# Total Brain Diagnostics (TBD): Analyzing the Impact of Physiologic Measures on Symptom Burden and Function Outcomes after TBI

> **NIH VA I01** · VA VETERANS ADMINISTRATION HOSPITAL · 2024 · —

## Abstract

The traumatic brain injury (TBI) literature provides preliminary evidence supporting associations
between TBI exposures and poor health and functional outcomes, particularly as they occur in
the context of the traumatic and stressful circumstances of military deployment. There is still much
to be understood, however, regarding the associations of patient and injury characteristics with
the prognosis of psychological health, physical health, functioning, and quality of life outcomes.
TBI has been a priority research area among veterans and military service personnel due to its
high prevalence in these populations. Ongoing longitudinal cohort studies of service members
and veterans with military combat and training exposures offer researchers access to extant data
addressing factors that modify risks for developing and/or recovering from a range of brain
disorders, including TBI, PTSD, pain, depression, and suicidality. Pooling individual participant
level data from longitudinal TBI research studies will result in a large enough dataset to consider
relevant moderators, mediators, and confounders in analyses and allow for more impactful and
clinically meaningful findings. In order to address the present knowledge gaps and harmonize
largescale, multi-modal data from varied sources, well-planned and reproducible standardization,
curation, and dissemination is needed to allow for meaningful analyses. The Long-term Impact of
Military-relevant Brain Injury Consortium's Prospective Longitudinal Study (PLS) is a 10-year, 17-
site cohort of >2,500 service members and veteran participants with combat-exposure who are
well-characterized initially and then have annual reassessments. The Translational Research
Center for TBI and Stress Disorders is a 14-year, 2-site longitudinal cohort of >925 veterans with
combat-exposure who are deeply characterized initially and then undergo comprehensive
reassessment at 2, 5 and 10 years. These two ongoing, prospective, longitudinal cohorts of active
duty and veteran service members offer access to a wide range of potential risk factors that can
affect response to care and outcomes including demographics (age, sex, race, ACEs, SDOH),
injury characteristics (pre-exposure factors, exposure factors), biomarkers including genetics and
epigenetics (serum, saliva, brain imaging, evoked potentials), and functional measures (functional
neuroimaging, EEG, computerized posturography, computerized eye tracking, special senses
testing, clinical examination, neuropsychological assessments, symptom questionnaires). While
there is considerable overlap across the LIMBIC and TRACTS cohorts' data elements,
considerable harmonization of the tools used and data obtained is needed to allow for valid and
meaningful analyses across cohorts. Additionally, a standardized and robust approach to the
clinical translation of the data to actionable risk stratification and/or clinical utility is necessary. For
this proposal, the researchers will work to ...

## Key facts

- **NIH application ID:** 10817281
- **Project number:** 1I01RX004908-01
- **Recipient organization:** VA VETERANS ADMINISTRATION HOSPITAL
- **Principal Investigator:** DAVID X. CIFU
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-01-01 → 2025-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10817281

## Citation

> US National Institutes of Health, RePORTER application 10817281, Total Brain Diagnostics (TBD): Analyzing the Impact of Physiologic Measures on Symptom Burden and Function Outcomes after TBI (1I01RX004908-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10817281. Licensed CC0.

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