David X. Cifu, M.D.

Repetitive Concussions from Blast and Combat Exposure: Update from the Prospective, Longitudinal Study of the Long-term Impact of Military-Relevant Brain Injury Consortium, 2013-2021

Abstract

Mild Traumatic Brain Injury was the “signature injury” of the Iraq and Afghan Wars of the 2000’s, with more than 350,000 service members being affected. Beginning in 2007, a nationwide system of Polytrauma Rehabilitation was established across the U.S. Departments of Defense (DoD) and Veterans Affairs (VA) to provide acute and chronic care in a uniform and evidence-based manner. Many of the American Heroes affected by these combat concussions continued to have persistent symptoms despite the comprehensive care systems in place, so in 2013, the DoD/VA funded the Chronic Effects of Neurotrauma Consortium (CENC) at Virginia Commonwealth University to establish a nationwide program of collaborative researchers to study both the short and long-term sequelae and outcomes of these military brain injuries, with specific focus on co-morbidities (PTSD, depression, pain, substance use), blast injury, repetitive insults, innovative treatment approaches and linkages to neurodegeneration, including dementia and Parkinson’s disease. Initially funded for $62.2 million and now renewed in 2019 for $50 million, the renamed Longterm Impact of Military-relevant Brain Injury Consortium (LIMBIC) has completed 11 research studies and is now focused on performing epidemiologic and health economic analyses on a big database of more than 2 million unique service members and Veterans and monitoring the prospective recovery and long-term outcomes of more than 3,000 combat-exposed service members and Veterans. are potential results of these military-relevant injuries. An update on the state of LIMBIC’s research, an overview of findings, and next steps will be presented.