# Traumatic and Treatable Vascular Pathology in the Outcome of TBI

> **NIH VA IK2** · PHILADELPHIA VA MEDICAL CENTER · 2022 · —

## Abstract

Objective: The overarching objective of this career development proposal is to develop Dr. Swanson’s
translational approach for investigating the relationship between mild traumatic brain injury (mTBI) exposure(s),
modifiable cardiovascular risk factors, and non-invasive measures of chronic cerebral microvascular pathology,
including advanced neuroimaging modalities.
Research Design and Methodology: Through resource sharing, previously collected and archived clinical
data, neuroimaging data, and blood samples from the joint DoD/VA Long-Term Impact of Military-Relevant
Brain Injury Consortium – Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) Prospective
Longitudinal Study Cohort will be utilized to perform a retrospective cohort study.
Aim-I will investigate potential associations between mTBI exposure(s) and advanced neuroimaging measures
of chronic cerebral microvascular pathology. Primary analysis will explore associations between the number of
mTBI exposures (none, 1-2, or 3+) and two independent advanced neuroimaging measures of cerebral
microvascular pathology (white matter hyperintensity quantification with Brain Intensity Abnormality
Classification Algorithm [BIANCA] analysis, and diffusion-MRI Free Water Volume Fraction [FW-VF] analysis)
at a single point in time (initial neuroimaging acquisition upon entry into the LIMBIC-CENC study), adjusting for
both age and sex. Secondary analysis will further categorize the mTBI exposure history into 7 severity
subgroups (accounting for the presence or absence of associated post-traumatic amnesia and loss of
consciousness), and then explore associations between resulting mTBI exposure severity and BIANCA / FW-
VF advanced neuroimaging analysis, adjusting for age and sex.
Aim-II will investigate potential associations between modifiable cardiovascular risk factors and advanced
neuroimaging measures of chronic cerebral microvascular pathology. Using a combination of ideal
cardiovascular health (I-CVH) behaviors (physical activity, sleep duration, smoking and alcohol use) and
factors (body mass index, blood pressure, total cholesterol, and diabetes mellitus status), we will calculate
patient-specific I-CVH Index scores and explore associations with BIANCA / FW-VF neuroimaging measures of
cerebral microvascular pathology, adjusting for age, sex and mTBI exposure(s) as independent risk factors. In
addition, we will evaluate longitudinal changes in cerebral microvascular pathology at 1, 3 & 5-year follow-up.
Candidate, Career Goals, Research Career Development: Dr. Randel Swanson is a prior enlisted U.S.
Marine who is board-certified in Physical Medicine & Rehabilitation, with subspecialty board certification in
Brain Injury Medicine. He is an Assistant Professor of Physical Medicine & Rehabilitation at the University of
Pennsylvania, and an Attending Physician at the Corporal Michael J. Crescenz VA Medical Center, where he
serves as a Polytrauma/TBI System of Care team physician. Dr. Swanson’s im...

## Key facts

- **NIH application ID:** 10421576
- **Project number:** 1IK2RX003651-01A2
- **Recipient organization:** PHILADELPHIA VA MEDICAL CENTER
- **Principal Investigator:** Randel L Swanson
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-02-01 → 2025-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10421576

## Citation

> US National Institutes of Health, RePORTER application 10421576, Traumatic and Treatable Vascular Pathology in the Outcome of TBI (1IK2RX003651-01A2). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10421576. Licensed CC0.

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