Translational Research Center for TBI and Stress Disorders (TRACTS)

VA RR&D TBI国家网络研究中心，总部设在VA波士顿医疗系统，拥有网络 位于迈克尔·E·德巴基退伍军人医学中心的网站，名为TBI和 应激障碍(TRADTS)(最初于2009年获得资助)建议继续执行其使命 多学科、临床研究，旨在提供心理、生物和神经生物学 描述创伤性脑损伤(TBI)和相关应激障碍的影响，并利用这一点 理解为持久自由行动退伍军人创造有效的治疗机会， 伊拉克自由行动和新黎明行动(OEF/OIF/OND)在上一个资助期内，大片土地 在了解轻度创伤性脑损伤(MTBI)的协同作用方面取得了显著进展 暴露于爆炸弹药对退伍军人的心理和身体健康的影响。这项基础性的工作， 从整体上综合了心理学、生物学和流行病学的方法来研究长期的- 战争期间脑损伤的长期影响，导致了“部署创伤”(DT)的概念的出现。 并帮助制定了治疗和康复复杂和相互作用的问题的路线图， 定义退伍军人在后9/11时代的平民经历。这是我们的首要目标和团结 确定、了解和治疗9/11事件后部署创伤的长期影响的使命 退伍军人。在下一个供资期间，区域基础设施将用于继续增长和 维持地区队列和地区前瞻性纵向队列研究，以及结果 Tracts数据存储库。在当前的应用中，我们建议研究三个相互关联的焦点领域 (FA)说明了我们知识中的严重差距，如果我们要成功地达到 我们的目标。这些重点领域建立在我们在过去8年多的基础观察基础上，并使用了以下内容 有关部署创伤的临床表现和内表型的不断丰富的信息 OEF/OIF/OND退伍军人开发康复治疗，以促进平民重返社会并减少 心理和医学症状的严重性。三个重点领域是：FA1：DT及其基因的深层表型 功能后果；FA 2：理解生物学和行为之间的动态相互作用 确定DT的生物和功能后果；FA 3：康复和治疗 DT的功能和神经生物学后果。 TRACTS将继续履行其使命，为下一代退伍军人研究人员提供创新和 通过培训在退伍军人管理局波士顿和休斯顿医疗中心提供出色的指导环境 评估、康复和临床神经科学研究。我们与内部其他计划的关联 VA，如国家创伤后应激障碍中心，Maveric，创伤后应激障碍/脑损伤脑库，以及我们的附属机构 大学，确保我们有丰富的资源，为本科生提供优秀的培养机会， 研究生、神经心理学实习生和博士后，以及老年病学、神经精神病学和多发性创伤 伙计们。 最后，TRATS发起了一项广泛的教育、外展和传播努力，旨在达到 研究人员、临床医生、退伍军人及其家人的广泛受众。这项努力包括提供 关于OEF/OIF/OND人群临床复杂性和特性的临床培训/教育 研究人员和临床医生，在大波士顿和休斯顿发展协作关系 向返乡的退伍军人及其亲人提供心理教育和资源。 总而言之，Tracts已经做好了在未来五年继续其尖端工作的准备。《知识》 从神经科学和在Tracts进行的康复研究中收集到的信息将继续填补电流 患有mTBI、BLAST和应激相关障碍的退伍军人的诊断和治疗方面的差距。

The VA RR&D TBI National Network Research Center based at VA Boston Healthcare System, with a network site at the Michael E. DeBakey VA Medical Center, called the Translational Research Center for TBI and Stress Disorders (TRACTS) (funded initially in 2009) proposes to continue its mission of conducting multidisciplinary, clinical research aimed at providing a psychological, biological and neurobiological characterization of the effects of traumatic brain injury (TBI) and related stress disorders, and to use this understanding to create effective treatment opportunities for Veterans of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND). Over the last funding period, TRACTS has made remarkable progress in understanding the synergistic effect of mild traumatic brain injury (mTBI) and exposure to blast munitions on the mental and physical health of Veterans. This foundational work, which holistically has integrated psychological, biological, and epidemiological approaches to the study of the long- term effects of brain injury incurred during war, has led to the emerging concept of “Deployment Trauma” (DT) and helped create a roadmap toward the treatment and rehabilitation of the complex and interacting issues that define the civilian experience of Veterans in the post 9/11 era. It is our overarching goal and unifying mission to identify, understand, and treat the long-term effects of deployment trauma in our post 9/11 Veterans. Over the next funding period, the TRACTS infrastructure will be used to continue to grow and maintain the TRACTS cohort and the TRACTS prospective longitudinal cohort study, as well as the resultant TRACTS Data Repository. In the current application, we propose to investigate three interlocking Focus Areas (FA) that speak to critical gaps in our knowledge that must be addressed if we are to be successful in reaching our goals. These focus areas build upon our foundational observations over the last 8+ years and use this evolving wealth of information regarding the clinical presentation and endophenotypes of deployment trauma in OEF/OIF/OND Veterans to develop rehabilitative treatments that will foster civilian reintegration and reduce psychological and medical symptom severity. The three focus areas are: FA1: Deep phenotyping of DT and its functional consequences; FA 2: Understanding the dynamic interplay between biology and behavior that determines the biological and functional consequences of DT; FA 3: Rehabilitation and treatment of the functional and neurobiological consequences of DT. TRACTS will continue in its mission to provide the next generation of VA researchers with an innovative and outstanding mentoring environment at both the VA Boston and Houston Medical Centers through training in assessment, and rehabilitation and clinical neuroscience research. Our affiliations with other programs within VA, such as the National Centers for PTSD, MAVERIC, PTSD/TBI Brain Bank, as well as our affiliated universities, ensure that we have rich resources for excellence in training opportunities for undergraduates, graduate students, neuropsychology interns and post docs, and geriatric, neuropsychiatry and polytrauma fellows. Finally, TRACTS has initiated a wide-ranging education, outreach and dissemination effort intended to reach a broad audience of researchers, clinicians, Veterans and their families. This effort has included the provision of clinical training/education on the clinical complexities and idiosyncrasies of the OEF/OIF/OND population to researchers and clinicians, development of collaborative relationships within the greater Boston and Houston communities, and provide psychoeducation and resources to returning Veterans and their loved ones. In sum, TRACTS is well poised to continue its cutting-edge work over the next five years. The knowledge gleaned from the neuroscience and rehabilitation research conducted at TRACTS will continue to fill current gaps in diagnostics and therapeutics for Veterans with mTBI, blast, and stress-related disorders.