A traumatic brain injury (TBI) refers to any damage to the brain caused by an external force. Think: a blow or jolt to the head. These can range from mild injuries like concussions to severe, life-altering injuries that come with significant physical, cognitive, and emotional changes.
According to the Department of Defense, in 2024 nearly 20,000 service members sustained a TBI. While most of these TBIs were mild, it is incredibly important that the department and its mission partners understand these types of injuries and how to prevent and treat them – especially since TBIs can be difficult to diagnose.
A key player in this research is the Defense Health Agency’s Traumatic Brain Injury Center of Excellence (TBICoE). GDIT closely collaborates with the team there to expand the body of knowledge about TBIs and, importantly, to help the DHA take action on that knowledge. GDIT’s team supporting TBICoE translates our research into evidence-based practice provider-support tools, clinical recommendations, fact sheets and training curriculums on TBI.
Challenge: Diagnosing TBIs that Often Go Undetected
Diagnosing TBIs caused by severe, penetrating injuries to the head is often a straightforward exercise. The challenge comes with diagnosing TBIs sustained during day-to-day activities, such as playing sports or participating in recreational events, military trainings or deployment scenarios. These milder blows or indirect injuries to the head or face can often go unnoticed and are called mild TBI or “mTBI” by medical professionals.
The dangers of an undiagnosed mTBI include persistent, concussion-like symptoms, an increased risk of future brain injuries and potential long-term neurological issues.
Approach: Leverage Neurology Network to Generate New Data and Novel Understanding
Our work with the TBICoE involves bringing together the expertise of nearly 90 neuroscientists, clinical researchers, dissemination and implementation specialists, educators, communication specialists, and healthcare providers across a network of military hospitals. Their efforts, along with the collaboration of traumatic brain injury experts at both public and private centers, are helping to cast new light on what we thought we knew --about mTBI.
For example, TBICoE is studying the effects of brain injuries on all aspects of human performance, from balance, vision, and hearing to cognitive functioning. GDIT plays a role in analyzing, preparing and promoting the data from these studies, which are enhancing the collective understanding of patients’ rehabilitation, resilience and readiness to return to training, work, or to the battlefield. For example, our team support of a longitudinal study over 15-years on service members with TBIs showed that for some, rehabilitation needs continued over 5, 10, and 15 years post a TBI. Additionally, over 60 percent of participants in this study required help with cognitive issues. Our progress return to activity study resulted in new tools and guidelines for how to transition a service member with a mild TBI (concussion) back to full duty. We know that 82% of military TBIs have been classified as mild and the majority fully recover within a few weeks.
GDIT supports the TBICoE team to better understand how blast overpressure affects the brain, and how the right training and treatment can help patients recover faster. Teams are also working to understand the effects of combat on warfighters – even the firing of one’s own weapon, which can come with powerful concussive force, or low-level blast exposure.
Impact: Research Insights Impact Both Care and Diagnostics
The new expanded understanding of TBI is helping to evolve the care that patients receive and the tools used to diagnose them. Today, new, more powerful MRIs, coupled with advanced digital-image processing, cognitive monitoring tools, blood biomarkers, and other innovative tools give us access to nuances that before were impossible to identify. These improved glimpses into brain function are helping doctors to see the finer distinctions between injuries, which in turn are helping to give patients better, more targeted treatments. And that means better outcomes.
One such major advancement is diffusion tensor imaging. By measuring the diffusion of water throughout the brain, doctors can see the white matter tracts in greater detail that electrical signals use to travel from one part of the brain to another. By comparing the brains of mTBI sufferers to control groups, science can support standardized measures for determining the extent of a patient’s injuries—along with treatment courses and likely outcomes. Just like common blood tests, a panel of standard neuroimaging tests could quickly classify brain injuries and indicate the best way to treat them.
Through a vast portfolio of research studies, multiple national presentations and the publication of numerous peer-reviewed research articles, GDIT’s team supporting the TBICoE is constantly improving the body of science known about mTBI.
Learn more about our dedication to improving the health of our service members.