TBI translational rehabilitation research in the 21st Century: exploring a Rehabilomics research model

Globally, traumatic brain injury (TBI) is a leading cause of death and persistent disability. Although improvements in standard of care have reduced the overall mortality rates associated with this disease, there is a paucity of effective neuroprotective therapies. However, some rehabilitation focused strategies have shown promise with enhancing neurorecovery. One major challenge in identifying effective therapies is that TBI is an inherently heterogeneous disease. Despite many patients having similar injury factors and clinical care after their TBI, recovery and outcomes can be very different. This commentary discusses the value of treatment effectiveness research that also incorporates theranostic principles of individualized care. Key to this concept is the utilization of state-of-the-art biomarker platforms and technologies that can identify relevant molecular or physiological fingerprints that can assist rehabilitation practitioners in delineating long term outcome that can be linked to plasticity, treatment response, and natural recovery. This commentary proposes a unique concept of "Rehabilomics" as a field of study involving the systematic collection and study of rehabilitation relevant phenotypes, in conjunction with a transdisciplinary evaluation of biomarkers, in order to better understand the biology, function, prognosis, complications, treatments, adaptation, and recovery for persons with disabilities. Specific Rehabilomics applications to TBI research, as well as relevance to the National Institutes of Health Roadmap, are discussed.