen
Department Department of Biomedical Engineering
Country Netherlands 
Sector Academic/University 
PI Contribution We provided human resources and research infrastructure for MSc students
Collaborator Contribution MSc students
Impact Publications
Start Year 2011
 
Description ERASMUS Exchange Programme 
Organisation University of Lisbon
Department Institute of Biophysics and Biomedical Engineering
Country Portugal 
Sector Academic/University 
PI Contribution We provided human resources and research infrastructure for MSc students
Collaborator Contribution MSc students
Impact Publications
Start Year 2011
 
Description Engineering - finite element analysis of decompressive craniectomy 
Organisation University of Cambridge
Department Department of Engineering
Country United Kingdom 
Sector Academic/University 
PI Contribution Increasing the understanding of the clinical consequences of brain deformation after craniectomy
Collaborator Contribution Finite element analysis of decompressive craniectomy
Impact Publications
Start Year 2010
 
Description European Brain Injury Consortium 
Organisation Antwerp University Hospital
Country Belgium 
Sector Hospitals 
PI Contribution European Brain Injury Consortium: Professor of Anaesthesia is now Co-Chair of the European Brain Injury Consortium, which has successfully lobbied the Directorate General (Health) of the European Commission to generate a call for research in TBI.
Impact The EU funding has now been agreed, and the Framework7 program will be issuing a € 30 million call in 2012.
Start Year 2011
 
Description ICNARC and NCCnet 
Organisation Queen's Medical Centre
Country United Kingdom 
Sector Hospitals 
PI Contribution ICNARC and NCCnet: Professor of Anaesthesia serves on the Management Board of the UK Intensive Care National Audit and Research Centre (ICNARC), and is Project Lead for NCCNet (http://www.nccnet.org.uk) - a research collaborative of UK neurocritical care units.
Impact A collaboration that included ICNARC and NCCNet was recently awarded a £595,000 grant from the HTA.
Start Year 2011
 
Description International Multicentre Randomised Trial 
Organisation European Brain Injury Consortium (EBIC)
Country European Union (EU) 
Sector Charity/Non Profit 
PI Contribution Study set-up, patient recruitment and data collection
Collaborator Contribution Patient recruitment
Impact Recruitment of 280 patients from 43 centres in 17 countries
 
Description International Multicentre Randomised Trial 
Organisation International Neurotrauma Society (INTS)
Country Hungary 
Sector Charity/Non Profit 
PI Contribution Study set-up, patient recruitment and data collection
Collaborator Contribution Patient recruitment
Impact Recruitment of 280 patients from 43 centres in 17 countries
 
Description International Multicentre Randomised Trial 
Organisation Society of British Neurological Surgeons
Country United Kingdom 
Sector Learned Society 
PI Contribution Study set-up, patient recruitment and data collection
Collaborator Contribution Patient recruitment
Impact Recruitment of 280 patients from 43 centres in 17 countries
 
Description MR Elastography 
Organisation Charité - University of Medicine Berlin
Country Germany 
Sector Academic/University 
PI Contribution We implemented and tested MRE equipment and methods on a 3T system. Developed an add-on for the image acquisition that allows automatic in-line analysis.
Collaborator Contribution Delivered the concept for equipment and method and offered expertise in the clinical use of the methods
Impact Constant improve of image acquisition and analysis methods.
Start Year 2009
 
Description MR Elastography 
Organisation University of Edinburgh
Country United Kingdom 
Sector Academic/University 
PI Contribution We implemented and tested MRE equipment and methods on a 3T system. Developed an add-on for the image acquisition that allows automatic in-line analysis.
Collaborator Contribution Delivered the concept for equipment and method and offered expertise in the clinical use of the methods
Impact Constant improve of image acquisition and analysis methods.
Start Year 2009
 
Description Mitochondrial PET Probes 
Organisation Medical Research Council (MRC)
Department MRC Mitochondrial Biology Unit
Country United Kingdom 
Sector Public 
PI Contribution Radiosynthesis and biological evaluation of the PET radioligands
Collaborator Contribution Novel PET probes. Synthesis and biological evaluation of novel chemical entities.
Impact PMID: 20621583
Start Year 2008
 
Description NINDS Common Data Elements in TBI 
Organisation National Institutes of Health (NIH)
Country United States 
Sector Public 
PI Contribution NINDS Common Data Elements in TBI: Professor of Anaesthesia was part of an international and interagency working group sponsored by the NIH, NINDS and US Dept of Defense, which developed new approaches to clinical research in traumatic brain injury, and produced Common data Elements (CDE) for such research.
Impact This process resulted in guidelines which underpins all TBI research, and the Professor of Anaesthesia is lead author on the first international consensus definition of traumatic brain injury. (see: http://www.commondataelements.ninds.nih.gov/TBI.aspx)
Start Year 2011
 
Description Novel Copper-64 
Organisation University of Bath
Department Department of Chemistry
Country United Kingdom 
Sector Academic/University 
PI Contribution Novel Copper-65 molecular imaging probes
Impact tba
Start Year 2008
 
Description Novel PET probes 
Organisation Medical Research Council (MRC)
Department MRC Clinical Sciences Centre (CSC)
Country United Kingdom 
Sector Academic/University 
PI Contribution Development of novel PET probes of mitochondirial dysfunction
Impact tba
Start Year 2009
 
Description Novel PET probes 
Organisation University of Otago
Country New Zealand 
Sector Academic/University 
PI Contribution Development of novel PET probes of mitochondirial dysfunction
Impact tba
Start Year 2009
 
Description Novel copper-64 
Organisation University of Oxford
Department Department of Chemistry
Country United Kingdom 
Sector Academic/University 
PI Contribution Development of Copper-64 hypoxia markers
Impact tba
Start Year 2007
 
Description PET in stroke research 
Organisation University of Cambridge
Department School of Clinical Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution Application of PET in Stroke Research with Prof Jean-Claude Baron of Neurology/Stroke
Impact see publications listing
 
Description Post traumatic pituitary function working group 
Organisation Society of British Neurological Surgeons
Country United Kingdom 
Sector Learned Society 
PI Contribution Led group.
Collaborator Contribution Production of guidance.
Impact In submission
Start Year 2015
 
Description Siemens MRI 
Organisation Siemens Healthcare
Department Siemens Medical Solutions
Country Germany 
Sector Private 
PI Contribution Development of pulse sequences for use on Siemens MRI systems
Collaborator Contribution Provision of the software development environment. Access to collaboration manager.
Impact Improved pulse sequences for diffusion modelling and real-time fMRI
Start Year 2006
 
Description Siemens Molecular Imaging 
Organisation Siemens Healthcare
Department Siemens Medical Solutions
Country Germany 
Sector Private 
PI Contribution Research collaboration in the development of PET probes for neurodegeneration.
Impact tba
Start Year 2009
 
Title Cranial access device 
Description MRI compatible device to transmit monitoring probes into the brain. 
IP Reference GB2330080 
Protection Patent granted
Year Protection Granted
Licensed Yes
Impact Use in clinical practice
 
Title ICM+ 
Description Software to collect data from multimodlaity bedside monitors in intensive care for subsequent analysis in real time. 
IP Reference  
Protection Copyrighted (e.g. software)
Year Protection Granted
Licensed Yes
Impact Basis for multinational research collaboration between worldcalss neurointensive care units.
 
Title ICM+ software 
Description Software that allows the collection of data from multimodlaity bedside monitors in neurointensive care and subsequent analysis in real time. 
IP Reference  
Protection Copyrighted (e.g. software)
Year Protection Granted
Licensed Yes
Impact ICM+ is the basis of a multinational collaboration of worldclass neurointensive care units.
 
Title Rapid uptake of lipophilic triphenylphosphonium cations by mitochondria in vivo following intravenous injection: Implications for mitochondria-specific therapies and probes. Biochim Biophys Acta. 2010 Jun 8. [Epub ahead of print] PubMed PMID: 20621583. 
Description Rapid uptake of lipophilic triphenylphosphonium cations by mitochondria in vivo following intravenous injection: Implications for mitochondria-specific therapies and probes. Biochim Biophys Acta. 2010 Jun 8. [Epub ahead of print] PubMed PMID: 20621583. 
IP Reference Insufficient Information 
Protection Patent application published
Year Protection Granted
Licensed Commercial In Confidence
Impact Has resulted in a patent application being filed; and award of MRC Development Grant Funding (DGF) for development of a clinically applicable PET tracer of mitochondrial function
 
Title ICM+ Sofware 
Description ICM+ software [www.neurosurg.cam.ac.uk/icmplus]. ICM+ captures the enormous quantities of physiological data from each patient in an neurointensive care environment form which information about cerebral auto regulation, cerebral compensatory reserve, oxygenation, metabolite production and function can be obtained. Minute to minute decisions about appropriate management can be made based on detection of changing cerebrovacular haemodynaamics. The same software has a major role in tyne management of hydrocephalus and other csf disorders. 
Type Support Tool - For Medical Intervention
Year Development Stage Completed 2016
Development Status Under active development/distribution
Clinical Trial? Yes
Impact ICM+ (http://www.neurosurg.cam.ac.uk/icmplus), which is by now used in many clinical centres worldwide, attempts to bridge the gap between laboratory and clinical application. It collects data from bedside monitors, calculates in real time 'secondary' parameters defined using highly configurable signal processing formulae and produces continuously updated charts. This way complex information coming off the bedside monitors can be summarized in a concise fashion and presented to medical staff in a simple way that alerts them to the development of various pathological processes. ICM+ software licensed by University of Cambridge Enterprise Ltd. [www.neurosurg.cam.ac.uk/icmplus Novel methods of measurement developed by Marek Czosnyka, Peter Hutchinson, David Menon and John Pickard have provided new insights into the pathophysiology of brain injury, led to commercial applications, and influenced patient care in terms of improved outcome for clinical trials. Multimodality brain monitoring of intracranial pressure (ICP), brain oxygen and microdialysis; PET/MRI imaging of critically ill patients; and computerised CSF infusion tests for shunt function in hydrocephalus have each impacted on the clinical practice and the ability to evaluate novel treatments and interventions in brain injury. This work has led directly to the establishment of a National Institute for Health Research (NIHR) Health Technology Cooperative for Brain Injury. Underpinning research In 1991 a research group was established across Departments in the Cambridge University Clinical School to undertake research in traumatic brain injury (TBI) and abnormalities of CSF. The group was led jointly by Marek Czosnyka (Senior Research Associate, 1991; Professor of Brain Physics, from 2013), Peter Hutchinson (Reader in Neurosurgery, 2008-date; NIHR Professor from 2013), David Menon (University Lecturer, 1993; Professor of Anaesthesia, from 2000) and John Pickard (Professor of Neurosurgery, from 1991). Central to the impact has been the introduction of technologies derived from brain physics for real-time measurement of brain function in the context of acute injury. Technology that combines monitoring and imaging techniques has been licensed and has increased understanding of the pathophysiology of TBI and CSF disorders; defined optimal physiological parameters associated with best outcome in clinical trials; and altered the care of patients in the neurosciences intensive care setting nationally and internationally. The research encompasses four domains: Brain physics: By applying multimodal brain monitoring1 (introduced 1991) novel indices of cerebrovascular physiology have been defined including autoregulation with the following major findings: • TBI: (1) cerebrovascular pressure reactivity independently associates with outcome; (2) extremes of cerebral perfusion pressure (CPP) contribute to worse outcome; and (3) optimal CPP is a valid therapeutic target (2012)2 • CSF: (1) non-invasive ICP can be estimated from cerebral blood flow velocity and arterial pressure (2000); (2) normal pressure hydrocephalus results from a dysfunction of CSF dynamics, white matter softening and dysautoregulation with aging (2008); and (3) idiopathic intracranial hypertension can be treated with venous stenting (2002)3 
URL http://www.neurosurg.cam.ac.uk/icm+home
 
Title Novel Mitochondrial PET probes 
Description Partnership with MRC an dthe University of Otago 
Type Diagnostic Tool - Imaging
Current Stage Of Development Initial development
Year Development Stage Completed 2010
Development Status Under active development/distribution
Impact TBD 
 
Title Novel PET markers of B-amyloid plaque in partnership with Merck 
Description Merck assisting with funding 
Type Diagnostic Tool - Imaging
Current Stage Of Development Initial development
Year Development Stage Completed 2010
Development Status Under active development/distribution
Clinical Trial? Yes
Impact tbd 
 
Title ICMplus 
Description ICM+ software [www.neurosurg.cam.ac.uk/icmplus]. ICM+ captures the enormous quantities of physiological data from each patient in an neurointensive care environment form which information about cerebral auto regulation, cerebral compensatory reserve, oxygenation, metabolite production and function can be obtained. Minute to minute decisions about appropriate management can be made based on detection of changing cerebrovacular haemodynaamics. The same software has a major role in tyne management of hydrocephalus and other csf disorders. 
Type Of Technology Software 
Year Produced 2006 
Impact ICM+ (http://www.neurosurg.cam.ac.uk/icmplus), which is by now used in many clinical centres worldwide, attempts to bridge the gap between laboratory and clinical application. It collects data from bedside monitors, calculates in real time 'secondary' parameters defined using highly configurable signal processing formulae and produces continuously updated charts. This way complex information coming off the bedside monitors can be summarized in a concise fashion and presented to medical staff in a simple way that alerts them to the development of various pathological processes. ICM+ software licensed by University of Cambridge Enterprise Ltd. [www.neurosurg.cam.ac.uk/icmplus 
URL http://www.neurosurg.cam.ac.uk/icm+home
 
Title ICMplus 
Description ICU monitoring software. Developed by Marek Czosnyka and Peter Smielewski. 
Type Of Technology Software 
Impact Take up internationally 
 
Company Name ICMplus - Cambridge Enterprise. Led by Marek Czosnyka and Peter Smielewski. 
Description Medical software, 
Impact Improvement of monitoring and data capture in Intensive Care.
 
Company Name Technicam and Medicam 
Description www.technicam.co.uk Technicam Limited, a British company, was established in 2000 by a group of neurosurgeons and Centrax Limited of Newton Abbot, a precision engineering company. The aim of the company is the development of innovative advances in the field of surgical devices. All Technicam products are patent protected and CE marked. The Technicam Cranial Access Device has received an award as a Millenium Product for innovation The indications for skull burr-holes include insertion of intra-cranial bolts, insertion of exterior ventricular drains(ventriculostomies) , insertion of ventricular catheters for shunts , drainage of chronic subdural haematomas and access for brain biopsies. Burr-holes have been traditionally performed either by using air-powered drills or by hand using a brace, perforator and spherical burr. Recently the demand for cranial access via burr-holes has increased due to the application of monitoring probes, (intra-cranial) pressure transducers, oxygen and multi-parameter sensors and micro-dialysis catheters, and the increasing use of external ventricular drains in patients with head injury and subarachnoid haemorrhage. Traditionally, burr-holes have been performed in the operating theatre. By undertaking them on the intensive care unit, however, the complications of transferring the patient to the operating theatre can be avoided. 
Impact Technicam have therefore developed a new cranial access system designed to simplify burr-holes, and facilitate the insertion of monitoring probes and external ventricular drains for use in the intensive care unit or the operating theatre - the Technicam Cranial Access System.
Website http://www.technicam.co.uk
 
Description Between Life and Death 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact The NCCU was the context for a recent BBC program on decision making in severe brain injury: "Between Life and Death" aired on BBCi on the 13th of July 2010. This program, and the accompanying blog by Professor of Anaesthesia have resulted in enormous public and media interest and discussion (see: http://www.bbc.co.uk/blogs/tv/2010/07/between-life-and-death-why-med.shtml#comments and http://www.bbc.co.uk/programmes/b00t3szs). An email to Professor of Anaesthesia from the Executive Producer of the program quotes the Head of BBC1 stating the film to be "one of the best uses of public service broadcasting" she has been involved with.

Extremely well received.This year the BBC documentary "Between Life and Death", filmed in the Neurocritical Care Unit about three patients' journeys post neurotrauma (see: http://www.bbc.co.uk/programmes/b00t3szs), generated a BBC blog run by Professor of Anaesthesia (http://www.bbc.co.uk/blogs/tv/2010/07/between-life-and-death-why-med.shtml), and
won a BAFTA television award (http://www.youtube.com/watch?v=8seN2xUwPxA) and a Royal Television Society Award.
Year(s) Of Engagement Activity 2010,2011
URL http://www.bbc.co.uk/blogs/tv/2010/07/between-life-and-death-why-med.shtml#comments
 
Description Cambridge Science Festival 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Over 30,000 members of the public attend. Open to families and school groups etc.
B.Sahakian - patron 2007

Very successful event as it combines fun and education. The support of the MRC is emphasised ast every appropriate opportunity.
Year(s) Of Engagement Activity 2007,2008,2009,2010
 
Description Headway support groups 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact TBI patients attended lectures by DKM, JDP and PJAH

Headway invited patient groups to the lectures.
Year(s) Of Engagement Activity 2006,2007,2008
 
Description Lecture 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Professor of Anaesthesia lecture to Royal Grammar School Guildford and Queens College, Cambridge - at the request of patient groups, including Headway.

HIgh interest from students
Year(s) Of Engagement Activity 2008,2009,2010
 
Description National Science Week 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact 25 students from Cambridge school attended open- day talks on MRI and PET.

School reported high interest.
Year(s) Of Engagement Activity 2006,2007,2008,2009,2010
 
Description Physics at Work 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact over 200 students from Cambridge area schools participate

high participation from high schools
Year(s) Of Engagement Activity 2006,2007,2008,2009,2010
 
Description Physics at Work programme 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact More than 200 pupils from Cambridge high schools attend.

n/a
Year(s) Of Engagement Activity 2006,2007,2008,2009,2010
 
Description TV Documentary 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Type Of Presentation Poster Presentation
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Panorama Special programme.

This programme was extremely well received and broadcast to many countries around the world.
Year(s) Of Engagement Activity 2012
URL http://www.bbc.co.uk/news/health-20268044
 
Description TV News 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Pilot studies on Down's syndrome with PIB on Channel 4 news http://www.channel4.com/news/more-people_with_downs_syndrome-developing_dementia.

na
Year(s) Of Engagement Activity 2011
 
Description University Alumni annual visit 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact average of 20 - 40 alumni visit annually.
Professor Pickard's 2013 lecture was highly rated and attracted some 200 delegates

Always well received.
Year(s) Of Engagement Activity 2006,2007,2008,2009,2010