The Department of Neurosurgery at Massachusetts General Hospital provides a complete range of surgical services for the diagnosis, surgical treatment and rehabilitation of neurologic disorders of the brain and spine. The department performs over 4,300 procedures each year, often removing tumors that other hospitals consider inoperable.
On the research side, neurosurgery clinicians and scientists work closely to identify new strategies to improve the prevention, diagnosis and treatment of brain and spine disorders.
Beth Costine-Bartell, PhD, an assistant investigator in Neurosurgery at Mass General and an assistant professor of Neurosurgery at Harvard Medical School, is working to identify new treatments to help children with traumatic brain injuries.
It’s a quest that requires long hours and a lot of persistence.
Beth Costine-Bartell, PhD
How would you briefly describe your research?
My primary research focus is the pathophysiology of traumatic brain injury (TBI) and the brain’s ability to self-repair after TBI in children. There is currently no successful therapeutic for any type of TBI in children.
Our work aims to understand the cascades that occur after brain injury as tissue damage evolves and spreads causing further damage after the initial injury. Through this understanding, we can identify and test potential therapies.
We focus on a severe traumatic brain injury (TBI) injury pattern that typically results from abusive head trauma in infants and children as well as a focal contusion model to study post-traumatic epilepsy and to evaluate cell-mediated therapies, which is along the lines of CAR T-cell therapy for cancers.
My long-term goal is to create age- and injury-specific treatments for TBI, contribute to better diagnosis of abusive head trauma, and improve scientific clarity in the medicolegal system surrounding abusive head trauma.
How many patients does your work impact and apply to those worldwide?
In the United States, TBI (accidental, abusive, or violent) is a major cause of death and disability, with 176 deaths per day and 3 million people affected annually. Worldwide, 96 million people sustain TBI per year. Because domestic violence is often concealed, the number of those affected by TBI is likely higher.
Most moderate to severe TBIs in infants and toddlers are due to abuse. It’s an epidemic that receives little attention, although the incident rate per 100,000 children is more than all childhood cancers combined.
What is the pace of your field?
Our pace is driven by the logistics of our complicated experiments, grant funding, and limited access to our popular core facilities. It is a privilege to do science at MGH with amazing collaborators and the excellent staff of our core facilities.
But the pace is often determined by the availability of shared resources, our funding, staff availability, or the urgency to get pilot data for the next grant submission deadline.
When all the resources align, we work at a pace that is faster than is comfortable but not so fast that the quality of our data is compromised.
You have to be passionate about doing research that can improve the lives of those suffering debilitating and life-altering traumatic brain injury to be willing to continue to jump all the logistical hurdles!
I sleep in my office a few nights a month to be onsite during our 30-hour experiments. My time at the bedside of TBI patients and their families while enrolling patients for clinical TBI trials and helping work up infant homicide cases from abusive head trauma fuels my passion and my all-out persistence.
Where do you see TBI research heading in the future?
Hundreds of therapies that successfully reduced the damage after TBI in small animal models have failed to translate to children or adults.
We need a three-pronged approach to future research to address this translatability issue: (1): movement towards large animal models, (2): new technologies, and (3): specific treatments for specific types of pathoanatomic lesions among specific ages.
We know that one therapy will not work for all ages or all types of TBI. While the chronic effects of repeat TBI on professional athletes have been a popular focus in the past decade, those sustaining TBI from domestic violence – both women and children, might finally be receiving more attention.
Unfortunately, the number of children sustaining abusive head trauma annually in the United States adds up to more than all the players in the NFL. I hope this underrepresented population in TBI research catches up to the incidence of TBI in this vulnerable population.
About the Mass General Research Institute
Massachusetts General Hospital is home to the largest hospital-based research program in the United States. Our researchers work side-by-side with physicians to develop innovative new ways to diagnose, treat and prevent disease.
Support our research
Leave a Comment