VA-DoD Long-Term Impact of Military-Relevant Brain Injury Consortium (LIMBIC)

VA-DoD 军事相关脑损伤联盟 (LIMBIC) 的长期影响

• 批准号: 10002386
• 负责人: DAVID X. CIFU
• 金额: --
• 依托单位: VA VETERANS ADMINISTRATION HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-10-01 至 2024-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10002386
• 关键词: Academia; Acute; Address; Anatomy; Area; Basic Science; Biological; Biological Markers; Biometry; Brain; Brain Injuries; Caring; Characteristics; Chronic; Chronic Care; Clinical; Clinical Research; Collaborations; Core Facility; Data; Dementia; Diagnostic; Elderly; Elements; Enrollment; Epidemiology; Family member; Functional disorder; Funding; General Population; Guidelines; Head; Healthcare; High Prevalence; Impaired cognition; Infrastructure; Knowledge; Late Effects; Leadership; Link; Literature; Long-Term Effects; Mental Health; Military Personnel; Mission; NIH Program Announcements; Nature; Nerve Degeneration; Neurocognitive Deficit; Neurodegenerative Disorders; Neurologic; Neurologic Signs; Neurosciences; Outcome; Pain; Phenotype; Physiological; Population; Population Characteristics; Post-Traumatic Stress Disorders; Prevalence; Private Sector; Prospective Studies; Recording of previous events; Research; Research Personnel; Risk; Risk Factors; Sensory Disorders; Series; Sleep; Support System; Symptoms; Therapeutic; Time; Veterans; Woman; Work; care systems; chronic pain; cohort; combat; comorbidity; experience; health economics; improved; knowledge translation; mild traumatic brain injury; neuroimaging; neurosensory; patient oriented; protective factors; rate of change; research study; tool

The 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 (Vs) and Servicemembers (SMs); 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 Vs/SMs, 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”.

CENC (W81XWH-13-2-0095) 是一个高效、协调、多中心、基础的 科学到临床的研究合作，由 VCU/VA 研究员 David Cifu 医学博士领导，并共同领导 自 2013 年起由国防部和退伍军人管理局资助。 CENC 将基础、转化、流行病学和临床联系起来 来自退伍军人事务部、军队、学术界和私营部门的神经科学研究人员有效解决 轻度创伤性脑损伤（mTBI）及其治疗的诊断挑战和治疗后果 潜在的长期影响。来自 CENC 的经验丰富且久经考验的研究人员包括 LIMBIC 团队处于联盟领导层、核心设施和研究总监级别。 这个经过验证的领导者、基础设施支持者和研究人员团队将发起有针对性的、 扩展研究，扩展 CENC 研究成果，解决所有优先事项（必需的和 次要研究要素）在计划公告中详细说明，并将产生可交付成果 对于该领域的临床医生。 四个基础设施核心（生物标记、神经影像、数据和生物统计学、临床研究）将 共同努力实现三个相互关联的总体目标： 目标 1. 将 CENC 过渡并扩展到 LIMBIC——注册并扩大相关群体的规模 退伍军人 (Vs) 和现役军人 (SM)；扩大收集的数据点；收集数据按照 具有既定的指导方针；识别和描述人群的关键特征以指导 随着时间的推移，对战斗 Vs/SM 中 mTBI 后期效应的性质和程度进行了严格的研究。 目标 2. 合并症和神经系统后遗症——确定 mTBI 的患病率以及与 重要的合并症和神经系统后遗症，例如痴呆和神经退行性疾病， 疼痛、心理健康（包括创伤后应激障碍）和神经感觉缺陷。确定性质和程度 随着时间的推移，mTBI 的迟发效应。 目标 3. 表型——识别特征（例如，重复性 mTBI、仅部署 mTBI、频繁 低水平爆炸或其他亚震荡性头部/大脑撞击暴露，基线神经认知 缺陷、神经体征的存在、症状的存在）、病理生理学、生物标志物和 作为长期结果的风险或保护因素的亚人群（例如女性），例如 神经变性、症状负担和健康经济学。 LIMBIC 将继续由 CENC 发起的使命，CENC 拥有 Vs/SM 及其家人 所开展工作的核心是开发、部署和传播以患者为中心的医疗保健 工具和策略。迄今为止进行的工作扩大了慢性疼痛领域的知识， 睡眠、感觉障碍、心理健康和重返工作岗位。知识翻译正在进行中 包括改善对民众的护理和护理系统，可转化为军事和医疗保健 广大公众。我们准备实现 LIMBIC 的“改善急性 TBI 护理”的意图 以及 mTBI 后慢性护理的后续支持系统”。