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TBICoE Research

TBICoE supports a network of military hospitals and clinics and Department of Veterans Affairs medical centers with traumatic brain injury research initiatives, including gap-driven analyses and congressionally directed programs such as the Section 721 Longitudinal Study of TBI and Section 734 investigation into the effects of blast exposure on Warfighter Brain Health and Performance.

TBICoE's extensive internal and external collaborations allow for clinical innovation and research along the continuum of care of TBI—from initial injury to acute and post-acute medical settings; rehabilitation; and ultimately a return to family, community, and work or continued duty.

Beyond conducting research, TBICoE periodically reviews available peer-reviewed scientific literature to summarize the state-of-the-science, consensus of medical approaches, as well as existing and new evidence of TBI research. These research reviews, information papers, and the NEW Clinical Pearls resources are available for download.

 

TBICoE Research Gaps and Priorities (2022-2024)

The Research portfolio meets DOD TBI clinical and operational research needs by aligning to TBI knowledge gaps. Every two years, TBICoE’s research section reviews, analyzes, and updates a data-driven, actionable list of research gaps and priorities.

Studies can contribute to multiple gaps depending on the scope of the aims. Primary alignment of a study to a gap occurs when most of the findings address that specific gap, while secondary alignment occurs when a smaller portion of the findings address the gap. The annual "TBICoE Publications Catalog" provides an overview of TBICoE's published work. The 2023 catalog is coming soon, and the 2022 publications catalog is available now.

Review the gaps and priorities.

TBICoE Information Papers

Neurodegenerative Diseases and Traumatic Brain Injury

The long-term effects of TBI are unknown, but there is concern that there may be an association with neurodegenerative diseases years after the injury. The intention of this information paper is to summarize the available evidence for or against an association of TBI with 3 of the more common neurodegenerative diseases, Alzheimer’s Disease, Parkinson’s Disease, and Amyotrophic Lateral Sclerosis.

Thumbnail image of the downloadable Neurodegenerative Diseases and TBI info paperDownload this information paper to learn more about neurodegenerative diseases and TBI.

 

 

 

 

 

 

The Impact of Mild Traumatic Brain Injury on the Autonomic Nervous System

The purpose of this information paper is to provide a general overview of the current evidence related to the impact of concussion, or mild traumatic brain injury, on the autonomic nervous system. This paper will focus on heart rate variability, pupillary light reflex, and hyperhidrosis within the military and civilian populations.

Thumbnail image of the downloadable Information Paper on the Impact of mTBI on the Autonomic Nervous SystemDownload this information paper to learn more about the state-of-the-science of how the autonomic nervous system is impacted by mild TBI. Researchers and clinicians can learn about current tools used to measure ANS and their current clinical utility at this time.

 

 

 

 

 

Research Reviews & Clinical Pearls

The following TBICoE research reviews are fluid areas of investigation and provide an overview on specific topics of interest related to TBI research. These reviews will be updated as new research emerges.

New in 2023, research reviews will be complemented by a supplemental resource, "Clinical Pearls." Both the research review and clinical pearls products are created for both the researcher and the military clinician.

 

Chronic Traumatic Encephalopathy Research Review and Fact Sheet

 

Multiple Traumatic Brain Injury/Multiple Concussion

TBICoE Congressional Reporting

Many of TBICoE’s drivers include mandates from Congress within the National Defense Authorization Act (NDAA). In response to and in accordance with the requirements of these mandates, a number of reports have been submitted to Congress and are available in the public record.

NDAA FY20 Sec 750 Report to Congress: Study and Report on Traumatic Brain Injury Mitigation Efforts

A study and report on TBI mitigation efforts. This report summarizes the DOD’s findings that assessed 30 unique TBI treatments published between 2015 and 2020, and provides a roadmap addressing TBI mitigation efforts.

NDAA FY19 on Chronic Traumatic Encephalopathy

A study and report on Chronic Traumatic Encephalopathy (CTE) research in the military. This report summarizes key knowledge gaps between CTE and traumatic brain injury, and outlines CTE-relevant initiatives pursued through research collaborations across Government agencies, academia, and leading research institutions.

NDAA FY18 Sec 734 Report to Congress: Longitudinal Medical Study on Blast Pressure Exposure of Members of the Armed Forces

Longitudinal medical study on Blast Exposure Pressure of Members of the Armed Forces. The Section 734 Program is inclusive of the following mandates: NDAA FY18 Section 734, NDAA FY19 Section 253, NDAA FY20 Section 717, and NDAA FY20 Section 742.

NDAA FY07 Sec 721 Report to Congress: Longitudinal Study on Traumatic Brain Injury Incurred by Members of the Armed Forces in OIF/OEF

Fifteen-year longitudinal study on health effects related to TBI incurred by members of the Armed Forces in OIF/OEF and their families.

TBICoE Publications

Since 1992, TBICoE has published over 700 peer reviewed manuscripts in collaboration with other institutions, which actively align and respond to trends, gaps, and priorities of the DHA or broader DOD to inform policy, resource management, and state of the science for warfighters, veterans, their families and caregivers, and health care providers.

2022 Publications Catalog

The purpose of this catalog is to:

  • Summarize key findings and potential clinical implications of calendar year 2022 TBICoE publications.
  • Increase awareness.
  • Assist in planning of future efforts.

This document contains figures that help visually categorize the publications, as well as citations and abstracts of each (abbreviations in abstracts may be modified for consistency throughout this document). Accompanying the abstracts are the potential clinical impact summaries of the work and the associated TBICoE research network site (including research at TBICoE headquarters). 

Download the catalog.

Sample images of the downloadable 2022 TBICOE Research Publications Catalog

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Publication
Mar 28, 2024

TBICoE Research Review: Multiple TBI/Multiple Concussion

.PDF | 284.05 KB

Prior history of TBI may predispose an individual to increased risk of subsequent TBI, which may result from less force, and lengthier recovery from post-injury symptoms. Activities such as contact sports and military service carry particular risk for multiple TBI.

Fact Sheet
Mar 7, 2024

Medical Devices for Assessment of TBI Fact Sheet

.PDF | 698.53 KB

This fact sheet defines the different regulatory terms and pathways of medical devices, provides an overview on what devices are currently FDA approved for assessing TBI, and shares some considerations for clinicians and researchers before using a device.

Report
Feb 22, 2024

2023 Q3 DOD Worldwide Numbers for TBI

.PDF | 1.29 MB

TBICoE is the Defense Department’s office of responsibility for tracking traumatic brain injury data in the U.S. military. Here you’ll find data on the number of active-duty service members—anywhere U.S. forces are located—with a first-time TBI diagnosis in the third quarter of calendar year 2023. The data is also broken down by each branch of the ...

Fact Sheet
Dec 13, 2023

Low-Level Blast: VA Provider Fact Sheet

.PDF | 820.18 KB

This fact sheet was developed specifically for VA medical providers. Low-level blast is defined as blast generated from firing heavy weapon systems or explosives in combat or training environments. Exposure to low-level blast does not typically result in a clinically diagnosable concussion, also known as mild traumatic brain injury.

Infographic
Nov 29, 2023

TBICoE's Low-Level Blast Research Infographic

What is TBICoE doing to help warfighters exposed to low-level blast? Leading the charge: 1. Collaborated on Military weapons training studies and Epidemiology studies 2. Led health and performance efforts in support of the Section 734 Program Advancing the science: 1. Measured LLB exposure effects on performance 2. Provided recommendations on LLB surveillance 3. Advanced DOD’s understanding of LLB health and performance effects Answering the call: 1. Outlined next steps for LLB research 2. Helped to develop guidance for managing brain health risk from blast overexposure 3. Recommended the development of a tool to capture career blast exposure These efforts are in support of the Warfighter Brain Health Initiative LLB Relevant Aims 1. Understand the known and emerging threats and hazards to brain health 2. Monitor warfighters for brain exposures 3. Reduce risk of brain exposures that may negatively impact brain health

This infographic illustrates TBICoE's research activity on understanding how low-level blast influences warfighter brain health. This work directly supports Line of Effort 2 of the Warfighter Brain Health Initiative. Learn more about low-level blast exposure and TBI at health.mil/LLB.

Publication
Sep 29, 2023

TBICoE Research Review: Mild TBI and PTSD

.PDF | 435.28 KB

This research review provides an in-depth summary of the available clinical research on the topic of co-morbid mild traumatic brain injury and posttraumatic stress disorder. Specifically, this review will address symptoms, anatomy, diagnosis, and treatment of mild TBI, PTSD, and the unique circumstances associated with the presentation of both.

Publication
Sep 29, 2023

Mild TBI and PTSD Clinical Pearls

.PDF | 924.82 KB

TBICoE's "Mild Traumatic Brain Injury and Posttraumatic Stress Disorder Clinical Pearls," is a new supplemental product to the detailed research review. This resource is designed to be brief and provide key actionable “clinical pearls” that should be considered in the treatment of service members with comorbid mild TBI and PTSD.

Fact Sheet
Jul 18, 2023

Low-Level Blast: Fact Sheet for Service Members

.PDF | 867.41 KB

Low-level blast is defined as blast generated from firing heavy weapon systems or explosives in combat or training environments. Exposure to low-level blast does not typically result in a clinically diagnosable concussion, also known as mild traumatic brain injury. Both providers and service members should be aware of the potential effects of low ...

Fact Sheet
Jul 18, 2023

Low-Level Blast: Fact Sheet for Providers

.PDF | 1.26 MB

Low-level blast is defined as blast generated from firing heavy weapon systems or explosives in combat or training environments. Exposure to low-level blast does not typically result in a clinically diagnosable concussion, also known as mild traumatic brain injury. Both providers and service members should be aware of the potential effects of low ...

Publication
Jun 16, 2023

Neurodegenerative Diseases and Traumatic Brain Injury Information Paper

.PDF | 310.80 KB

The long term effects of TBI are unknown, but there is concern that there may be an association with neurodegenerative diseases years after the injury. The intention of this information paper is to summarize the available evidence for or against an association of TBI with three of the more common neurodegenerative diseases.

Publication
Apr 7, 2023

2022 TBICoE Publication Catalog

.PDF | 577.80 KB

TBICoE publication citations and summaries are organized by category, or overarching research topic. The purpose of this document is to (1) summarize key findings and potential clinical implications of calendar year 2022 TBICoE publications, (2) increase awareness, and (3) assist in planning of future efforts.

Last Updated: March 25, 2024
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