Many active duty military, national guard, and reserves personnel who served in the recent conflicts in Afghanistan and Iraq were exposed to blasts and other mechanisms of traumatic brain injury (TBI).1,2 Although physical trauma is not unexpected during war fighting, survival after head injury, particularly blast-related, has become a common occurrence only in recent decades. As such, the associated cerebral damage is less well studied and understood, particularly over the long term. The Brain Injury Outcomes (BIO) is a longitudinal study with the short-term objective of better characterizing multi-modal outcomes in individuals who have sustained a brain injury using a systems medicine approach. Long-term aims include monitoring participants for signs of emerging symptoms or age-related vulnerabilities. Identification of abnormality profiles for multiple severity levels of brain injury (from any source, including blast and non-blast) reflects a second long-range goal. Third, the investigators will examine and compare physiology between Veterans who have sustained a Mild Traumatic Brain Injury (mTBI) with and without persisting symptoms and various co-morbidities including posttraumatic stress disorder (PTSD) and depression. A control group of Veterans who have not sustained a TBI will also be recruited for comparison. Fourth, the investigators intend to facilitate the clinical use of advanced methodologies, such as brain imaging measures, with the brain injured (and other populations). Finally, the investigators will assess methods of analysis, separately and in combination through integration, for multi-modal data in search of diagnostic profiles. Increased knowledge of injury patterns and the trajectory associated with brain injury could contribute to better methods of diagnosis, monitoring and, perhaps, treatment. This investigation has spawned several sub-studies, one of which was the Validation of Brief Objective Neurobehavioral Detectors (BOND) of Mild TBI, which continues. The investigators have collaborated with Harvard/Boston Children's Hospital in the Angiogenic Signaling Signatures Identified in Stress and Trauma (ASSIST) sub-study. Oak Ridge National Laboratory (ORNL) will assist in integrating BIO Study multi-modal data. Investigators at Johns Hopkins School of Medicine collaborate with neuroimaging sequences and methods.

Population

OEF/OIF/OND Veterans with and without mTBI and/or PTSD

Brief Title

Brain Injury Outcomes (BIO) Study

Official Title

Validation of Brief Objective Neurobehavioral Detectors of Mild TBI

Brief Summary

Many active duty military, national guard, and reserves personnel who served in the recent <br /> conflicts in Afghanistan and Iraq were exposed to blasts and other mechanisms of traumatic <br /> brain injury (TBI).1,2 Although physical trauma is not unexpected during war fighting, <br /> survival after head injury, particularly blast-related, has become a common occurrence only <br /> in recent decades. As such, the associated cerebral damage is less well studied and <br /> understood, particularly over the long term. <br /> <br /> The Brain Injury Outcomes (BIO) is a longitudinal study with the short-term objective of <br /> better characterizing multi-modal outcomes in individuals who have sustained a brain injury <br /> using a systems medicine approach. Long-term aims include monitoring participants for signs <br /> of emerging symptoms or age-related vulnerabilities. Identification of abnormality profiles <br /> for multiple severity levels of brain injury (from any source, including blast and non-blast) <br /> reflects a second long-range goal. Third, the investigators will examine and compare <br /> physiology between Veterans who have sustained a Mild Traumatic Brain Injury (mTBI) with and <br /> without persisting symptoms and various co-morbidities including posttraumatic stress <br /> disorder (PTSD) and depression. A control group of Veterans who have not sustained a TBI will <br /> also be recruited for comparison. Fourth, the investigators intend to facilitate the clinical <br /> use of advanced methodologies, such as brain imaging measures, with the brain injured (and <br /> other populations). Finally, the investigators will assess methods of analysis, separately <br /> and in combination through integration, for multi-modal data in search of diagnostic <br /> profiles. Increased knowledge of injury patterns and the trajectory associated with brain <br /> injury could contribute to better methods of diagnosis, monitoring and, perhaps, treatment. <br /> <br /> This investigation has spawned several sub-studies, one of which was the Validation of Brief <br /> Objective Neurobehavioral Detectors (BOND) of Mild TBI, which continues. The investigators <br /> have collaborated with Harvard/Boston Children's Hospital in the Angiogenic Signaling <br /> Signatures Identified in Stress and Trauma (ASSIST) sub-study. Oak Ridge National Laboratory <br /> (ORNL) will assist in integrating BIO Study multi-modal data. Investigators at Johns Hopkins <br /> School of Medicine collaborate with neuroimaging sequences and methods.

Detailed Description

This study was previously paused due to the pandemic.

Many active duty military, national guard, and reserves personnel who served in the recent
conflicts in Afghanistan and Iraq were exposed to blasts and other mechanisms of traumatic
brain injury (TBI).1,2 Although physical trauma is not unexpected during war fighting,
survival after head injury, particularly blast-related, has become a common occurrence only
in recent decades. As such, the associated cerebral damage is less well studied and
understood, particularly over the long term.

The Brain Injury Outcomes (BIO) is a longitudinal study with the short-term objective of
better characterizing multi-modal outcomes in individuals who have sustained a brain injury
using a systems medicine approach. Long-term aims include monitoring participants for signs
of emerging symptoms or age-related vulnerabilities. Identification of abnormality profiles
for multiple severity levels of brain injury (from any source, including blast and non-blast)
reflects a second long-range goal. Third, the investigators will examine and compare
physiology between Veterans who have sustained a Mild Traumatic Brain Injury (mTBI) with and
without persisting symptoms and various co-morbidities including posttraumatic stress
disorder (PTSD) and depression. A control group of Veterans who have not sustained a TBI will
also be recruited for comparison. Fourth, the investigators intend to facilitate the clinical
use of advanced methodologies, such as brain imaging measures, with the brain injured (and
other populations). Finally, the investigators will assess methods of analysis, separately
and in combination through integration, for multi-modal data in search of diagnostic
profiles. Increased knowledge of injury patterns and the trajectory associated with brain
injury could contribute to better methods of diagnosis, monitoring and, perhaps, treatment.

This investigation has spawned several sub-studies, one of which was the Validation of Brief
Objective Neurobehavioral Detectors (BOND) of Mild TBI, which continues. The investigators
have collaborated with Harvard/Boston Children's Hospital in the Angiogenic Signaling
Signatures Identified in Stress and Trauma (ASSIST) sub-study. Oak Ridge National Laboratory
(ORNL) will assist in integrating BIO Study multi-modal data. Investigators at Johns Hopkins
School of Medicine collaborate with neuroimaging sequences and methods.

Outcome Measures

Outcome measures are the tests that investigators perform to prove whether or not a treatment being tested in a clinical trial is having any effect.