Savalia Lab | Neurology Research

This research aims to better understand the pathomechanisms of secondary injuries following TBI, with a specific focus on intracranial hypertension and paroxysmal sympathetic hyperactivity, to ultimately improve therapeutic options, patients’ clinical trajectories, long term recovery, and health system outcomes.

Project Title: Characterization and Validation of Biomarkers in the Acute Stage of TBI to Predict Secondary Injuries and Outcomes following Injury

Brief Description: Enrollment into prospective observational study to examine biospecimens (CSF, blood, urine, sputum) for the investigation, characterization, and validation of biomarkers during the acute stage following TBI to refine injury characterization, accurately predict risk of developing specific secondary injuries, and improve our ability to clinical intervene in an effort to improve prognostication and outcomes following TBI. This project involves close collaboration with my colleague, Dr. Kassandra Ori-McKenney (Molecular & Cellular Biology) where we have two specific endeavors: a) exploring tau pathoconversion in serial CSF/blood samples to identify potential mechanistic link(s) between severe TBI patients experiencing recurrent intracranial hypertension and development of neurodegenerative disease; b) elucidating the impact of sedative choice on tau pathology and neurological outcomes after severe TBI - through characterizing temporal dynamics of CSF tau and phosphorylation in relation to sedative use and biodirectional patient outcomes; investigating the relationship between CSF tau profiles and aggregation propensity in vitro.

Project Title: I-TAME PSH in TBI: Improving Treatment Approaches and Methods for Evaluation (I-TAME) of Paroxysmal Sympathetic Hyperactivity (PSH) in Traumatic Brain Injury (TBI)

Brief Description: This is an interdisciplinary clinical-research project in collaboration with my colleague, Dr. Nicholas Race (Physical Medicine & Rehabilitation), focused on paroxysmal sympathetic hyperactivity (PSH). PSH is a well-documented but poorly understood complication of severe brain injury. Our overall goal is to deply an interdisciplinary clinical-research ecosystem with paradigm-shifting implementation of modernized precision approaches to PSH diagnosis and management. There are three specific areas of research focus: i) implementation science, ii) treatment approaches, iii) predictive/diagnostic biomarkers enabling precision medicine. There is an additional quality-improvement component of our project which focuses on i) evaluation of PSH in neurologically injured patients at UC Davis with an emphasis on how implementation of a validated scoring tool may influence specific outcome measures (i.e., medication regimen, length of ICU/hospital stay, morbidity, functional outcomes, etc.), and ii) nursing education to improve understanding of this physiologic phenomenon with implementation of a validated scoring system in clinical practice.

Project Title: Investigating the Effects of Recurrent Intracranial Hypertension following TBI in a Novel Rat Model of Secondary Injury

Brief Description: Development of a secondary injury animal model that mimics human pathophysiology to investigate mechanisms (and ultimately develop novel treatment targets) whereby recurrent intracranial hypertension worsens morbidity. 

Project Title: Investigation of physiologic, mechanistic, or socioeconomic data to enhance understanding the pathophysiology and/or outcomes following traumatic brain injury. 

Brief Description: Utilizing the UC Davis TBI Registry (adult and pediatric population; 2008-present), we hope to investigate pathophysiology and determinants of patient outcomes following TBI. We are specifically interested in developing probabilistic models of temporal state-change using flowsheet trends post-TBI for prediction of intracranial hypertensive crises and patient outcomes. We are additionally exploring the increased incidence of scooter accidents cared for at UC Davis to evaluate epidemiologic trends and potential need for policy changes in Sacramento.

• Meghan Gann, Assistant Specialist
• Close collaborators:
  • Kassandra Ori-McKenney, Ph.D. (Molecular & Cellular Biology)
  • Nicholas Race, M.D., Ph.D. (Physical Medicine & Rehabilitation)