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”.

该CENC（W81 XWH-13-2-0095）一直是一个高产，协调，多中心，基本 科学到床边，由VCU/VA研究员大卫Cifu，医学博士和联合 自2013年以来，由国防部和VA资助。CENC将基础、转化、流行病学和临床 来自退伍军人事务部、军方、学术界和私营部门的神经科学研究人员， 轻度创伤性脑损伤（mTBI）的诊断挑战和治疗后果及其 潜在的长期影响。来自CENC的经验丰富和久经考验的研究人员组成了 LIMBIC团队在联盟领导层，核心设施和研究研究总监的水平。 这个由领导者、基础设施支持者和研究人员组成的成熟团队将发起有针对性的， 扩大研究，扩大CENC的研究成果，解决所有优先事项（需要和 次要研究要素），并将产生可交付成果 为临床医生提供了帮助。 四个基础设施核心（生物标志物、神经影像学、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.过渡和扩大CENC到LIMBIC -招募和扩大相关队列的规模 退伍军人（Vs）和军人（SM）;扩大收集的数据点;根据 确定和描述人口的主要特征，以指导 严格研究了随着时间的推移，战斗Vs/SM中mTBI晚期效应的性质和程度。 目标2.合并症和神经系统后遗症-确定mTBI的患病率和与 重要合并症和神经系统后遗症，如痴呆和神经变性疾病， 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 mTBI的晚期效应。 目标3.表型-确定特征（例如，重复性mTBI、仅部署mTBI、频繁 低水平冲击波或其他亚震荡性头部/脑部撞击暴露，基线神经认知 缺陷、神经系统体征的存在、症状的存在）、病理生理学、生物标志物，以及 亚群（例如，作为长期结果的风险或保护因素，例如 神经变性、症状负担和卫生经济学。 LIMBIC将继续CENC开始的使命，CENC拥有V/SM及其家庭成员 在执行工作的中心，发展，部署和传播以病人为中心的卫生保健 工具和战略。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 包括改善对人口的护理和护理系统，既可用于军事， 普通大众。我们准备实现LIMBIC的意图，“改善急性TBI护理 和随后的长期护理支持系统”。