The 3.5-year study is a follow-up to the initial study Hartings published in 2011 that surprised the medical world with its novelty. This more rigorous study further confirmed what the pilot data showed: that spreading depolarizations (known colloquially as, “brain tsunamis”) have an independent, adverse impact on recovery of patients with severe brain injury.   

Hartings essentially put spreading depolarizations on neurologists’, neurosurgeons’ and neurointensivists’ radars over the past two decades. Had it not been for a commitment with the military, the discovery may have never occurred. 

Dr. Hartings never had any intention of getting into medicine. “I got into neuroscience because I wanted to understand the mind and human behavior,” he says. But when his Army ROTC commitment sent him to Walter Reed Army Medical Center’s neuroscience lab, he had to quickly shift gears and apply what he knew to studying brain injury. 

It was there that he made a discovery that would forever change the course of his life. “I came across some literature on this phenomenon called spreading depression (now referred to as spreading depolarizations), which is a really old topic,” he remembers. “It had first been discovered in the 1940s, and there were sporadic publications, but it didn’t really take hold. Yet it seemed really important to me.” 

Dr. Hartings began doing experiments to see if he could observe this phenomenon. “Lo and behold, they were everywhere, and they blew me away,” he says. Not only was it there, it was five times more prevalent than any other published literature had suggested before. 

This is what Dr. Hartings calls the biggest “ah-ha” moment of his career. “In the end, it was something I couldn’t turn my back on. In understanding neurophysiology, brain health and disease, and what these events are, it seemed they had to be very damaging to the brain. It became a mission to convey that knowledge to the medical community. If you extrapolate our data, it means that right now, there are thousands, if not tens of thousands of patients around the world in hospital beds having these events. We had to figure out what this means for patients and their treatment.” 

Hartings found a neurosurgeon in London in 2002 who was also interested in these waves following brain injury. He was putting electrodes directly on the brain of patients to record them. Hartings immediately flew to London to see his work and strike up a collaboration. “And now for most of my career I’ve been following up on his initial finding - investigating what impact these waves have on outcome from traumatic brain injury, developing this into a new field of clinical science” explains Dr. Hartings. 

Since then, Dr. Hartings has spoken to doctors all over the world teaching about spreading depolarizations. At first, he was met with skepticism because it was a new concept. But now the idea has gained acceptance and is starting to appear in medical textbooks, such as the upcoming version of Youmans Neurosurgery.  

Hartings is taking his research one step further, and is currently the principal investigator for a new study at 8 medical centers across the U.S. He is testing whether less-invasive methods, like putting electrodes on the scalp, can be used to detect these harmful waves. 

“My vision is that one day these concepts could be a cornerstone in managing stroke and brain trauma patients, and lead to better outcomes.” Dr. Hartings says his findings are just the beginning. “We need to bring it into every intensive care unit, to bring it into every clinicians’ hands. Really, the field is in its infancy.”