Allocation of funding into blast injury-related research and blast traumatic brain injury between 2000 and 2019: analysis of global investments from public and philanthropic funders

Denny, Jack; Brown, Rebecca J.; Head, Michael G; Batchelor, James; Dickinson, Alexander

doi:10.1136/bmjmilitary-2020-001655

Cited by 11 publications

(8 citation statements)

References 13 publications

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“…While the authors concluded that blast TBI research received 42.6% ($384..3 million) of all blast-injuryrelated research [8], the study did not examine concurrent trends in TBI mortality. Thus, in our study, we examined recent trends in the National Institutes of Health, NIH-funded clinical TBI research and concurrent TBI-related in-hospital mortality.…”

Section: Introductionmentioning

confidence: 99%

National Institutes of Health Clinical Research Funding and All-Cause In-Hospital Traumatic Brain Injury-Related Mortality

Alinani¹,

Mills²,

Gause³

et al. 2022

Cureus

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Higher federal research funding levels may improve patient outcomes. We examined this relationship between traumatic brain injury (TBI) funding and all-cause in-hospital TBI-related mortality. MethodsUsing an ecological series analysis, we examined the linear trend in both clinical TBI research funding in year 2000 United States dollars ($) (National Institutes of Health [NIH] RePORTER) and in-hospital isolated TBI mortality among patients aged 15 and older (National Trauma Data Bank [NTDB], TBI-related ICD-9 or ICD-10 code, abbreviated head injury score >2 and body region score <2 with ICU admission) between 2007-2015 with data from centers contributing all years of data for the study period. Linear regression was used to assess the relationship between mortality rate and total funding, lagged one to three years, both overall and within ten-year age groups.

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Section: Introductionmentioning

confidence: 99%

National Institutes of Health Clinical Research Funding and All-Cause In-Hospital Traumatic Brain Injury-Related Mortality

Alinani¹,

Mills²,

Gause³

et al. 2022

Cureus

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“…In the past 20 years, ∼$900 million USD has been spent on research funding related to BINT. 6 In this short communication, we summarize ( Fig. 1 ) the current knowledge, consensus, controversies, and potential future directions.…”

Section: Introductionmentioning

confidence: 99%

Twenty Years of Blast-Induced Neurotrauma: Current State of Knowledge

Sachdeva,

Ganpule

2024

Neurotrauma Reports

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Blast-induced neurotrauma (BINT) is an important injury paradigm of neurotrauma research. This short communication summarizes the current knowledge of BINT. We divide the BINT research into several broad categories—blast wave generation in laboratory, biomechanics, pathology, behavioral outcomes, repetitive blast in animal models, and clinical and neuroimaging investigations in humans. Publications from 2000 to 2023 in each subdomain were considered. The analysis of the literature has brought out salient aspects. Primary blast waves can be simulated reasonably in a laboratory using carefully designed shock tubes. Various biomechanics-based theories of BINT have been proposed; each of these theories may contribute to BINT by generating a unique biomechanical signature. The injury thresholds for BINT are in the nascent stages. Thresholds for rodents are reasonably established, but such thresholds (guided by primary blast data) are unavailable in humans. Single blast exposure animal studies suggest dose-dependent neuronal pathologies predominantly initiated by blood–brain barrier permeability and oxidative stress. The pathologies were typically reversible, with dose-dependent recovery times. Behavioral changes in animals include anxiety, auditory and recognition memory deficits, and fear conditioning. The repetitive blast exposure manifests similar pathologies in animals, however, at lower blast overpressures. White matter irregularities and cortical volume and thickness alterations have been observed in neuroimaging investigations of military personnel exposed to blast. Behavioral changes in human cohorts include sleep disorders, poor motor skills, cognitive dysfunction, depression, and anxiety. Overall, this article provides a concise synopsis of current understanding, consensus, controversies, and potential future directions.

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“…Mild traumatic brain injury (mTBI) has been a priority of the US Department of Defense (DOD) for nearly two decades ( 1 ). However, there is recent recognition of hazards to the brain beyond mTBI that may produce cognitive and physical alterations, potentially impacting the strength and readiness of the force ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Perspectives on Development of Measures to Estimate Career Blast Exposure History in Service Members and Veterans

et al. 2022

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The Department of Defense (DOD) has recently prioritized the investigation of the acute and chronic adverse brain health and performance effects of low-level blast (LLB) generated by the use of weapons systems. While acute exposure can be quantified by sensor technology, career exposure has no widely accepted and validated measure for characterization. Currently, distinct research groups are developing and validating four promising measures to estimate career blast exposure history: the Salisbury Blast Interview, Blast Exposure Threshold Survey, Blast Ordnance and Occupational Exposure Measure, and the Blast Frequency and Symptom Severity. Each measure offers an assessment of blast history that is uniquely beneficial to addressing specific research questions. However, use of divergent strategies is not efficient to accelerate the field's understanding of the impact of career exposure and Service-connected health outcomes. As a DOD-wide solution, collaboration across these groups is required to develop a tool(s) that can be standardized across research studies and, ultimately, pared down to be implemented in clinical settings. Here, we overview the current four measures and provide a perspective on the way forward for optimization and/or combination in support of this solution.

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Allocation of funding into blast injury-related research and blast traumatic brain injury between 2000 and 2019: analysis of global investments from public and philanthropic funders

Cited by 11 publications

References 13 publications

National Institutes of Health Clinical Research Funding and All-Cause In-Hospital Traumatic Brain Injury-Related Mortality

National Institutes of Health Clinical Research Funding and All-Cause In-Hospital Traumatic Brain Injury-Related Mortality

Twenty Years of Blast-Induced Neurotrauma: Current State of Knowledge

Perspectives on Development of Measures to Estimate Career Blast Exposure History in Service Members and Veterans

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