1. Determine the cumulative effects of multiple concussive or sub-concussive exposures or events, on acute and long-term physical, psychological, and cognitive outcomes.
2. Determine the prevalence of brain injuries within the military and identify environmental risk factors and variables in various settings (operations, weapons training, combatives, parachute training, etc.).
3. Determine the relationship(s) between adverse brain health outcomes resulting from brain injury and/or brain exposures (e.g. blast, blunt, accelerative, and directed energy) and potential co-occurring/influential individual factors, including (but not limited to): health conditions, genetic factors, psychological factors, stress, chronic pain, and substance overuse/dependence.
4. Define the chronic/long-term effects which result from brain injury and/or exposure(s) that mayor may not lead to a clinical diagnosis that may influence occupational performance and military readiness in warfighters. This includes the dose/response relationship between exposure(s) and these long-term outcomes and age-related decline or neurodegenerative diseases.
5. Determine the mechanisms underlying neuroprotection and cognitive enhancement following brain exposure(s) or brain injury and adapt or refine the use of cognitive performance improvement tools, capabilities, and supplements for the warfighter.
6. Evaluate neurocognitive assessment tools and validated metrics that enable an accurate understanding of a warfighter’s cognitive readiness for military activities and readiness requirements.
7. Determine the utility and effectiveness of novel TBI treatments, assessments, diagnostic and clinical decision-support tools, and technologies based on objective measures (e.g., biomarkers, sensory system status, neuroimaging changes, and neurocognitive status), all with the aim of supporting care in any environment, including future operations.
8. Reliably predict symptom trajectory and variables associated with treatment response for mild TBI patients with common co-occurring conditions (e.g., PTSD, depression, insomnia, etc.).
9. Define and mitigate the acute effects of brain injury or exposures that can prevent warfighters from returning to optimal brain health required for military service.
10. Evaluate and prioritize novel treatments for TBI, and determine optimal categorization of treatment courses based on symptom subgroups/clusters (e.g., vestibular, headache, PTSD, and psychological health or cognitive).

Revised in March 2023, the research review addresses the current state-of-the-science of CTE, including an in-depth look at available peer-reviewed scientific literature and a bulleted quick-reference summary for clinicians and the operational community. The revised fact sheet is a quick reference for researchers, the operational community, and clinicians to understand what is known, and not known, about CTE.

In cases with confirmed CTE, there is noteworthy overlap of symptomology and comorbid neuropathological conditions. CTE currently cannot be diagnosed in living persons. The clinical syndrome for living persons, Traumatic Encephalopathy Syndrome, is associated with CTE but is not diagnostic of the condition. 

• Chronic Traumatic Encephalopathy Research Review
• Chronic Traumatic Encephalopathy Frequently Asked Questions Fact Sheet
• CUBIST Podcast episode (S6 Ep6) Evaluating Media Attention on CTE — In this episode of CUBIST, TBICoE hosts discuss the article, "Telling the whole story: Bibliometric network analysis to evaluate impact of media attention on chronic traumatic encephalopathy research," by Sean Eagle and Dave Okonkwo and published in the Journal of Neurotrauma in January of 2023. Principal investigator, Sean Eagle joins the discussion.

Prior history of TBI may predispose an individual to increased risk of subsequent TBI when exposed to less force, and may engender lengthier recovery from postinjury symptoms. Activities such as contact sports and military service carry particular risk for multiple TBI. In addition to acute postinjury difficulties, cumulative TBI may increase the risk of chronic cognitive and functional impairment. Conservative management of postinjury symptoms as part of a medically monitored, progressive plan for returning to activities is recommended for individuals with a history of TBI.

• Multiple TBI/Multiple Concussion Research Review

This research review provides an overview of the topic of comorbid mild TBI and posttraumatic stress disorder (PTSD). The symptoms, diagnosis, and treatment of PTSD and mild TBI symptoms in patients with mild TBI history will be discussed. While it can be difficult to differentiate symptoms of mild TBI from PTSD symptoms, especially months or years after the injury event, this review aims to present information relevant to understanding these often complex cases.

• Mild Traumatic Brain Injury and Posttraumatic Stress Disorder

• TBICoE Publications 2021
• TBICoE Publications 2020
• TBICoE Publications 2019
• TBICoE Publications 1992-2018