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USU Co-leads Largest NCAA-DOD Concussion Study in History

Image of A doctor looks at a patient's prosthetic arm. Dr. Paul F. Pasquina examines Sgt. 1st Class Ramon Padilla’s prosthetic arm in his office at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. (Photo courtesy of PBS)

Uniformed Service University’s (USU) Dr. Paul Pasquina will co-lead the next phase of the largest concussion and repetitive head impact study in history, the NCAA-U.S. Department of Defense Concussion Assessment, Research and Education (CARE) Consortium.

Pasquina, professor and chair of USU’s Department of Physical Medicine and Rehabilitation, will lead the upcoming phase, known as CARE/Service Academy Longitudinal mTBI Outcomes Study (SALTOS) Integrated Study, as principal investigator for the DoD through USU’s Center for Rehabilitation Sciences Research, coordinating engagement with the four military academies, the military’s Explosive Ordnance and Disposal school at Eglin Air Force Base, as well as the Defense Health Agency’s National Intrepid Center of Excellence for TBI and Intrepid Spirit Centers at Fort Hood, Fort Bragg, and Joint Base Lewis-McChord.

CARE is the most comprehensive and prospective study of its kind, and is the product of the historic NCAA-DOD Grand alliance created in 2014. The Consortium seeks to better understand concussion, as well as Head Impact Exposure (HIE), with broad aims to enhance the health and safety of NCAA student-athletes and military service members. It is also the first major concussion study to assess both women and men in 24 sports, and serves as a valuable resource for youth sports participants and society at large. Prior to CARE, most concussion literature came from men’s football and men’s ice hockey. Leveraging its extensive infrastructure and experienced research team, the consortium has now published more than 80 scientific papers that have been critical to advancing the science of mild Traumatic Brain Injury (mTBI)/concussion and HIE.

The initial phase of CARE focused on the six-month natural history and neurobiology of acute concussion and HIE. The second phase, CARE 2.0, prospectively investigated the intermediate effects -- such as changes in brain health outcomes over a college career -- and early persistent health effects associated with HIE and concussion soon after graduation. CARE/SALTOS will investigate the nature and causes of long-term effects of HIE and concussion/mTBI in NCAA student-athletes and military service members.

“As a former member of West Point’s varsity football team, where I sustained several concussions, my interest in this study is both personal and professional,” Pasquina said. “There remain a number of unanswered questions surrounding concussion and head impact exposure that we hope to be able to help answer through this study. Our team remains committed to help protect, promote, and preserve brain health for service members, athletes, and the public.”

The Consortium has also just received a combined $42.65 million in funding to begin the next phase of its landmark research project. The newly-awarded funding includes a $25 million award from the Medical Technology Enterprise Consortium via the U.S. Army Medical Research and Development Command, from the Defense Health Program under the oversight of the Assistant Secretary of Defense for Health Affairs. An additional $10 million in funding was awarded by the NCAA, and $7.65 million was granted by the Defense Health Agency via a Cooperative Research and Development Agreement. This latest funding will allow the research team additional resources to build upon existing CARE/SALTOS research by following former CARE research participants beyond graduation to evaluate the long-term or late effects (up to 10 years) on brain health after mTBI/concussion and/or HIE.

The CARE/SALTOS Integrated study is an integrated public/private effort, and is designed to identify the unique individual characteristics (such as phenotypes/genotypes) of individuals at a higher versus lower risk of negative outcomes associated with concussion and HIE. This data set will be made available to the broader scientific community to promote further development of specific strategies for injury prevention, early recognition, and mitigating treatments of those at greatest risk of brain health effects.

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