VA-DoD Long-Term Impact of Military-Relevant Brain Injury Consortium (LIMBIC): Data and Biostatistics Core

神经创伤联合会(CENC；W81XWH-13-2-0095)的慢性影响一直是一个高效、 由VCU/VA研究员David领导的协调、多中心、基础科学到床边的研究协作 慈福，MD，自2013年以来由国防部和退伍军人事务部联合资助。CENC链接基础、翻译、流行病学、 以及来自退伍军人管理局、军方、学术界和私营部门的临床神经科学研究人员，有效地解决 轻型创伤性脑损伤的诊断挑战、治疗后果及其潜在价值 长期影响。来自CENC的经验丰富和久经考验的研究人员组成了边缘团队 财团领导力、核心设施和研究研究主管。这支久经考验的领导团队， 基础设施支持者和研究人员将启动有针对性的、扩展的研究，以扩展CENC 研究结果，解决计划中详细说明的所有优先事项(必需的和次要的研究要素) 宣布，并将为该领域的临床医生提供交付成果。 四个基础设施核心(生物标志物、神经成像、数据和生物统计、临床研究)将在 演唱会以实现三个相互关联的首要目标： 目标1.向边缘过渡和扩大CENC--招收和扩大相关退伍军人和 服务成员；扩大收集的数据点；按照既定的指导方针收集数据；以及 确定和描述人口的主要特征，以指导对人口的性质和程度的严格研究 随着时间的推移，MTBI在战斗中的滞后效应VS/短信。 目的2.合并症和神经系统后遗症--确定mTBI的患病率及其与重要的 合并症和神经后遗症，如痴呆症和神经退行性疾病，疼痛，心理 健康，包括创伤后应激障碍和神经感觉障碍。随着时间的推移，确定mTBI后遗症的性质和程度。 目标3.表型--确定特征(例如，重复的mTBI、仅部署的mTBI、频繁的低水平 冲击波或其他亚缩性头部/脑撞击暴露，基线神经认知障碍，存在 神经学体征、症状的存在)、病理生理学、生物标志物和亚群(例如，女性) 作为长期结果的风险或保护因素，如神经变性、症状负担和 健康经济学。 Limbic将继续由CENC开始的任务，CENC有退伍军人、服役人员和他们的家人 处于工作中心的成员，制定、部署和传播以患者为中心的健康 护理工具和策略。到目前为止开展的工作扩大了对慢性疼痛领域的了解， 睡眠、感觉障碍、心理健康和重返工作岗位。正在进行的知识翻译包括 改善对民众的护理和护理系统，军队和普通公众都可以翻译 人口。我们已做好准备，以实现利贝克的意图，即“改善急性脑外伤的护理和后续支持 结核分枝杆菌感染后的慢性护理系统“。

The Chronic Effects of Neurotrauma Consortium (CENC; W81XWH-13-2-0095) has been a highly productive, coordinated, multicenter, basic science-to-bedside, research collaboration led by VCU/VA researcher David Cifu, MD and jointly funded since 2013 by the DoD and VA. CENC linked basic, translational, epidemiologic, and clinical neuroscience researchers from the VA, military, academia, and private sector to effectively address the diagnostic challenges and therapeutic ramifications of mild traumatic brain injury (mTBI) and its potential long-term effects. Experienced and proven researchers from the CENC comprise the LIMBIC team at the level of Consortium Leadership, Core Facility, and Research Study Directors. This proven team of leaders, infrastructure supporters and researchers will initiate targeted, expanded research studies that extend CENC research findings, address all priorities (required and secondary research elements) detailed in the program announcement, and will produce deliverables for the clinicians in the field. The four infrastructure Cores (Biomarkers, Neuroimaging, Data and Biostatistics, Clinical Studies) will work in concert to accomplish three overarching, interrelated aims: Aim 1. Transition and expand CENC to LIMBIC -- Enroll and expand sizes of relevant cohorts of Veterans and Servicemembers; expand data points collected; collect data in accordance with established guidelines; and identify and describe key characteristics of populations to guide rigorous studies on the nature and degree of mTBI late effects in combat Vs/SMs over time. Aim 2. Comorbidities & Neurologic sequela -- Determine prevalence and associations of mTBI with important comorbidities and neurologic sequela, such as dementia and neurodegenerative disease, pain, psychological health including PTSD, and neurosensory deficits. Determine nature and degree of mTBI late effects over time. Aim 3. Phenotypes -- Identify characteristics (e.g., repetitive mTBI, deployment-only mTBI, frequent low level blast or other subconconcussive head/brain impact exposure, baseline neurocognitive deficits, presence of neurologic signs, presence of symptoms), pathophysiology, biomarkers, and subpopulations (e.g., women) that serve as risk or protective factors for long-term outcomes such as neurodegeneration, symptom burden and health economics. LIMBIC will continue the mission begun by CENC, which has the Veterans, Service Members, and their family members at the center of the work performed, to develop, deploy, and disseminate patient-centered health care tools and strategies. Work conducted to-date has expanded knowledge in the areas of chronic pain, sleep, sensory disorders, psychological health, and return to work. Knowledge translation underway includes improving both care and systems of care to the population, translatable to both military and the general public populations. We are poised to achieve LIMBIC’s intent to “improve acute TBI care and subsequent support systems for chronic care following mTBI”.