CENC0004C - Epidemiology of mTBI and Neurosensory Outcomes

The primary objective of this project is to integrate and analyze existing VA healthcare data to study the chronic effects of mild traumatic brain injury (mTBI) on neurodegenerative disease and other comorbidities, and the methods to treat and rehabilitate adverse effects of mTBI, in Veterans over time. Although prior studies have found that moderate and severe TBI are associated with a variety of adverse clinical outcomes, the effects of mTBI are less well understood. This study aims to address this gap in knowledge through four complementary Specific Aims:

Aim 1: To evaluate the association between mTBI and important shorter-term clinical outcomes such as accidents and injuries in Veterans from recent conflicts in Iraq and Afghanistan, focusing on identifying factors associated with resilience and the potential benefits of adequate treatment.

Aim 2: To expand Aim 1 to include Veterans from all eras and to study longer-term clinical outcomes including neurosensory disorders and mortality, focusing on the potential confounding effects of comorbid medical conditions and the impact of their treatment.

Aim 3: To identify different trajectories of mTBI-related comorbid burden, with the goal of identifying factors associated with being in low and high distress trajectories.

Aim 4: To lay the groundwork for future analyses using more detailed and unified mTBI data by developing the groundwork to create a National CENC Data Repository (NCDR).

Together, these Aims will advance our knowledge of the effects of mTBI on important clinical outcomes in Veterans of all ages and eras in a highly efficient manner and will provide insight into potential strategies for prevention and intervention.

At a Glance

Study type:

Retrospective cohort study

Objective:

To integrate and analyze VA healthcare data to study the chronic effects of mild traumatic brain injury (mTBI) on neurodegenerative disease and other comorbidities, and the methods to treat and rehabilitate adverse effects of mTBI, in Veterans over time.

Population:

Veteran Service members over 18 years of age who have utilized Veterans Health Administration healthcare

Number of participants:

Over a million

Data collection:

This study will utilize accruing national healthcare databases

Participating sites:

San Francisco VA, Milwaukee VA, San Antonio VA, and Duke University

Principal investigator:

Kristine Yaffe MD, University of California, San Francisco

Duration:

3 years