Tracking traumatic brain injuries

The Virginia Tech Carilion School of Medicine Medical Student Research Symposium is an annual event that highlights the research students conduct over their four years at the medical school. The event is free and open to the public and will be held from noon-5 p.m. March 28 in Roanoke. This article focuses on one of the 2025 Letter of Distinction recipients.

Student: Liliana Ladner

Research project: Vascular-Immune Biomarkers for Traumatic Brain Injury

Hometown: Philadelphia, Pennsylvania  

Undergraduate: Columbia University – Barnard College

What inspired you to pursue a career in medicine and what drew you to the Virginia Tech Carilion School of Medicine (VTCSOM)?

I’m somewhat spiritual about this and believe we all are drawn to our purpose. When I realized where I was most fulfilled, medicine became my purpose. I am intrigued by human anatomy and physiology, capable of being calm in high-intensity settings, and passionate about mentorship and research, so medicine was an easy choice. 

VTCSOM struck my interest because, like medicine, it just made sense. I knew I would thrive in this tight-knit community with a research-oriented curriculum. The small class size intrigued me and living with a playground of trails in my backyard didn’t hurt either.

Can you provide a brief overview of your project and its key findings? 

When patients suffer from severe traumatic brain injuries (TBI), there is no promise of recovery. Families of those who are injured may struggle to understand when, or if, their loved one will get back to normal. To mitigate this uncertainty, efforts have been made to define biomarkers that reflect chemical pathways that are altered by TBI. By identifying these biomarkers, we can predict how well patients will do in the long term.

In my lab, we study TBI biomarkers in a pathway that interacts with the space between the blood vessels that surround the brain and the brain itself, called the blood brain barrier. For my project, we studied how well these biomarkers could reflect the severity of a patient’s TBI, as well as their long-term prognosis. 

What motivated you to choose this research topic? Was there a personal or academic influence behind it? 

I developed an early interest in neuroscience after my sister was diagnosed with Guillain-Barre syndrome. As I delved into my undergraduate studies, I became fascinated with how little we know about TBI pathophysiology, and it ended up being the focus of my senior thesis. Once in medical school, I wanted the little free time I had to be dedicated to research that I was excited about. So I followed my passion and found a TBI lab willing to give me a chance at Virginia Tech.

How do you see your research contributing to the field of medicine or patient care in the future?

Although I’m pursuing a career in neurosurgery, I dream of a time when surgery becomes irrelevant. The better we can predict patient outcomes, the more patient-specific drug targets we can identify, the less we will need to operate. I dream of a time when pathways like the one that I study will be the target of medications for TBI patients that prevent damage before it is too late, and surgery is the only option.

What were some of the biggest challenges you faced during your research, and how did you overcome them?

For my research, I have met many TBI patients and their families in the worst hours of their lives. During these painful hours, I have the unfortunate role of asking grieving family members to take extra blood from their very sick family member for research that will not provide them any benefit until years later. These are conversations that have challenged me to take time and listen, to carry a pack of tissues, and to be gentle to every person I meet.

Did your research experience shape your career aspirations? What field of medicine are you planning to specialize in? 

Certainly. Every time I consented a patient, I was in direct contact with the neurosurgery residents at Carilion. For a while, I think I was known as “the TBI girl.” As I spent more time with the neurosurgery team at Carilion, I began to shadow in the operating room and realize how incredible this job is. I was quickly enamored by this field, the people, the patients. I am now pursuing a career in neurosurgery, in large part because of the people who believed in me when I was first introduced to neurosurgery as an M1.

Looking ahead, do you plan to continue research in your medical career? If so, what areas are you interested in exploring further? 

Yes, I’d like to continue to do translational research throughout my career. I envision a career as a neurosurgeon-scientist, where I can run a lab that studies the diseases that my patients suffer from. Right now, I’m — still — excited by TBI, but I am very open to shifting my research focus as I discover my subspecialty interest in residency.

Beyond research, what has been the most rewarding part of your experience at medical school?

This corner of the earth is a special place to live. Within minutes of leaving my apartment, I can be running in the Blue Ridge Mountains, skiing in the foothills of West Virginia, or sipping on wine in the Charlottesville vineyards. As I tell people when they ask about Roanoke – it’s the five-minute city: Five minutes to Kroger, five minutes to school, five minutes to wherever you need to be. There’s something magical about going to medical school in a place so livable.

What advice would you give to future medical students who are interested in research? 

1. Follow your passion. If you are not excited about the research you are doing, it will always feel like work. Don’t let it feel like work.
2. Be proactive. If you have an idea, pursue it now. If you don’t know a technique, learn it now. If you need help, ask now.
3. Find your people. So many people around you are rooting for your success – the VTC research team, your mentor, your classmates. Create your research team early and lean on them often. It can be easy to get lost in your project and this team will bring you back to the surface.