Susan Margulies, Ph.D.
Georgia Institute of Technology
Dr. Susan Margulies is one of the world’s top researchers on traumatic brain injury in children. The methods she’s developed for diagnosing and assessing these injuries are helping children receive earlier and more effective treatment. Her research on how head injuries affect brain tissues has led to promising preclinical trials for new treatment strategies.
Traumatic brain injury is one of the leading causes of death in childhood, but there is not yet a truly effective treatment for brain injury in either children or adults.
One major obstacle is the challenge of conducting a preclinical trial with an animal model: Human brains are unique in their ability to process information and use language, and our highly developed white matter is what separates us most dramatically from many other animals. However, when researchers want to test a potentially effective treatment on a non-human animal with a head injury, they can’t use human metrics requiring language or information processing. Instead, they typically look at convenient variables such as an animal’s ability to navigate a maze — not a perfect comparison for human cognition.
Margulies has developed more objective metrics to assess the severity of a brain injury and evaluate improvements. She’s explored methods such as measuring balance, looking at the electrical activity of the brain as it processes sounds or tracking involuntary eye movements. She’s also explored physical biomarkers of traumatic brain injury, like the presence of certain proteins in a blood sample. Such metrics provide a better comparison between animal and human models to facilitate more productive preclinical trials. They also provide an effective way to detect brain injury in babies and children who are too young to describe their own symptoms.
Another aspect of her research is exploring how a child’s response to a head injury differs from an adult’s. A child’s brain is still developing, and the brain tissue is dynamic, plastic and adaptable. Historically, doctors believed this would reduce the long term consequences of an injury, because the same biological processes that support the growing brain mean it can also recover more quickly.
However, Margulies and others are demonstrating that this adaptability can be a double-edged sword. An injury that occurs while the brain is developing could have more serious health impacts and significant early cognitive effects. This offers significant implications for the entire field of diagnosis, treatment and even prevention.
Margulies’ team has also worked with lifelike infant dolls equipped with sensors that measure acceleration and rotational forces, using these “crash test dummies” in various scenarios that could cause a brain injury. This has expanded understanding of the specific injuries an infant would experience from falling from different heights onto different surfaces. She also uses sophisticated computational models to understand why head injuries can occur from rapid head rotations.
Margulies and her colleagues have partnered with a number of different teams who are working on brain injury therapies. Using the effective and objective metrics they’ve developed, Margulies’ lab is providing drug researchers with valuable data on the effectiveness of their treatment. Three of these drugs are in preclinical or clinical trials.
Margulies’ lab has also conducted extremely significant research in the related biomechanics field of pulmonary injury. Much of that work was focused on preventing and treating lung injuries caused by ventilators, a major concern for patients who are being treated in critical care for acute respiratory distress syndrome.
Using in vitro and animal models, Margulies’ lab demonstrated biomechanical mechanisms underlying this injury at a tissue- and molecular-level and identified potential drugs to treat the causes. Drawing on her findings, scientists may be able to design better approaches to mechanical ventilation and better strategies to prevent ventilator-induced lung injury in critical care settings.
As chair of the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University, with labs on both campuses, Margulies is drawing on the considerable resources and expertise of both universities to advance our understanding of traumatic brain injury. Georgia Tech is offering support for the biomechanical and biomarker aspects of the research and developing novel devices for testing. At Emory and the Children’s Healthcare of Atlanta network, Margulies will work with animals and patients to improve health outcomes.
- Injury thresholds in brains and lungs
- Guidelines for injury prevention and intervention
- Deriving biomechanical information from computational models
- Animal models of pulmonary disease and brain injury
- Drug treatments for ventilator-induced lung injury and traumatic brain injury
- Region- and age-dependent variations in brain and skull properties
- The impact of head rotational acceleration during injury
- More than $34 million in federal research grants (as of 2017)
Straight from the Scholar
“There are very strong neuroscience and neuroengineering programs here in Georgia. I see integrating my work with both of these. Some of the tools that are being used to measure progress in rehab after strokes and Parkinson are tools we could be using in traumatic brain injury. And the close collaboration opportunities with Children’s Healthcare of Atlanta are very important to advancing prevention, diagnosis and treatment of brain injuries.”