Progress and Future Directions of the NCAA-DoD Concussion Assessment, Research, and Education (CARE) Consortium and Mind Matters Challenge at the US Service Academies.

Megan N Houston,J Kenneth Wickiser,Jonathan C Jackson,Rachel M Brodeur,Gerald T Mcginty,Steven P Broglio,Christopher J D'Lauro,Steven J Svoboda,Adam J Susmarski,Thomas W Mcallister,Jesse R Trump,Paul Pasquina,Kevin J O'Donovan,Kenneth L Cameron,Michael A Mccrea

doi:10.3389/fneur.2020.542733

Abstract

Despite the significant impact that concussion has on military service members, significant gaps remain in our understanding of the optimal diagnostic, management, and return to activity/duty criteria to mitigate the consequences of concussion. In response to these significant knowledge gaps, the US Department of Defense (DoD) and the National Collegiate Athletic Association (NCAA) partnered to form the NCAA-DoD Grand Alliance in 2014. The NCAA-DoD CARE Consortium was established with the aim of creating a national multisite research network to study the clinical and neurobiological natural history of concussion in NCAA athletes and military Service Academy cadets and midshipmen. In addition to the data collected for the larger CARE Consortium effort, the service academies have pursued military-specific lines of research relevant to operational and medical readiness associated with concussion. The purpose of this article is to describe the structure of the NCAA-DoD Grand Alliance efforts at the service academies, as well as discuss military-specific research objectives and provide an overview of progress to date. A secondary objective is to discuss the challenges associated with conducting large-scale studies in the Service Academy environment and highlight future directions for concussion research endeavors across the CARE Service Academy sites.

Highlights

An estimated 64 million to 74 million new cases of traumatic brain injury (TBI) occur each year [1]
The National Collegiate Athletic Association (NCAA)-Department of Defense (DoD) CARE Consortium was established with the aim of creating a national multisite research network to study the clinical and neurobiological natural history of concussion in NCAA athletes and military Service Academy cadets and midshipmen
In addition to the data collected for the larger CARE Consortium effort, each academy has pursued military-specific lines of research relevant to operational and medical readiness associated with concussion

Summary

Introduction

An estimated 64 million to 74 million new cases of traumatic brain injury (TBI) occur each year [1]. Most concussion symptoms and deficits resolve within days to weeks, there has recently been growing concern about the potential longterm consequences of injury [4, 5]. Over the past 20 years, fears heightened as soldiers returned home from war with blast injuries and sports such as football and boxing gained popularity [9]. These concerns prompted further investigation into concussion and stimulated numerous studies that would transform our knowledge and understanding of what has been termed the invisible wound in military service members [10]. Even with the increased attention concussion has received and the immense progress that has been made in the field, the natural history and clinical management of concussion remain challenging, and the consequences of repetitive head impact exposure over time are not well-understood

Objectives

Findings

Conclusion