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Long-Term Impact of Military-Relevant Brain Injury Consortium (LIMBIC) - Chronic Effects of Neurotrauma Consortium (CENC)

The objectives of LIMBIC-CENC program are to link basic science, translational, and clinical neuroscience researchers from the Department of Veterans Affairs (VA), military, and academia. The goal is to effectively address the long-term effects of mild traumatic brain injury (mTBI) and its diagnosis and treatment.

LIMBIC-CENC includes eleven participating VA and DoD hospital centers and academic partners in Boston, MA; Fort Belvoir, VA; Fort Gordon, GA; Houston, TX; Minneapolis, MN; Portland, OR; Richmond, VA; Tampa, FL; Salisbury, NC; San Antonio, TX and San Diego, CA. LIMBIC-CENC also has a Coordinating Center in Virginia and three primary Research Cores: the Clinical Studies Core in Virginia, the Data and Biostatistics Core (DBC) in Virginia and Utah, the Biomarkers Core in Maryland, and the Neuroimaging Core in Utah.

Study Overview

This is a longitudinal cohort study. Participants are previously combat-deployed current and former U.S. Service Members with and without mild TBI (mTBI). The general objectives of this study are to understand the role of mTBI(s) in later life outcomes, including neurodegeneration, and seek converging behavioral and biological evidence for chronic traumatic encephalopathy (CTE) and other forms of dementia. The study’s design is a cross-sectional and longitudinal, repeated measure observational study. Participants will be followed for the remainder of their lives contingent on their ongoing agreement and continuation of study funding.

All participants will undergo an initial in-person comprehensive visit. This is followed by periodic, in-person and remote longitudinal reassessment to monitor the status of their condition and to assess for evidence of biologic, behavioral, cognitive, neurologic, and functional decline.

LIMBIC-CENC Research Cores

There are three LIMBIC-CENC Research Cores and one Coordinating Center. The four organizations are described below.

Coordinating Center

The Coordinating Center (VCU) provides logistical and call center support for study management and Institutional Review Board (IRB) approvals. It also coordinates the development and finalization of all LIMBIC-CENC study protocols, Manuals of Procedures (MOPs), and data collection forms. In addition, it assists and facilitates the work of the 3 cores described below.

Data and Biostatistics Core (DBC)

The DBC (Hunter Holmes McGuire VA Medical Center, Virginia Commonwealth University and VA Salt Lake City Healthcare System) provides data capture systems and data management. It also provides data quality procedures and statistical support for study design and data analysis.

Biomarkers Core

The Biomarkers Core (Uniformed Services University of the Health Sciences) develops procedures for and oversight of biospecimen collection and processing. It also serves as the main storage facility for biospecimens and conducts biomarker assays.

Neuroimaging Core

The LIMBIC-CENC Neuroimaging Core (University of Utah) facilitates and manages collection and analysis of structural and functional MRI. The objective is to detect imaging-related changes following traumatic brain injury (TBI).