A Virginia university has launched a massive research study to better understand the relationship between concussions and future neurological conditions such as dementia and Parkinson’s disease in military personnel.

The Departments of Defense and Veterans Affairs have awarded Virginia Commonwealth University $50 million to explore the long-term impacts of combat concussion.

The new money will be used to explore the health and military records of more than 2 million veterans and add 3,000 more former service members who suffered multiple concussions in combat to a program that is monitoring them for life.

“There is a clear understanding that concussions are an epidemic in sports, the military ... Related to that, dementia is as well. There is a very strong belief in 2019 that there is cause and effect, but we are not sure what is in the middle there. We are studying the middle,” said Dr. David Cifu, chairman of VCU’s Department of Physical Medicine and Rehabilitation and a senior TBI specialist at VA, in a release.

The federal grant follows a $62 million award to the school in 2012 to lead a consortium of 30 universities and 27 military and veterans medical facilities to study the chronic effects of brain injuries.

Nearly 384,000 U.S. service members experienced a traumatic brain injury between 2000 and June 2018, 83 percent of which were classified as “mild,” another descriptor for a concussion. Previous research has associated traumatic brain injury with increased risk for dementia and other conditions, including Parkinson’s, suicide risk and Alzheimer’s disease, but more studies must be done to fully understand the relationship, Cifu said.

“We are getting a 360-degree overview of all aspects of these veterans and service members, from their brains and nervous systems to emotional well-being to their day-to-day functioning," Cifu said. “That is exactly what is required to finally understand these combat concussions and their linkages to symptoms and secondary conditions like dementia.”

To conduct the research, VCU will work closely with several VA hospitals, including Hunter Holmes McGuire VA Medical Center in Richmond, as well as the Department of Defense and other members of the Long-term Impact of Military-relevant Brain Injury Consortium, or LIMBIC.

In 2012, President Barack Obama created the National Research Action Plan on Traumatic Brain Injury and Psychological Health. The plan led to the creation of the Chronic Effects of Neurotrauma Consortium which studies the relationship between TBI, post-traumatic stress disorder and long-term neurological conditions.

Obama later launched an initiative to map the human brain and further study its diseases and capabilities. BRAIN, or the Brain Research through Advancing Innovative Neurotechnologies, initiative, has funded research on imaging, brain modulation, neural circuits and the ethics of brain research and manipulation, according to the National Institutes of Health.

Among the studies most relevant to service members and veterans published this year was research conducted by VA and civilian researchers at University of California-San Diego and Harvard University that found patients who experienced a concussion had a higher risk of post-traumatic stress disorder and depression after the injury, compared with patients who experienced a traumatic injury but whose head wasn’t involved.

Research also has shown that concussion may increase risk of Parkinson’s, dementia, Alzheimer’s and other conditions.

Former Army Staff Sgt. Joe Montanari suffered a head injury while serving in Iraq. Today, he is a research assistant at VCU’s Department of Physical Medicine and Rehabilitation. He also is a participant in the new LIMBIC study.

“I have a couple of issues as far as balance goes headaches. This really sheds a light everything for me personally. If I can help out brothers and sisters in the future, I want to do that," Montanari said.

Cifu said the research is important because if the team can understand the relationship between concussion and brain changes or deterioration later in life, it may lead to preventive treatments or therapies.

“We are going to be the link to help people understand when [they] have this kind of injury, what is the chance [they] are going to get to a level [of dementia and] what can you do to prevent it from happening,” Cifu said.

Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.

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