range. In addition, the current evidence supporting various treatment and
management methods of concussion effects is examined, including cog-
nitive restructuring/ reassurance, aerobic therapy, and other therapies.
Return to school and activity will also be reviewed. Reference is made to
the 2013 American Academy of Neurology Sport Concussion evidence-
based guidelines as well as more recent research. Recommendations for
future research is provided to address the existing needs.
Keywords: Sport Concussion, Evidence Based, Concussion As-
sessment, Concussion Management
S08 Operation Brain Trauma Therapy: The Thrill of
Victory and the Agony of Defeat
S08-01
MULTI-CENTER PRE-CLINICAL THERAPY SCREENING IN
TBI: RESULTS OF THE OBTT CONSORTIUM
Patrick Kochanek
Safar Center for Resuscitation Research, Univ. of Pittsburgh, De-
partment of Critical Care Medicine, Pittsburgh, USA
Operation Brain Trauma Therapy (OBTT) is a fully operational, rigorous,
and productive multi-center, pre-clinical drug and circulating biomarker
screening consortium for the field of traumatic brain injury (TBI). In this
presentation, I will synthesize the findings from the first five therapies
tested by OBTT, and discuss both the current work that is ongoing and
potential future directions. Based on the results generated from the first five
therapies tested within the exacting approach used by OBTT, four (nico-
tinamide, erythropoietin, cyclosporine A, and simvastatin) performed be-
low or well below what was expected based on the published literature.
However, OBTT has identified the early post-TBI administration of le-
vetiracetam as a promising agent and has advanced it up the phylogenic
scale to a FPI model in micropigs. The 6th and 7th therapies have just
completed testing (glibenclamide and Kollidon VA 64) and an 8th drug an
aquaporin-4 blocker AER 271 is in testing. The results of those three
therapies will also be updated. Given the concerns related to what has been
described as a reproducibility crisis in basic and pre-clinical research, and
the failures in clinical translation of therapies in TBI, rigorous multi-center,
pre-clinical approaches to therapeutic screening such as OBTT may be
important for the ultimate translation of therapies to the human condition.
Keywords: consortium, reproducibility, behavior, neuropathology,
biomarkers
S08-02
A UNIQUE TOOL FOR CROSS MODEL COMPARISON IN
PRECLINICAL TRAUMATIC BRAIN INJURY
Deborah Shear
Walter Reed Army Institute of Research, Brain Trauma Neuropro-
tection and Neurorestoration Branch, Center for Military Psychiatry
and Neuroscience, Silver Spring, USA
The Operation Brain Trauma Therapy (OBTT) testing platform is
comprised of 4 Drug Screening Centers and a Biomarker Core. Candidate
TBI therapies are first screened across well-established rodent models of
traumatic brain injury (TBI) with the most promising drugs selected for
advanced testing in a micropig animal model (VCU). In this presentation,
I will give an overview of the OBTT approach to primary drug screening
in rodent TBI models to include comparing and contrasting neurobeha-
vioral outcomes specific to each model. The primary OBTT TBI drug
screening models include the fluid percussion injury (FPI) model (Mi-
ami), the controlled cortical impact (CCI) model (U. Pitt.) and the pen-
etrating ballistic-like brain injury (PBBI) model (WRAIR). In addition,
this presentation will illustrate the underlying rationale for combining
neurobehavioral outcomes with neuropathological and biomarker mea-
sures into a scoring matrix to provide comprehensive top-down vs. bot-
tom-up comparisons on each drug. Importantly, for primary drug
screening, unified treatment regimens (tailored to each drug) are em-
ployed across all TBI models and animals are randomly assigned to
treatment vs. control groups with surgeries, behavioral testing and all
subsequent analyses conducted in a blinded fashion within and between
each Center. The strength of this approach is that it provides unprece-
dented rigor to pre-clinical TBI drug research that has been deemed
critical for the successful translation of therapies to clinical studies. This
project is supported by U.S. Army Grant W81XWH-10-1-0623.
Keywords: TBI, OBTT, Neuroprotection, Biomarkers
S08-03
BIOMARKERS AS A WINDOW ON TBI MODELING AND
THERAPEUTIC EFFICACY: RESULTS OF THE OBTT CON-
SORTIUM
Stefania Mondello
University of Messina, Neurosciences, Messina, Italy
Operation Brain Trauma Therapy (OBTT) is a multi-center pre-clin-
ical drug screening consortium testing promising therapies for trau-
matic brain injury (TBI) in 3 well-established TBI models, namely
parasagittal fluid percussion injury (FPI), controlled cortical impact
(CCI), and penetrating ballistic-like brain injury (PBBI) using state-
of-the-art behavioral and histological outcome tools as well as as-
sessing circulating brain damage biomarkers.
In this presentation, I will discuss unique characterization of these
models using novel candidate biomarkers [glial fibrillary acidic protein
(GFAP) and ubiquitin C-terminal hydrolase (UCH-L1)] demonstrating
that different experimental TBI models display specific biomarker
profiles. Furthermore, I will present evidence that drugs differently af-
fect distinct types of lesions as reflected by distinct biomarker pathways
that are also associated with diverse functional deficits and pathological
consequence in brain tissue. These observations indicate that bio-
markers may be a valuable means for characterization, standardization
and refinement of TBI animal models, and serve as surrogate markers of
treatment effect after a specific therapeutic intervention.
In reviewing these concepts, a series of critical issues such as need
for evidence of analytical validity and clinical translation as well as
implications for future research and theranostic roles of biomarkers in
drug discovery and clinical trials will be discussed.
Keywords: Ubiquitin carboxyl-terminal hydrolase-L1, Glial fi-
brillary acidic protein, Fluid percussion injury, Controlled cortical
impact, Penetrating ballistic-like brain injury, Rat
S09 Influence of Lesion, Stress, and Exercise on
Blood Brain Barrier Permeability in the CNS
S09-01
REMOTE BLOOD BRAIN BARRIER DISRUPTION AFTER
MID-THORACIC SPINAL CORD INJURY
D. Michele Basso
1
, Jonathan Godbout
2
, Timothy D Faw
3
, Christopher
N. Hansen
4
, John F. Sheridan
5
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