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Innovative Treatments in Disorders of Consciousness (ITDC) Grant Program

The Rehabilitation Outcomes Center at Spaulding in collaboration with the Curing Coma Campaign administers the following funding opportunity to generate and initiate disruptive ideas in the treatment of patients with disorders of consciousness.

This award funds projects that create infrastructure to enable prospective multicenter RCTs and/or evaluate biologically plausible treatments. Acquisition of pilot data for larger multicenter studies is a key aim of this initiative.

The next grant cycle is expected to open for letters of intent in June 2026. Subscribe to the Rehabilitation Outcomes Center Newsletter for email updates about the ITDC program and other outcomes research.

Background

Disorders of consciousness (DoC) — including coma, vegetative state, and minimally conscious state — are highly prevalent with estimates in the United States (2018)1 of:

  • up to 42,000 people in a coma and vegetative state
  • up to 280,000 in a minimally conscious state.

The landscape of DoC management is fraught with challenges. Diagnosis is difficult, with no laboratory nor imaging tests to detect consciousness. Published estimates of misdiagnosis among people with DoC are around 40%. No treatments are available to prevent secondary effects of primary brain injury. There is only one proven post-acute treatment available with narrow indications — amantadine hydrochloride.

A 2020 Symposium from the Curing Coma Campaign2 laid out research targets across six areas: defining endotypes/phenotypes, biomarkers, proof-of-concept clinical trials, prognostication, long-term recovery, and large data sets. Advances in our understanding of brain pathophysiology and biotechnology offer new avenues to improve diagnosis and treatment through research. The below table lists potential areas of exploration for applicants to consider. It is not an exhaustive list, and applicants are not limited to the below topics.

Knowledge Gap Area of Exploration
Infrastructure for clinical trials and observational studies Establish infrastructure, such as a multicenter DoC network or model system, designed to address a specific research question
Poor understanding of neurobiological mechanisms underlying consciousness/DoC Connectomics / Circuit mapping
Patient classification Phenotyping / Endotyping
Long-term outcome Trajectory modeling
Lack of biomarkers Validation of diagnostic, prognostic, response biomarkers
Prognostication Modeling, large datasets, machine learning
Effective treatments for neuroprotection & post-acute recovery Focus on innovative proposals, from proof-of-concept to comparative effectiveness drug (re-purposed agents) and device (DBS, tDCS, TMS, VNS, LIFUP) studies

 

1Giacino et al. “Comprehensive systematic review update summary: disorders of consciousness.” Neurology, 2018 Sept. 4; 91(10:461–470)

2Claassen J, Akbari Y, Alexander S, et al. Proceedings of the First Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness. Neurocrit Care. 2021;35(Suppl 1):4-23. doi:10.1007/s12028-021-01260-x

Prior Awards

The 2024 grant cycle funded two projects:

  • A novel brain stimulation target for patients with disorders of consciousness” led by John Rolston, MD, PhD, Brigham and Women’s Hospital and Harvard Medical School
  • “DECodIng endotype and PHEnotypes of Recovery from Coma (DECIPHER-COMA)” led by Chethan P. Venkatasubba Rao, MD, Baylor College of Medicine

Rolston, who is also director of epilepsy surgery at the Brigham, is leading a study that will evaluate the safety and efficacy of applying noninvasive or invasive forms of electrical stimulation to a so-called “sweet spot” deep within the brains’ thalamus, that has been previously identified as a potential treatment target due to it overlapping arousal fibers and being functionally connected to the cortical network. Studying this region more closely and testing different electrical stimulation interventions may one day lead to promising new treatment options.

Rao’s DECIPHER-COMA project seeks to identify unknown biomarkers of coma recovery, in an effort to create a roadmap for recovery that can fill current knowledge gaps within the field of neurocritical care. The researchers plan to utilize cutting edge techniques, including machine learning and AI, to review enrolled patients’ electronic health records and find new markers and patterns that can deepen their understanding of coma recovery. The hope is that in the future, this roadmap can serve as an adaptable platform that powers clinical trials of coma treatments. 

View the full 2024 grant application instructions.

Grant Contact

Shonali Gaudino
sgaudino@mgb.org
(617) 952-6509