Virginia Commonwealth University has been awarded a $50 million federal grant to oversee a national research consortium of universities, hospitals and clinics that will study the long-term impacts of mild traumatic brain injuries or concussions on service members and veterans.

The principal investigator on the grant is David X. Cifu, M.D., professor and chair of the VCU School of Medicine's Department of Physical Medicine and Rehabilitation and senior traumatic brain injury specialist for the U.S. Department of Veterans Affairs.

The Long-term Impact of Military-relevant Brain Injury Consortium (LIMBIC) will study the ongoing health impacts of combat concussions, such as those from blasts, bullets and hand-to-hand fighting as well as vehicle accidents, sports injuries and falls. Researchers from the LIMBIC team have already discovered links between combat concussions and dementia, Parkinson’s disease, chronic pain, opioid usage and suicide risk.

“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. We’re getting a full look because they’re enrolled in this ongoing comprehensive study,” Cifu said. “This is the largest study of its kind that is entailing a deeper dive and more thorough investigation than any person, patient or even research participant could get. The individual being studied is getting the most comprehensive evaluation of its kind because that is exactly what is required to finally understand these combat concussions and their linkages to symptoms and secondary conditions, like dementia.”

The Departments of Defense and Veterans Affairs are funding the grant, which will bring together universities, Veterans Health Administration hospitals — including Richmond's Hunter Holmes McGuire VA Medical Center — and the military to study the impact of combat concussions.

“Nationally prominent universities like VCU, and like those we partner with, conduct research because it has the power to make the human experience better, and that's especially meaningful when it helps veterans who have given so much to our nation, sometimes at great personal expense,” said VCU President Michael Rao, Ph.D. “I am proud of VCU's commitment to research, innovation and scholarship that saves and improves lives, and this is the latest example. I am also grateful to our LIMBIC partners and excited about the groundbreaking work we will do together."

This new LIMBIC research, which launches Oct. 1, will continue for five years.

"VCU Health is on a relentless pursuit to better health for everyone we serve but we can’t do it alone," said Marsha Rappley, M.D., senior vice president for Health Sciences and CEO of the VCU Health System. "Through grants and partnerships, like the LIMBIC, we can become a model that improves the health of those who need us, especially the men and women of the armed services. This is a story of science that will drastically improve the quality of life of those who selflessly sacrificed so much for the freedoms we enjoy.”

Interest in this type of research intensified in 2009, when service members and veterans were returning home from Iraq and Afghanistan with long-term, ongoing effects from concussions they had experienced in combat.

President Barack Obama signed an executive order in 2012 that created the National Research Action Plan on Traumatic Brain Injury and Psychological Health. The plan called for research on post-traumatic stress disorder and traumatic brain injury. Under the plan, the Departments of Defense and Veterans Affairs awarded a $62 million grant to VCU, the largest in university history, to lead the Chronic Effects of Neurotrauma Consortium (CENC), which included 30 universities, 15 VA hospitals and 12 military treatment facilities to study combat concussions.

CENC developed an electronic medical records database of more than 2 million veterans and service members and completed 11 research studies to determine best practices in assessing and monitoring health conditions in people with combat concussions to determine effects over time. CENC also developed specialized diagnostic tests using questionnaires, physical testing, brain imaging, fluid biomarkers and electrophysiology to study all aspects of the brain’s recovery from injury, from the basic biological to the day-to-day functional status.

This new $50 million LIMBIC award will allow researchers to expand the work of CENC. The award will extend the analyses of the “big data” of the more than 2 million veterans and service personnel with a range of linked electronic medical and administrative records and increase the enrollment to more than 3,000 veterans and service members with multiple combat concussions whose recovery is being systematically monitored for life. Innovative treatments for the difficulties that accompany combat concussions also will be studied in this large group.  

“Dr. Cifu and his team are a terrific example of the exciting and highly collaborative research that takes place at the VCU School of Medicine,” said Peter Buckley, M.D., dean of the School of Medicine. “This new grant increases Cifu’s team’s ability to improve the care of veterans and service members through cutting-edge research, which then gets applied to the civilian population. Ultimately, we all benefit from their work on concussion research.”

Virginia’s U.S. senators said the new research will advance a nationwide effort on the part of the Veterans Administration and the Department of Defense to understand the health of troops and veterans related to their combat exposures.

“I am thrilled to know that Virginia Commonwealth University will be able to continue furthering our understanding of service-related traumatic brain injuries and their effects,” said Sen. Mark R. Warner, D-Va. “This grant will help VCU remain on the cutting edge of research and continue its long tradition of medical innovation and care. I applaud VCU for the great strides it has already made, and I look forward to seeing how their ongoing research will help our veterans in the future.”

“VCU has played a critical role in improving the nation’s understanding of the long-term ramifications of brain injuries on our men and women in uniform. I wrote to support funding for this essential research because we need to do everything we can to support active-duty service members and veterans who have sacrificed so much to serve our nation,” said Sen. Tim Kaine, D-Va. “I’m thrilled that VCU will have the opportunity to continue this important work to better understand the impacts of brain injuries and concussions on our military.”

Rep. Donald McEachin, D-4th, supported the grant application with a letter signed by most members of Virginia’s House of Representatives.

“As a representative of the commonwealth of Virginia, a state with one of the highest percentages of veterans nationally, we are committed to ensuring our veteran population has access to the highest quality of care and services available,” McEachin said. “Our servicemen and women make significant sacrifices to protect our liberty and freedom. This research will help us to better treat the injuries and long-term ailments resulting from combat. It is the least we can do and I commend VCU for their groundbreaking role in this important work."