A major obstacle in advancing TBI treatment is the lack of mechanistic targets for personalized treatment. Current assessments of secondary injury merely reflect injury processes, often after the damage is done, and do not allow detection of mechanisms that could be targeted for neuroprotection therapy. The discovery and characterization of spreading depolarizations (SD) offer hope to improve this situation. SDs are a sustained loss of membrane electrochemical gradients in cells - the largest possible disturbance of still-viable nervous tissue.

Led by PI Jed Hartings, PhD, Spreading Depolarization II (SDII) is a next stage multi-center study, leveraging the rich infrastructure and data collection of TRACK-TBI. Conducted as an add-on study, it provides for maximal electrophysiologic monitoring of patients admitted to the TRACK-TBI ICU cohort. All patients also undergo EEG recordings to determine, by comparison to invasive recordings, whether EEG manifestations of SD can be reliably observed non-invasively. Electrophysiology and all other high-resolution physiologic monitoring data (e.g. ICP, P_tiO₂, blood pressure) are captured using the Moberg CNS monitors and the Advanced ICU Amplifier, which was specially engineered for SD data collection.