COSBID is an international group of clinical and basic scientists working on various types of brain injury resulting from head injuries or vascular strokes of different types. Our work includes both the investigation and treatment of human patients and the investigation of experimental models of these diseases.
Since 2000 the group has expanded from two centers in Europe to 16 contributing centers in Europe and USA. More centers are preparing to recruit patients.
Members of the group convene twice a year for a two day meeting.
Top row: Jed Hartings, Jens Dreier, Anthony Strong, Rudolf Graf
Bottom row: Martin Fabricius, Martin Lauritzen, Peter Hutchinson
This group of seven persons, mainly from the early core centres, meet twice a year in connection with the general COSBID meetings and have a continuous debate and decision process running throughout the year. The steering committee addresses development of the research protocol, ethical questions, substudy applications and monitoring, recruitment of new centers, and grant application strategies.
The core null hypothesis of the study is that repeated depolarisations are unrelated to the 6 month clinical outcome in acute brain injury. This is addressed through clinical assessments and registration and analysis of the electrocorticogram (ECOG) as recorded by subdural electrodes. Most of the centers also engage in a variety of substudies. The general aim of these studies is to document the structural, metabolic, circulatory and other paraclinical consequences of the depolarisations. This is achieved by applying various techniques such as neuroimaging, microdialysis, cerebral blood flow measurement and a variety of other methods in parallel to the elctrocorticography. Participation in these studies is based on mutual agreement and is organised and supervised by the steering committee.
Four disease groups are recruited to the study. While the ECOG and outcome data are evaluated for the joint study population, more extensive studies are conducted as an add-on for each group. These studies are targeted on collecting data of particular importance for that specific group. The diagnoses are:
At the June 2005 meeting in Cologne, it was agreed to form an Experimental Section, which will comprise research-active basic neuroscientists studying mechanisms with a bearing on spreading depression, who can provide experience and advice that will inform the main clinical research activities of COSBID. It is expected that investigators joining this section will be willing, like the accredited members, (1) to contribute actively to grant-writing, and (2) to recruit neuro-clinicians in their centre to contribute core clinical data to COSBID, and (3) to accompany clinical studies by complementary experimental work, preferentially using models of the 4 disease groups studied by COSBID.