1 The Outcomes of Neural Stem Cell Transplantation and Localized Drug Therapy on Patients Suffering from Traumatic Brain Injury John Doe Panther ID: 12121212 Assignment #1 Florida International University 2 Introduction TBI Trend and Growth Traumatic Brain Injury (TBI) affects a wide variety of people nationwide. One constant does remain; the human condition suffers, both internally and externally. Studies confirm that caregivers of those who suffer from TBI may experience feelings of burden, distress, anxiety, anger, and recurring depression (Brain Injury Association of America [BIAUSA], 2015). More detrimental is the alarming number of deaths and disabilities caused by TBI, which contribute to roughly 30% of ALL injury related deaths in the U.S. (Centers for Disease Control and Prevention [CDCP], 2014). The effects of TBI can include impaired thinking or memory, movement, sensation, or emotional function (CDCP, 2014). The ferocity and utter devastation of those afflicted with this condition are severely hindered in life and in turn the negative prognosis can have an enduring effect on relatives and even on a community as a whole. The proposed study will review current literature and collective research models and data based on neural stem cell transplantation on injured brains and their positive outcomes; as well as, the facilitation of newly implemented procedures for localized drug therapy on their respective injury sites. Studies are primarily collected in controlled laboratory setting and modeled on mice for efficacy of desired treatment protocol. Study goals will also encompass current newly invested research at the University of Miami Miller School of Medicine and the University of Michigan Medical School so as to further support the indicated research listed above. Background: Origins of TBI and Impact TBI is primarily found in patients who suffer from penetrating head injuries that disrupt the normal function of the brain. It is important to note that not all blows and bumps necessarily result in TBI formation, but, is based on how serious head trauma is and can range from mild 3 (i.e. brief change in mental status) to severe (i.e. an extended period of unconsciousness or major loss of cognitive and motor function) (CDCP, 2014). According to the CDCP (2014), most cases of TBI result in mild symptoms, like concussions, but if left unchecked can result in serious injury or even death in some cases. TBI has a very unpredictable form of recovery and many factors can contribute to the ultimate outcome, such as, pre-morbid personality and oriented goal direction of healthcare team and patient alike, length of coma, specific area of the brain or brain stem damaged, family support, age the injury occurs, and care of specialized rehabilitation services (BIAUSA, 2015). General Problem Statement The general problem is represented with the ...

1. 1
The Outcomes of Neural Stem Cell Transplantation and
Localized Drug Therapy on Patients
Suffering from Traumatic Brain Injury
John Doe
Panther ID: 12121212
Assignment #1
Florida International University
2
Introduction

2. TBI Trend and Growth
Traumatic Brain Injury (TBI) affects a wide variety of people
nationwide. One constant
does remain; the human condition suffers, both internally and
externally. Studies confirm that
caregivers of those who suffer from TBI may experience
feelings of burden, distress, anxiety,
anger, and recurring depression (Brain Injury Association of
America [BIAUSA], 2015). More
detrimental is the alarming number of deaths and disabilities
caused by TBI, which contribute to
roughly 30% of ALL injury related deaths in the U.S. (Centers
for Disease Control and
Prevention [CDCP], 2014). The effects of TBI can include
impaired thinking or memory,
movement, sensation, or emotional function (CDCP, 2014). The
ferocity and utter devastation of
those afflicted with this condition are severely hindered in life
and in turn the negative prognosis
can have an enduring effect on relatives and even on a
community as a whole. The proposed
study will review current literature and collective research
models and data based on neural stem

3. cell transplantation on injured brains and their positive
outcomes; as well as, the facilitation of
newly implemented procedures for localized drug therapy on
their respective injury sites. Studies
are primarily collected in controlled laboratory setting and
modeled on mice for efficacy of
desired treatment protocol. Study goals will also encompass
current newly invested research at
the University of Miami Miller School of Medicine and the
University of Michigan Medical
School so as to further support the indicated research listed
above.
Background: Origins of TBI and Impact
TBI is primarily found in patients who suffer from penetrating
head injuries that disrupt
the normal function of the brain. It is important to note that not
all blows and bumps necessarily
result in TBI formation, but, is based on how serious head
trauma is and can range from mild
3
(i.e. brief change in mental status) to severe (i.e. an extended
period of unconsciousness or major

4. loss of cognitive and motor function) (CDCP, 2014). According
to the CDCP (2014), most cases
of TBI result in mild symptoms, like concussions, but if left
unchecked can result in serious
injury or even death in some cases. TBI has a very
unpredictable form of recovery and many
factors can contribute to the ultimate outcome, such as, pre-
morbid personality and oriented goal
direction of healthcare team and patient alike, length of coma,
specific area of the brain or brain
stem damaged, family support, age the injury occurs, and care
of specialized rehabilitation
services (BIAUSA, 2015).
General Problem Statement
The general problem is represented with the figures provided
by the CDCP in 2010;
about 2.5 million Emergency Department (ED) cases were
associated with TBI; either presented
singly or in combination with another injury here in the United
States (CDCP, 2014). TBI was a
diagnosis in more than 280,000 hospitals and of those cases
50,000 ended in death before and
while at the ED (CDCP, 2014). Based on the collection of data

5. by the CDCP (2014), leading
causes of TBI include: Falls (40.5%), unknown (19.0%), struck
by/against (15.5%), motor
vehicle/ traffic accident (14.3%), and assaults (10.7%). Data
also suggests that falls account for
the greatest reason for TBI from 2006-2010 (CDCP, 2014).
Falls also disproportionately affect
the youngest and oldest age groups across the board, although
no definitive correlation expresses
causation between the older you are the More likely you are to
fall and the younger you are the
Less likely you are to fall and become burdened with TBI.
Specific Problem Statement
The specific problem in TBI is that it can be rooted based on
scientific evidence that out
of the 73 institutions currently focused on TBI research, only
three are using neural stem cells to
4
promote neurogenesis in the brain and out of those three
institutions, only two have a drug
approved by the FDA that increases glucose activity in injured

6. bregma regions of the brain
(National Institute of Neurological Disorders and Stroke
[NINDS], 2016). As aforementioned in
the previous paragraph, TBI is a major source of death and
disability here in the US; not only
does it account for a large portion of ED care and attention,
treatment procedures and positive
outcomes in today’s world of modern day medicine are very
sporadic in nature and thus can be
emotionally devastating on the family of the afflicted patient.
Sometimes good days are followed
by bad days in the ICU and that doesn’t always imply
permanent reversals of conditions due to
TBI (i.e. paralysis, mental retardation, comatose, concussion,
etc.). Only the University of Miami
Miller School Of Medicine and the University of Michigan
Medical School have been able to
successfully immobilize the lingering effects of decreased brain
glucose metabolism due to TBI,
as well as, genetically modify neural progenitor cells (NPC’s)
in order to increase
histopathological outcomes thus increasing hippocampal
neurogenesis in patients who suffered
from Projectile Ballistics Brain Injuries [PBBI] (Bramlett et al.,

7. 2015). If clinical professionals
began to implement the models and research methods that have
been tested in the lab setting,
then it is ultimately believed that TBI treatment outcomes and
prognosis will be headed towards
the right direction.
Purpose of the Study
The purpose of this research will be to gather existing data set
for analysis on TBI
research and test the effectiveness associated with
transplantation of NPC’s and the results of
localized drug therapy on major traumatic injury sites of the
brain. After statistical data has been
compared to those research facilities that are not implementing
this treatment methodology,
literature review of information pertaining to efficacy of lab
results and extrapolation of data
5
synthesis; as to why most research is going to be gearing
towards this new path of medicine in
the near future will also be discussed in detail. Overall the

8. researcher hopes to raise awareness of
the achievable goals and positive steps that have been affiliated
with this specific type of
research methodology. By examining the impact of the
programs at the University of Miami and
the University of Michigan and the integration of existing
knowledge in the fields of
neuroscience and emergency medicine, more preventative
resources including newly integrated
assessments such as genetically modified pro-survival multi-
neurotrophin will be allocated to
this specific type of injury nationwide (Blaya, Furones-Alonso
&,Tsoulfas, 2015).
Research Questions
The researcher hopes to address these questions in particular:
1. Is there a correlation between increasing brain glucose
utilization on affected TBI mice
that have been injected with Chronic A20?
2. Is there sufficient clinical evidence to support that the usage
of neural progenitor cells
expand neurogenesis activity within TBI structures of the brain?
3. Does surgical intervention create better treatment outcomes
than injected NPC’s and

9. Schwann cells within the brain stem on TBI patients over an
extended period of time?
4. What are the effects of neural stem cell transplants on
endogenous neurogenesis and
neurobehavioral outcomes of PBBI patients (type of TBI)?
5. In regards to PBBI patients, how does delivery of optimal site
and cell concentration to
produce maximal engraftment of neural stem cells increase
motor and cognitive behavior in rat
model (brain function similar to humans)?
6
References
Blaya, M., Furones-Alonso, O., Tsoulfas, P. (2015).
Transplantation of Genetically-Modified
Neural Progenitor Cells to Improve Histopathological
Hippocampal Neurogenesis:
Attenuates cognitive impairment after traumatic brain injury.
Miami Project to Cure

10. Paralysis. Department of Veterans Affairs Medical Center,
University of Miami Miller
School of Medicine. Published on April 2015.
Brain Injury Association of America. (2015). Family and
Caregivers: Brain injury affects the
whole family. Baylor Institute of Rehabilitation. Published on
February 2015.
Bramlett, H., Bullock, R., Diaz, J., Gajavelli, S., Jackson, C.,
Spurlock, M., et al. (2015).
Penetrating Ballistic Brain Injury Reduces Focal & Global
Brain Glucose Utilization: A
C-2DG autoradiography study in a rat model. Miami Project to
Cure Paralysis,
Department of Nuerosurgery, University of Miami Miller
School of Medicine. Published
on June 2015.
Center for Disease Control and Prevention. (2014). Traumatic
Brain Injury.
Retrieved January 29, 2016, from
http://www.cdc.gov/traumaticbraininjury/get_the_facts.html
National Institute of Neurological Disorders and Stroke. (2016).
Transforming Research and
Clinical Knowledge in Traumatic Brain Injury. Published on

11. January 2015. Retrieved
January 29, 2015, from
http://www.ninds.nih.gov/disorders/tbi/detail_tbi.htm
http://www.cdc.gov/traumaticbraininjury/get_the_facts.html
Title Here
Student Name (First and Last)
Panther ID
Florida International University
Month Year

12. Introduction:
Type your introduction here. Remember to include an overview
of what your manuscript aims to
do (e.g. research a problem, identify a new management
concept, etc.). This section requires one
paragraph in length.
Background:
This is an informative paragraph that helps the reader
understand why you chose this
topic. Review the background of the topic and elaborate here.
Use language such as, The
following section will discuss the background of the topic. This
should be one paragraph in
length.
General Problem Statement
This paragraph piggybacks on the previous paragraph. Now
that you have discussed the

13. background, tell the reader what the general problem is and why
you want to research it. Your
general problem is a broad overview of the general problem.
Oftentimes, the general problem is
viewed at the national level with supporting evidence from
governmental websites that provide
quantitative statistics. The paragraph must begin with, The
general problem is…
Specific Problem Statement
This paragraph piggybacks on the previous paragraph. Now
that you have discussed the
general problem, tell the reader what the specific problem is and
why you want to research it.
Your specific problem statement usually encompasses a specific
population, demography, or
geographic location. Oftentimes, the specific problem is
viewed at the local level with
supporting evidence that provides quantitative statistics. The
paragraph must begin with, The
specific problem is…
Purpose Statement
This paragraph simply tells the reader the purpose of your

14. research. (Example: The
purpose of this research is to determine whether a relationship
exists between nursing assistant
staffing levels and quality of care in skilled nursing facilities).
The paragraph must begin with,
The purpose of this research is…
Research Questions
This paragraph provides an overview of the specific research
questions you plan to
investigate. You are only required to have one research
question; however, you may use more
if needed. This section is where you unfold your research to the
reader. What do you want to
uncover? This is where you ask the question(s). Use language
such as: The research addressed
the following research questions.
RQ1: Ask your research question here.
RQ2: Ask your research question here.
Example:
RQ1: How does geographic location relate to the level of
quality in nursing homes?
RQ2: How does socioeconomic status relate to the level of

15. quality in nursing homes?
References
Remember that any reference in your reference list must be
present in your paper in the form of a
citation (Author, year). Likewise, any citation in your paper
must be present in your
reference list. Refer to your APA Handbook 6th edition for
more detailed information on
developing a reference list. For your Assignment 1 you need a
minimum of three (3)
scholarly references.
Assignment 1 Grading Rubric: Research Proposal
Criteria Points Possible
Title of Proposed Topic/Research 5

16. Introduction 20
Background 20
General Problem Statement 20
Specific Problem Statement 10
Purpose statement 10
Research Questions 10
References (Three Required) 5
Deductions: APA formatting,
Spelling/Grammar/Punctuation at the College
Level, Originality etc.
-
Total Points Possible 100
General Problem StatementSpecific Problem StatementPurpose
StatementResearch Questions