New round of funding expands UGA lab's involvement in concussion research

The University of Georgia will continue its partnership in the world's most comprehensive concussion study thanks to a new round of funding from the U.S. Department of Defense and the NCAA.

Faculty in the UGA Concussion Research Lab in the UGA College of Education joined the project in 2014, with the shared goal of understanding how concussions affect the brain and identifying ways to improve diagnosis, treatment and prevention. Known as the NCAA-DOD Concussion Assessment, Research and Education Consortium, or CARE Consortium, the study is led by the Indiana University School of Medicine, the University of Michigan and the Medical College of Wisconsin, in collaboration with the Uniformed Services University.

So far, researchers across the country have collected data on more than 39,000 student-athletes and cadets at 30 colleges and military service academies, including more than 3,300 who have experienced concussions. This represents the largest sample of concussions ever researched in a single study.

At UGA, faculty and graduate students in the Concussion Research Lab administer baseline assessments to all student-athletes, and also provide evaluation services to any athlete that sustains a concussion. The data collected by the lab has also been used in several published research papers, with assistant professors Julianne Schmidt and Robert Lynall, co-directors of the lab, as authors or co-authors.

"It has been a great honor for UGA to serve as a CARE Consortium site over the past 4 years, and we are excited to continue this important work," said Schmidt, a co-investigator on the grant. "We work hard to provide the best possible concussion evaluation and management services to UGA student-athletes. Combining our efforts with the other sites within the CARE Consortium allows us to research the injury in a much larger sample over a much more diverse group, which ultimately cycles back to improve the care we provide here at UGA and across the country."

This second phase of the study is funded by a $22.5 million grant over several years.

The initial study was made possible by a joint NCAA-Department of Defense grant of $30 million and focused on the acute effects of concussions by evaluating concussed participants with a sequence of clinical and advanced research tests in the hours, days and weeks after a head injury, then comparing the results with baseline tests given at the start of the study.

The new phase will include comprehensive testing of participants when they leave college and up to four years after their collegiate sports or service academy career has ended. This expanded approach will enable researchers to study the intermediate and cumulative effects of concussion and repetitive head impact exposure. More importantly, researchers hope to differentiate between the effects of concussion, repetitive head impact and sports participation with no history of either concussion or repetitive head impact exposure.

"We have gathered important information about the short-term effects of concussions over the past few years, but there is still a lot we do not understand about how our brains respond to different types of impact over time," said Dr. Thomas W. McAllister, chair of the Department of Psychiatry at Indiana University School of Medicine and the leader of the study's administrative and operations center. "By comparing these groups across multiple years, we think we can parse out the effects of concussions, versus repetitive head impacts, versus normal life at university. This is critical for us to make informed decisions that protect our athletes, members of the military and other members of our communities."

The evaluations will include clinical tests to assess attributes such as balance and memory but also will probe changes to participants' psychological health to determine what role, if any, concussions and repetitive head impacts may have on depression, anxiety and emotional control. Researchers also will continue to conduct advanced research tests, including genetic analysis, brain imaging and blood tests to measure biomarkers associated with inflammation and nervous system dysfunction. It is conceivable that the advanced research tests will help identify genes and other objective markers that render an athlete or cadet more or less susceptible to concussion or injury from repetitive head impacts.

The NCAA is providing $12.5 million in funding over two years for the second stage of research. The Department of Defense approved a two-year grant of nearly $10 million.

"This new phase of funding represents a critical extension to the original study goals, allowing us to take an unprecedented look at cumulative and persistent effects of concussion and repetitive head impact exposure," said Dr. Brian Hainline, NCAA chief medical officer. "What we learn from this research will advance the science of traumatic brain injury and improve our understanding of how to best support the health and well-being of student-athletes, not only during their collegiate athletics experience but beyond."

In addition to expanding the scope of the study, the CARE Consortium is adding a representative from the Uniformed Services University of the Health Sciences to its research team. Dr. Paul F. Pasquina is a retired Army colonel, professor and chair of the Department of Rehabilitation Medicine and director of the Center for Rehabilitation Sciences Research. His role with the CARE Consortium is to promote and facilitate the involvement of the four military service academies in the consortium.

"Optimizing the health and performance of our warfighters is paramount to enhancing the readiness and lethality of the force," Terry M. Rauch, acting deputy assistant secretary of defense (Health Readiness Policy and Oversight), said regarding the Department of Defense's participation in the study. "Traumatic brain injuries are a major readiness concern as our warfighters are particularly susceptible to these injuries during combat and training. The department is leading efforts in research to better understand how to prevent, diagnose and treat TBIs across the range of military operations. However, much more work needs to be done, and this partnership with the NCAA and participating academic institutions provides valuable evidence to optimize the health and performance of our warfighters."

Already, the CARE Consortium has generated information related to topics such as the effect of removing student-athletes from play after a concussion, the influence of age at the time of first concussion, sleep and concussion recovery and tools and tests used to assess concussions.