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ADVANCE-TBI study protocol: traumatic brain injury outcomes in UK military personnel serving in Afghanistan between 2003 and 2014 – a longitudinal cohort study

INTRODUCTION: Outcomes of traumatic brain injury (TBI) are highly variable, with cognitive and psychiatric problems often present in survivors, including an increased dementia risk in the long term. Military personnel are at an increased occupational risk of TBI, with high rates of complex polytraum...

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Autores principales: Graham, Neil S N, Blissitt, Grace, Zimmerman, Karl, Friedland, Daniel, Dumas, Marc-Emmanuel, Coady, Emma, Heslegrave, Amanda, Zetterberg, Henrik, Escott-Price, Valentina, Schofield, Susie, Fear, Nicola T, Boos, Christopher, Bull, Anthony M J, Cullinan, Paul, Bennett, Alexander, Sharp, David J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10032415/
https://www.ncbi.nlm.nih.gov/pubmed/36944467
http://dx.doi.org/10.1136/bmjopen-2022-069243
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author Graham, Neil S N
Blissitt, Grace
Zimmerman, Karl
Friedland, Daniel
Dumas, Marc-Emmanuel
Coady, Emma
Heslegrave, Amanda
Zetterberg, Henrik
Escott-Price, Valentina
Schofield, Susie
Fear, Nicola T
Boos, Christopher
Bull, Anthony M J
Cullinan, Paul
Bennett, Alexander
Sharp, David J
author_facet Graham, Neil S N
Blissitt, Grace
Zimmerman, Karl
Friedland, Daniel
Dumas, Marc-Emmanuel
Coady, Emma
Heslegrave, Amanda
Zetterberg, Henrik
Escott-Price, Valentina
Schofield, Susie
Fear, Nicola T
Boos, Christopher
Bull, Anthony M J
Cullinan, Paul
Bennett, Alexander
Sharp, David J
author_sort Graham, Neil S N
collection PubMed
description INTRODUCTION: Outcomes of traumatic brain injury (TBI) are highly variable, with cognitive and psychiatric problems often present in survivors, including an increased dementia risk in the long term. Military personnel are at an increased occupational risk of TBI, with high rates of complex polytrauma including TBI characterising the UK campaign in Afghanistan. The ArmeD SerVices TrAuma and RehabilitatioN OutComE (ADVANCE)-TBI substudy will describe the patterns, associations and long-term outcomes of TBI in the established ADVANCE cohort. METHODS AND ANALYSIS: The ADVANCE cohort comprises 579 military personnel exposed to major battlefield trauma requiring medical evacuation, and 566 matched military personnel without major trauma. TBI exposure has been captured at baseline using a standardised interview and registry data, and will be refined at first follow-up visit with the Ohio State Method TBI interview (a National Institute of Neurological Disorders and Stroke TBI common data element). Participants will undergo blood sampling, MRI and detailed neuropsychological assessment longitudinally as part of their follow-up visits every 3–5 years over a 20-year period. Biomarkers of injury, neuroinflammation and degeneration will be quantified in blood, and polygenic risk scores calculated for neurodegeneration. Age-matched healthy volunteers will be recruited as controls for MRI analyses. We will describe TBI exposure across the cohort, and consider any relationship with advanced biomarkers of injury and clinical outcomes including cognitive performance, neuropsychiatric symptom burden and function. The influence of genotype will be assessed. This research will explore the relationship between military head injury exposure and long-term outcomes, providing insights into underlying disease mechanisms and informing prevention interventions. ETHICS AND DISSEMINATION: The ADVANCE-TBI substudy has received a favourable opinion from the Ministry of Defence Research Ethics Committee (ref: 2126/MODREC/22). Findings will be disseminated via publications in peer-reviewed journals and presentations at conferences.
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spelling pubmed-100324152023-03-23 ADVANCE-TBI study protocol: traumatic brain injury outcomes in UK military personnel serving in Afghanistan between 2003 and 2014 – a longitudinal cohort study Graham, Neil S N Blissitt, Grace Zimmerman, Karl Friedland, Daniel Dumas, Marc-Emmanuel Coady, Emma Heslegrave, Amanda Zetterberg, Henrik Escott-Price, Valentina Schofield, Susie Fear, Nicola T Boos, Christopher Bull, Anthony M J Cullinan, Paul Bennett, Alexander Sharp, David J BMJ Open Neurology INTRODUCTION: Outcomes of traumatic brain injury (TBI) are highly variable, with cognitive and psychiatric problems often present in survivors, including an increased dementia risk in the long term. Military personnel are at an increased occupational risk of TBI, with high rates of complex polytrauma including TBI characterising the UK campaign in Afghanistan. The ArmeD SerVices TrAuma and RehabilitatioN OutComE (ADVANCE)-TBI substudy will describe the patterns, associations and long-term outcomes of TBI in the established ADVANCE cohort. METHODS AND ANALYSIS: The ADVANCE cohort comprises 579 military personnel exposed to major battlefield trauma requiring medical evacuation, and 566 matched military personnel without major trauma. TBI exposure has been captured at baseline using a standardised interview and registry data, and will be refined at first follow-up visit with the Ohio State Method TBI interview (a National Institute of Neurological Disorders and Stroke TBI common data element). Participants will undergo blood sampling, MRI and detailed neuropsychological assessment longitudinally as part of their follow-up visits every 3–5 years over a 20-year period. Biomarkers of injury, neuroinflammation and degeneration will be quantified in blood, and polygenic risk scores calculated for neurodegeneration. Age-matched healthy volunteers will be recruited as controls for MRI analyses. We will describe TBI exposure across the cohort, and consider any relationship with advanced biomarkers of injury and clinical outcomes including cognitive performance, neuropsychiatric symptom burden and function. The influence of genotype will be assessed. This research will explore the relationship between military head injury exposure and long-term outcomes, providing insights into underlying disease mechanisms and informing prevention interventions. ETHICS AND DISSEMINATION: The ADVANCE-TBI substudy has received a favourable opinion from the Ministry of Defence Research Ethics Committee (ref: 2126/MODREC/22). Findings will be disseminated via publications in peer-reviewed journals and presentations at conferences. BMJ Publishing Group 2023-03-21 /pmc/articles/PMC10032415/ /pubmed/36944467 http://dx.doi.org/10.1136/bmjopen-2022-069243 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Neurology
Graham, Neil S N
Blissitt, Grace
Zimmerman, Karl
Friedland, Daniel
Dumas, Marc-Emmanuel
Coady, Emma
Heslegrave, Amanda
Zetterberg, Henrik
Escott-Price, Valentina
Schofield, Susie
Fear, Nicola T
Boos, Christopher
Bull, Anthony M J
Cullinan, Paul
Bennett, Alexander
Sharp, David J
ADVANCE-TBI study protocol: traumatic brain injury outcomes in UK military personnel serving in Afghanistan between 2003 and 2014 – a longitudinal cohort study
title ADVANCE-TBI study protocol: traumatic brain injury outcomes in UK military personnel serving in Afghanistan between 2003 and 2014 – a longitudinal cohort study
title_full ADVANCE-TBI study protocol: traumatic brain injury outcomes in UK military personnel serving in Afghanistan between 2003 and 2014 – a longitudinal cohort study
title_fullStr ADVANCE-TBI study protocol: traumatic brain injury outcomes in UK military personnel serving in Afghanistan between 2003 and 2014 – a longitudinal cohort study
title_full_unstemmed ADVANCE-TBI study protocol: traumatic brain injury outcomes in UK military personnel serving in Afghanistan between 2003 and 2014 – a longitudinal cohort study
title_short ADVANCE-TBI study protocol: traumatic brain injury outcomes in UK military personnel serving in Afghanistan between 2003 and 2014 – a longitudinal cohort study
title_sort advance-tbi study protocol: traumatic brain injury outcomes in uk military personnel serving in afghanistan between 2003 and 2014 – a longitudinal cohort study
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10032415/
https://www.ncbi.nlm.nih.gov/pubmed/36944467
http://dx.doi.org/10.1136/bmjopen-2022-069243
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