Faculty spotlight: Jed Hartings, PhD
Jed Hartings, PhD, is an Associate Professor in the Department of Neurosurgery at the University of Cincinnati College of Medicine and a member of the Mayfield Clinic. He researches the pathology of brain trauma and stroke, mentors young scientists and clinicians in research, and develops new ways to monitor patients’ brains in the Neuroscience Intensive Care Unit (NSICU) at University Hospital.
Many patients in the NSICU have suffered a severe neurological injury from stroke, trauma, or bleeding in the brain. Monitoring the brain for parameters such as intracranial pressure, temperature, oxygenation, and blood flow plays a key role in the ability of these patients not only to survive but also to survive with a minimum of disability. If a patient’s brain experiences a change in blood flow or temperature, for example, neurocritical care specialists need that information as quickly as possible so that the situation can be treated and reversed.
However, the processes of injury and recovery are not well understood, and current monitoring technologies are limited. Meanwhile, traumatic brain injury is an under-appreciated public health problem and is the leading cause of mortality and disability in young people in high-income countries. It is also the signature wound of the wars in Iraq and Afghanistan.
Dr. Hartings, a former Major in the U.S. Army’s Medical Service Corps who earned six medals for service and achievement, became interested in a phenomenon known as spreading depolarization while working under Frank C. Tortella, PhD, at the Walter Reed Army Institute of Research.
Spreading depolarization is a pathologic brain activity and complication thought to play a key role in brain trauma and subarachnoid hemorrhage (bleeding stroke). Spreading depolarizations are electrical disturbances that spread through an injured brain like tsunamis. Dr. Hartings recognized early on that this was of critical importance to our brain-injured war veterans, and this area of research became his life’s work and passion.
Today he is at the forefront of research on spreading depolarizations and is a founding member of the international organization COSBID (Co-Operative Study on Brain Injury Depolarizations). Only 40, he has published more than 40 peer-reviewed journal articles and has one patent and two invention disclosures to his credit. In 2011 Dr. Hartings was the lead author of two papers about spreading depolarizations that were published in prestigious international journals (Brain and Lancet Neurology). He is making discoveries about how depolarizations impact patients – they contribute to worse outcomes -- while investigating new ways to monitor these disruptions.
Currently, depolarizations can be monitored only with an electrode strip placed during surgery at the surgical site. Dr. Hartings is exploring different types of monitors that don’t have to be placed directly on the brain, thus enabling them to benefit patients who have not undergone surgery while allowing doctors to monitor the entire head.
In a separate but compatible effort, Dr. Hartings is overseeing a $2.1 million U.S. Department of Defense Advanced Technology/Therapeutic Development Award to develop a new monitor -- a multi-tasking "lab-on-a-tube." The ultra-thin, spirally rolled tube – also known as a "smart catheter" – is designed to provide real-time brain monitoring of seven parameters while simultaneously draining cerebrospinal fluid. The single catheter would be placed inside the brain through a hole in the skull. The seven parameters would include EEG, which would reveal spreading depolarizations. In current practice, only two or three of these parameters are measured in most patients.
Dr. Hartings’s discoveries will likely lead to improved monitoring techniques, new medications to treat spreading depolarizations, and real-time adjustments in the care of patients in intensive care settings all over the world. Together, these improvements will save lives and reduce disability in patients who have suffered significant brain injury.
Recent Publications by Dr. Hartings:
1. Brain-friendly amperometric enzyme biosensor based on encapsulated oxygen generating biomaterial. Conf Proc IEEE Eng Med Biol Soc. 2012;2012:6003-6.
2. Correlates of spreading depolarization in human scalp electroencephalography. Brain. 2012 Mar;135(Pt 3):853-868.
3. Spreading convulsions, spreading depolarization and epileptogenesis in human cerebral cortex. Brain. 2012 Jan;135(Pt 1):259-275.
4. Spreading depolarisations and outcome after traumatic brain injury: a prospective observational study. Lancet Neurol. 2011 Dec;10(12):1058-64.
5. Brain temperature measurement: A study of in vitro accuracy and stability of smart catheter temperature sensors. Biomed Microdevices. 2012 Feb;14(1):109-18.
6. Spreading depolarizations have prolonged direct current shifts and are associated with poor outcome in brain trauma. Brain. 2011 May;134(Pt 5):1529-40.