Defense and Veterans Brain Injury Center

ANNUAL REPORT 2017

25 YEARS OF SERVICE
2 DVBIC Annual Report 2017 DVBIC Annual Report 2017 3

Table of Contents

Ongoing 

Initiatives 

Partnerships

Acknowledgements

Network Site 

Updates

Publications 

and 

Presentations

Introduction Mission Statement 03

Letter from the Director 04

Surveillance 34

TBI Pathway of Care Manager 35

Working Groups and Committees 36

Outreach and Events 36

Leadership Acting Director 06

Divisions 07

38

67

The DVBIC Story Celebrating 25 Years of Service 10

Timeline 12

The Year 

in Review Expansion 20

Advances 22

New Directions 26

Military Hospitals and Clinics 40

VA Medical Centers 47

Resources Print Products Distributed and 

Downloaded in 2017

28

New Print Products 29

Webinars 30

Revisions and Updates 31

Newsletters 32

Podcasts 32

Research Reviews 33

Publications 50

Presentations 54

Front Cover: MACE training aboard U.S. Navy Ship Mercy. (U.S. Navy photo by Petty Officer First Class Ralph Doria, 

USNS Mercy)
4 DVBIC Annual Report 2017 DVBIC Annual Report 2017 5

As the traumatic brain injury (TBI) Pathway of Care manager 

within the Military Health System (MHS), the Defense and 

Veterans Brain Injury Center (DVBIC) promotes state-of-thescience care from point-of-injury to reintegration for service 

members, veterans, and their families to prevent and mitigate 

consequences of mild to severe TBI. 

MISSION Statement Letter from the Director

As DVBIC celebrates its 25th anniversary, I am 

proud of how far we, as an organization, have 

advanced evidence-based TBI care for our service 

members and veterans. Working with partners, 

collaborating across the Military Health System 

and Department of Veterans Affairs (VA), and 

leveraging the expertise at each of our network 

sites, we continue to develop and deploy the 

very best assessment and treatment paradigms.

One of DVBIC’s signature accomplishments is 

having had the right footprints at the right places 

to fulfill our mission. This year is no exception. In 

2017, we added four new sites, rounding out our 

presence across the entire network of Intrepid Spirit 

centers and enabling us to impact how U.S. Special 

Operations Command (USSOCOM) addresses 

TBI. Through research conducted at the network 

sites, we learn more each year about the relationship 

between TBI and occupational vulnerabilities from 

everyday training and work activities, including 

low level blast exposure. Despite a drawdown in 

war in recent years, Special Operations Forces 

are still carrying out missions in over 80 countries. 

At USSOCOM, DVBIC can engage as a true 

combat support agency. DVBIC has also been 

listening to our family caregivers and patients with 

chronic TBI sequelae to improve daily functioning 

and quality of life. Our congressionally mandated 

longitudinal research studies have provided 

essential findings to help with this endeavor.

Looking back across DVBIC’s history, our 

accomplishments would not have been possible 

without the astute, accountable leadership of 

past directors such as Dr. Andres Salazar, who 

founded DVBIC with George Zitnay of the Brain 

Injury Association of America, and Dr. Deborah 

Warden, who led DVBIC through the massive 

transition following 9/11. After 9/11, TBI came 

to be recognized as the “signature injury” of 

Operation Enduring Freedom and Operation 

Iraqi Freedom. Drs. Salaazar and Warden and 

subsequent national directors elevated the status 

of TBI as a national challenge and leveraged 

partnerships to ensure it was addressed as such.

Looking ahead, TBI is not going away any time 

soon, but I believe we are on the brink of resolving 

some of the most stubborn knowledge gaps in 

areas such as chronic traumatic encephalopathy, 

the physiological basis for concussion, objective 

biomarkers and prognostication. I am extremely 

excited about finding answers in these and 

other areas, which will help us to protect the 

public and provide more precise evaluation and 

treatment to our service members and veterans. 

After 14 years at DVBIC, I’m personally most 

proud of our boots-on-the-ground efforts. When 

I visit network sites, see our products displayed 

in the halls, observe people reading them, and 

hear clinicians’ stories about their patients’ 

resilience and recovery, I know we are making a 

difference. I am humbled by the many talented 

people working for DVBIC. I thank the entire 

staff, along with all those who worked for DVBIC 

over the past 25 years, for their dedication 

and enduring commitment to the mission. 

Sincerely,

Katherine M. Helmick

Acting National Director

Defense and Veterans Brain Injury Center

Dear Colleagues and Collaborators:

Work group of experts from military hospitals and clinics, Defense Department, Department of Veterans Affairs 

and academia met to discuss clinical recommendations on cognitive rehabilitation. (DVBIC photo)
6 DVBIC Annual Report 2017 DVBIC Annual Report 2017 7

Acting National Director

Katherine M. Helmick, M.S., CRNP, ANP-BC, CNRN

Helmick is the deputy director of DVBIC. 

She brings considerable clinical, educational 

and research experience in the field of 

neuroscience to include more than 150 regional, 

national and international presentations and 

more than 15 peer-reviewed publications.

Helmick has served in a variety of leadership, 

advisory and operational roles, including deputy 

director for the Defense Centers of Excellence for 

Psychological Health and Traumatic Brain Injury, 

deputy director for the Clinical and Educational 

Affairs Office for DVBIC, manager of the Office of 

Clinical Standards at DVBIC, neurological surgery 

nurse practitioner at Hodes Neurosurgery in 

Louisville, Kentucky, nurse practitioner and clinical 

care coordinator at the University of Louisville 

Hospital; and clinical research coordinator in the 

Division of Neurosurgery at the Medical College of 

Virginia Hospitals.

Helmick holds both a bachelor’s and master’s 

degree in nursing from Virginia Commonwealth 

University, as well as a Bachelor of Science degree 

in family and child development from Virginia Tech 

University.

She has earned the following certifications: Adult 

Nurse Practitioner (ANP) through the American 

Nurses Credentialing Center and Neuroscience 

Registered Nurse (CNRN) through the American 

Board of Neuroscience Nursing

Leadership

Divisions

DVBIC accomplishes its mission through its three divisions: 

Research, Clinical Affairs and Education, as well as the Office 

of the Chief of Staff (TBI Mission Support). Each division relies 

on DVBIC’s extensive network to coordinate with the individual 

services to advance care, conduct clinically meaningful research 

within the Defense Department and VA, and improve caregiver, 

patient and clinician awareness.

Research

Mission: To provide evidence-based knowledge by conducting and supporting hypothesis driven, 

clinically-focused research that improves treatment and outcomes for service members, veterans and 

beneficiaries affected by a TBI.

“DVBIC has successfully supported many high visibility clinical research studies over the past 25 years. 

Driven by DoD requirements, our research has resulted directly in state-of-the-science, evidence-based 

clinical care for service members and veterans affected by TBI. DVBIC’s current research portfolio 

supports known MHS TBI research gaps and priorities, thereby significantly raising return-on-investment 

compared to traditional research models and highlighting DVBIC’s clinical research expertise and 

responsiveness supporting a medically ready force.”

Saafan Malik, M.D. 

Director, Research Division

Malik is the director of the Research Division at DVBIC. He has been 

working in the field of TBI for over a decade and has expertise in 

basic science, translational and clinical research, and care related to 

TBI. Prior to DVBIC, Malik served as the senior research investigator 

at the University of Pennsylvania Perelman School of Medicine and 

at the Texas Tech University Health Sciences Center. He undertook 

his postdoctoral work at the University of Pennsylvania Perelman 

School of Medicine and Carolinas Healthcare System and clinical 

neurosurgery at Cleveland Clinic. He has authored several peerreviewed publications and book chapters and received multiple 

academic awards and grants, including the National Institutes of 

Health-National Research Service Award on TBI and the Murray 

Goldstein Award from the National Neurotrauma Society. He received 

his medical degree from King Edward Medical University.
8 DVBIC Annual Report 2017 DVBIC Annual Report 2017 9

Clinical Affairs

Mission: To provide state-of-the-science TBI knowledge by developing clinical recommendations, 

analyzing outcomes, providing subject matter expertise on TBI-related matters, and assisting service 

members and veterans in accessing TBI clinical care, supportive services and information throughout 

the TBI Pathway of Care.

“Clinicians always say that if you’ve seen one TBI, you’ve seen one TBI. The DVBIC Clinical Affairs 

Division strives to support clinicians treating some of the most complex TBI patients. Over the past 25 

years, we have built a close working relationship with DVBIC’s other divisions to equip clinicians across 

the DoD and VA with the most relevant, state-of-the-science information supporting the best care for our 

service members and veterans.”

Katharine Stout, P.T., DPT, NCS, MBA

Director, Clinical Affairs Division

Chief of Staff (TBI Mission Support)

Mission: To provide operational and administrative support for DVBIC headquarters and its 22 network 

sites to advance top DVBIC priorities and ensure that infrastructure, regulatory compliance and financial 

accountability — including personnel, budgeting, communications, strategic planning, and logistics — are 

consistent with Defense Health Agency (DHA) guidance and DVBIC mission and strategic direction. 

“Our longevity as a center of excellence for 25 years is a direct result of our ability to build effective 

partnerships. DVBIC is the only center serving both the military and veteran communities. It’s the only 

center with clinical support, clinical research and education staff working side by side with clinicians at 

military treatment facilities and VA polytrauma centers. It’s the only center with an infrastructure to ensure 

ongoing collaboration with the four services through the TBI Pathway of Care.”

U.S. Public Health Service Capt. H. Charles Cathlin, MPH

Chief of Staff

Education

Mission: To provide evidence-based knowledge about TBI through implementation of educational 

programs, activities and resources along the continuum of care for health care providers; conduct 

outreach and education to service members, veterans, caregivers, family members and providers; and 

produce state-of-the-science education and training resources.

“The education and training of health care providers across the Military Health System remains our most 

significant priority in the Education Division. We are using educationally sound and scientifically proven 

methods for translating knowledge about best clinical practices and cutting edge research to the TBI 

community, thereby enabling health care providers of today and the future to provide the best possible 

care to our service members, veterans and their families.”

Scott Livingston, Ph.D., P.T., ATC

Director, Education Division

Stout is director of the Clinical Affairs Division at DVBIC. Stout is a 

board-certified neurological specialist by the American Board of 

Physical Therapy Specialties. For the last 10 years, she has worked in 

TBI and military medicine in a variety of roles including direct clinical 

care, research portfolio management and program management within 

telehealth. In addition to her work with the military, Stout has taught 

as an adjunct faculty member at the University of Maryland School of 

Medicine and served as a board member for the Maryland Board of 

Physical Therapy Examiners. She has authored several publications 

and a book chapter. Stout received her doctorate in physical therapy 

from Northeastern University and her master’s degree in business 

administration with a concentration in health care administration from 

the University of Scranton.

Cathlin directs the DVBIC Chief of Staff Office. Prior to DVBIC, Cathlin 

served as chief of the Radiology, Anesthesiology and Neurology Devices 

Branch at the U.S Food and Drug Administration (FDA), where he regulated 

the design, manufacturing and marketing of complex medical devices. 

He also served as an Air Force bioenvironmental engineer responsible 

for managing occupational health, environmental, and radiation safety 

programs. Cathlin served for over 20 years as a military and commissioned 

corps officer and earned decorations for accomplishments while deployed 

to the Middle East, Albania and Mozambique, as well as to New York 

after 9/11 and the Gulf Coast and Texas for hurricanes Katrina, Ike and 

Gustav. Cathlin received his Bachelor of Science in civil and environmental 

engineering from the U.S Air Force Academy and his Master of Public 

Health from the Uniformed Services University of the Health Sciences.

Livingston is director of the Education Division at DVBIC. 

Previously, he was the program manager for the Warrior Adaptive 

Reconditioning Program of Wounded Warrior Battalion East — one 

of two components of the U.S. Marine Corps’ Wounded Warrior 

Regiment. He also served as a Medical Service Corps officer 

(physical therapist) in the U.S. Navy. Livingston held academic 

positions at the University of Kentucky, the George Washington 

University and Gannon University, worked in a variety of clinical 

settings in physical therapy and athletic training, and has published 

numerous peer-reviewed articles. He received his doctorate in 

kinesiology from the University of Virginia and is board certified as 

a sports clinical specialist (SCS) by the American Board of Physical 

Therapist Specialties and a certified athletic trainer (ATC) by the 

National Athletic Trainers’ Association Board of Certification.

DVBIC is the only center serving both the military 

and veteran communities. It’s the only center with 

clinical support, clinical research and education 

staff working side by side with clinicians at military 

treatment facilities and VA polytrauma centers.

Divisions

Leadership

U.S. Public Health Service Capt. H. Charles Cathlin, MPH

Chief of Staff
10 DVBIC Annual Report 2017 DVBIC Annual Report 2017 11

Prior to DVBIC, military and civilian research on 

TBI, particularly concussion, was sparse. During 

the Persian Gulf War, brain injuries accounted 

for 17 percent of all casualties. The Scud missile 

attacks conducted by the Iraqi military during the 

war drew increased attention to head and neck 

injuries. Responding to these injuries, Congress 

authorized creation of the Defense and Veterans 

Head Injury Program (DVHIP) in the Department 

of Defense Appropriations Act of 1991. Eventually 

renamed DVBIC, DVHIP launched in February 

1992, forming a unique collaboration between the 

DoD and the VA. 

Over subsequent decades, TBI received growing 

attention among both military and civilian 

stakeholders. During peacetime in the 1990s, Army 

researchers studying hospitalization rates found 

training and motor vehicle accidents accounted for 

many TBIs. Army hospitalization rates decreased 

over the decade as efforts in prevention, safety 

and education increased. Training and regulations 

(e.g., stricter enforcement of drug and alcohol 

policies) most likely contributed to this decline. 

With the onset of Operation Enduring Freedom 

(OEF) and Operation Iraqi Freedom (OIF), the 

hospitalized TBI incident rate doubled between 

2000 and 2006 in the active-duty Army population. 

The rate for TBI attributed to weapons increased 60 

percent. Recognition of blast injuries during these 

conflicts led to screening efforts to identify probable 

TBI and TBI in individuals with multiple traumas. 

DVBIC developed the Military Acute Concussion 

Evaluation (MACE) to enable front line providers 

to quickly assess cognitive functions in four areas: 

orientation, immediate memory, concentration, and 

memory recall. This information, which providers 

can combine with other clinical data, supported 

better determinations about treatment and care.

DVBIC was one of the first organizations to 

recognize combat-related TBI needs and to 

execute a systematic program of research 

and treatment to improve outcomes of service 

members and veterans with TBI. These efforts 

during OEF, OIF and Operation New Dawn (OND) 

led to development of more resources devoted 

to military TBI and collaborations with organized 

sports to address concerns about concussions. 

The early partnership of DVBIC and the VA set 

the stage for the Veterans Heath Administration 

polytrauma centers to treat veterans and service 

members from OEF, OIF and OND. 

As patient needs evolved, DVBIC evolved to meet 

those needs and came to be widely recognized 

for substantial contributions to the evidence base 

for TBI treatment in both military and civilian 

communities. DVBIC studies conducted in 

partnership with a wide range of multidisciplinary 

clinicians and researchers have produced, to date, 

over 480 publications contributing to improved 

levels of evidence on issues critical to the 

identification of, treatment for and education about 

TBI in military and veteran populations. DVBIC 

studies (randomized controlled trials, as well as 

observational, epidemiological, retrospective and 

longitudinal analyses) address gaps in knowledge 

about military and veteran TBI.

DVBIC’s influence extends beyond deployed U.S. 

forces. In 2009, the NATO Science and Technology 

Organization formed Task Group 193. This 

international group synthesized existing knowledge 

and clinical practices for managing mild traumatic 

brain injury (mTBI) in a military operational setting 

for task force NATO countries. Representatives 

from the United States, United Kingdom, Sweden, 

Canada, France and the Netherlands participated. 

The U.S. delegation included DVBIC subject 

matter experts and leadership. The task group’s 

final report was published in January 2015.

In 2007, DVBIC became the TBI component center of the Defense Centers of Excellence for Psychological 

Health and Traumatic Brain Injury, which merged in 2016 with the Defense Health Agency.

DVBIC’s success in its first 25 years resulted from active collaboration with providers and researchers within 

the DoD, other federal agencies and academia. The DVBIC mission of preventing TBI and improving the lives 

of service members and veterans with TBI continues. Twenty-five years of contributions and innovations set a 

strong foundation for the next 25 years of DVBIC service and leadership in TBI education, research and care.

The DVBIC Story

Celebrating 25 Years of Service

n Serving as the single point of contact for TBI for 

the MHS.

n Publishing quarterly reports on all DoD TBIrelated incidences and prevalence, as well as 

capturing and classifying TBI severity data.

n Identifying and analyzing gaps in TBI 

knowledge to encourage research in areas 

identified as critical to the military.

n Strengthening communication among health 

care providers. 

n Refining definitions of TBI severity. 

n Conducting joint research projects and 

educational efforts.

n Developing clinical recommendations and new 

clinical practice guidelines.

Focusing on research, clinical support and education, DVBIC today 

plays a major role in advancing and standardizing TBI treatment 

and rehabilitative services among military service members and 

veterans by:

Katherine Helmick, DVBIC acting director, addresses an expert work group session on developing clinical 

recommendations for cognitive rehabilitation. (DVBIC photo)

DVBIC is the first and longest running systematic program serving 

DoD and VA TBI patients.
12 DVBIC Annual Report 2017 DVBIC Annual Report 2017 13

From the beginning, DVBIC adopted “learn as we treat” as a guiding 

principle and benefitted from past national directors’ clinical and 

research experience with TBI patients during deployment. The 

success of DVBIC as an organization would not 

have been possible without their expertise, guidance and leadership

Andres M. Salazar, M.D. (1992-2001)

Salazar, an Army neurologist, was DVBIC’s first national director. Prior 

to DVBIC, Salazar led an intensive investigation of penetrating head 

injuries incurred in Vietnam (subsequent to the death of the study’s 

original investigator). The landmark Vietnam Head Injury Study, as 

it is known, identified the consequences of penetrating head injury 

following a cohort of these patients over 40 years and resulted in over 

100 publications. Working with George Zitnay, president of the Brain 

Injury Association of America (BIAA), Salazar was instrumental in 

cultivating a unique collaboration between the Departments of Defense 

and Veterans Affairs and the Brain Injury Association of America. 

Under Salazar’s leadership, DVBIC completed its first decade with 

many notable accomplishments.

Deborah L. Warden, M.D. 

(2001-2007)

Warden, a neurologist and 

psychiatrist at Walter Reed 

National Military Medical Center 

and the Uniformed Services 

University, led DVBIC following 

9/11. Her 2006 publication 

Military TBI during the Iraq and 

Afghanistan Wars was a major 

milestone setting the stage for 

conceptualizing and describing 

wartime TBIs and remains one 

of the most cited TBI publications. During her term as director, early 

versions of DVBIC programs and projects were adapted and revised 

to meet the needs of wounded service members from OEF, OIF and 

OND. Under her leadership, DVBIC contributed to the development of 

in-theater concussion clinics and guidance for in-theater TBI evaluation 

and care, along with many other accomplishments.

1992

n The Defense and Veterans Head Injury 

Program (DVHIP), later renamed DVBIC, 

launched in February 1992 with six TBI centers 

to treat troops with head and neck injuries. The 

program was mandated by the Department 

of Defense Appropriations Act of 1991, 

which added “$18,000,000 ... for a facility to 

enable collaborative research and training for 

Department of Defense and military personnel 

in trauma care, head, neck, and spinal injury, 

paralysis, and neuro-degenerative diseases.”

n DVHIP developed the Brain Injury Resource 

Center with BIAA.

1993

n DVHIP documented peacetime TBI.

n DVHIP began the first large randomized clinical 

trial of TBI rehabilitation at the Walter Reed 

Army Medical Center.

1994

n DVHIP added new sites at National Naval Medical 

Center San Diego, California, and McGuire VA 

Medical Center in Richmond, Virginia.

1995

n Recruitment and data collection continued for the 

randomized controlled trial of TBI rehabilitation 

and DVHIP multicenter study of TBI patients.

1996

n DVHIP’s VA randomized controlled trial of 

cognitive rehabilitation began recruiting patients 

at VA medical centers.

1997

n DVHIP Tampa and DVHIP Minneapolis became 

the first VA sites in the nation to achieve 

Commission of Accreditation of Rehabilitation 

Facilities (CARF) accreditation, the civilian world’s 

gold standard for brain injury rehabilitation.

n VA developed a TBI network 

of care following guidelines 

created by the DoD and DVHIP 

Criteria and Standards for TBI 

Rehabilitation Programs.

1998

n Fort Bragg started clinical 

assessments of concussed 

paratroopers to help medical 

providers and unit leaders 

assess function after a TBI — 

the first coordinated military 

program to track soldiers within 

a week after their head injury 

through their recovery.

n Collaboration began with 

the United States Military 

Academy at West Point to 

study concussion recovery 

from boxing injuries.

1999

n Recruitment began for the Fort 

Bragg paratrooper study.

n DVHIP established a 

concussion clinic at Camp 

Pendleton, California.

2000

n DVHIP published results from 

the first ever randomized 

controlled trial of rehabilitation 

treatments in a TBI population 

in the Journal of the American 

Medical Association.

2001

n DVHIP West Point study was published in the journal Neurology 

showing that concussion is associated with slowed reaction time.

n DVHIP established site in Charlottesville, Virginia.

n Operation Enduring Freedom began in Afghanistan.

2002

n DVHIP was renamed the Defense and Veterans Brain Injury Center 

(DVBIC).

n The Vietnam Head Injury Registry was changed to the DVBIC 

Registry, which is available to deployed doctors.

n DVBIC Walter Reed team screened all OEF wounded service 

members at risk for TBI. TBI-specific clinical evaluations and 

education were provided as indicated and entered into approved 

research database.

2003

n Operation Iraqi Freedom began.

n DVBIC sites provided multidisciplinary evaluations and education 

for injured service members with TBI. 

n VA sites provided intensive treatment for injured service members 

with all severities of TBI and with polytrauma.

The DVBIC Story

Timeline

Original DVHIP logo
14 DVBIC Annual Report 2017 DVBIC Annual Report 2017 15

2004

n DoD and VA memorandum of agreement 

allowed active-duty service members who 

sustain a spinal-cord injury, TBI or blindness to 

seek health care and rehabilitative services at 

VA medical facilities.

n VA augmented DVBIC resources to create the 

polytrauma system of care at four VA hospitals.

n U.S. embassy opened in the Green Zone where 

DVBIC provided Department of State medical 

personnel with concussion evaluation materials 

and held weekly concussion management 

phone conferences with experts at Walter 

Reed Army Medical Center and the State 

Department’s site in Baghdad.

2005

n TBI surveillance mission for OEF/OIF service 

members began at the direction of the Army 

Office of the Surgeon General (OTSG) and 

Assistant Secretary of Defense for Health 

Affairs (ASD/HA).

n DVBIC began coordinating with Landstuhl 

Regional Medical Center in Germany to support 

their TBI screening program and consult on care 

of service members with polytrauma and mTBI.

n DVBIC’s first site director at Landstuhl was 

appointed.

n DVBIC initiated teleconferencing for patient 

care transitions.

n DVBIC Fort Carson initiated post-deployment 

TBI screening with the Army 2nd Brigade of the 

2nd Infantry Division (line command directed).

2006

n DVBIC coordinated with the Brain Trauma 

Foundation to develop guidelines for field 

management of combat-related head trauma.

n DVBIC held consensus conference for the 

deployment of acute management of mild 

traumatic brain injury in-theater guidelines. 

n DVBIC led team of national experts in 

publication of Evidence-Based Guidelines on 

Pharmacologic Treatment of Neuropsychiatric 

Sequelae of TBI.

Air Force Col. Michael S. Jaffee, M.D. 

(2007-2010)

With expertise in neurology, psychiatry, sleep medicine and brain injury 

medicine, Jaffee also brought to DVBIC wartime experience as the 

chief of the medical staff for the largest U.S. military hospital in Iraq and 

neurology consultant to the U.S. Air Force surgeon general. In addition, 

he had served as the U.S. Department of Defense liaison to two White 

House-appointed panels of the Defense Health Board. At DVBIC, he 

oversaw deployment of the DVBIC developed MACE tool, among other 

accomplishments.

2007

n DVBIC held first annual TBI 

military training conference for 

providers within the MHS and VA.

n A five-agency initiative, TBI 

Common Data Elements began.

n Section 721 of the National 

Defense Authorization Act 

(NDAA) for 2007 mandated 

a “Longitudinal study on 

traumatic brain injury incurred 

by members of the Armed 

Forces in Operation Iraqi 

Freedom and Operation 

Enduring Freedom.”

n Section 744 of the NDAA 

mandated the development 

of “Training curricula for family 

caregivers on care and assistance 

for members and former members 

of the Armed Forces with 

traumatic brain injury.”

n TBI screening of service 

members returning from OEF/OIF 

began within DoD and VA based 

on DVBIC Brief TBI Screen.

n Retired Army Gen. Colin 

Powell provided opening for 

the DVBIC documentary titled 

“Survive, Thrive and Alive”.

n DVBIC deployed the first intheater guidance for evaluating 

concussion: the Military 

Acute Concussion Evaluation 

(MACE). 

n Camp Lejeune joined the 

DVBIC network. 

n Regional education 

coordination program launched 

to support the DVBIC network. 

n DVBIC created regional care 

coordination program to 

help keep wounded warriors 

connected to care.

n DVBIC created TBI.consult 

email service for in-theater 

consultations. 

n DVBIC became office 

of responsibility for TBI 

surveillance.

2008

n Second annual TBI military 

training conference held. 

n DVBIC became the primary 

TBI operational component 

center of the Defense Centers 

of Excellence for Psychological 

Health and Traumatic Brain 

Injury (DCoE). 

n Pre-deployment Automated 

Neuropsychological 

Assessment Metrics (ANAM) 

testing began; DVBIC 

developed related educational 

resources for the services.

n DVBIC led U.S. delegation 

to meet with the NATO 

exploratory team for mTBI 

international standards.

n DVBIC collaborated with WETA 

to develop BrainLine.org.

n Organizational mission 

expanded to include force health 

protection and management 

support to ASD/HA.

n DVBIC began collaboration 

with Labor Department 

program, America’s Heroes 

at Work, to help veterans who 

sustained TBIs find jobs. 

n DVBIC initiated comprehensive 

head-to-head study, which 

compared computerized 

cognitive assessment tools.

n DVBIC-led multi-agency 

workgroup published new 

ICD-9 case definitions.

n Armed Forces Institute of 

Pathology collaborated with DVBIC 

on several research projects.

n NFL commissioner credited 

DVBIC-NFL Symposium for 

laying the foundation for 

enhanced concussion safety and 

evaluation guidelines in NFL.

n DVBIC-VA randomized 

controlled trial comparing 

two cognitive rehabilitation 

treatments was published. 

2009

n DVBIC held third annual 

military training conference.

n Recruitment began at Fort 

Carson for the longitudinal 

study of mTBI and validation 

of the brief TBI screen, which 

was funded through the 

Congressionally Directed 

Medical Research Programs.

n DVBIC served as a member 

of the Gray Team III, a triservice, multi-agency team that 

examined in-theater TBI care.

n First case report published 

showing neuroimaging findings 

for a service member exposed 

to primary blast waves.

The DVBIC Story

Timeline
16 DVBIC Annual Report 2017 DVBIC Annual Report 2017 17

Army Col. Jamie Grimes, M.D. (2010-2013)

Neurologist and psychiatrist Grimes served on the Gray Team, along 

with DVBIC director Michael Jaffee. Founded in 2009, the Gray Team 

was the first military medical assessment team to evaluate and provide 

recommendations for in-theater TBI care. As part of the Gray Team 

in 2011, Grimes traveled to each of the major concussion care sites, 

deployed to the Afghanistan theater of operation, and served on the 

Gray Team’s tour at Baghram Airfield and other NATO locations. 

At DVBIC, Grimes oversaw many advances, including the start of 

recruitment for the congressionally mandated 15-Year Study.

2010

n DVBIC held fourth annual military training 

conference. 

n DoD released landmark guidance on the 

treatment of mTBI in theater (DTM 09-033).

n DVBIC launched virtual TBI clinic.

n DVBIC and DCoE issued first modules of the 

multimedia family caregiver curriculum.

2011

n DVBIC held fifth annual military training 

conference.

n Recruitment began for the 15-Year Study of 

mild, moderate and severe TBI mandated by the 

John Warner National Defense Authorization 

Act for Fiscal Year 2007. 

n First public service announcement (PSA) aired 

on the American Forces Network and online.

n DVBIC and WETA launched BrainLineMilitary.org, 

a website geared towards service members and 

veterans.

n Mobile sites were launched for both BrainLine.

org and BrainLineMilitary.org.

n DVBIC’s Education Division distributed 

approximately one million products to promote 

awareness, prevention and education.

2012

n Retired Army Staff Sgt. Reanita Gray and 

former Army Sgt. Adam Anicich, veterans of the 

Iraq war, encouraged other TBI survivors to use 

BrainLineMilitary.org in a new PSA that aired on 

the American Forces Network.

n DoD issued updated guidance on how to 

manage concussion in the deployed setting 

(DoDI 6490.11).

n DVBIC expanded outreach to Times Square 

with a digital public service announcement 

(PSA) urging people to protect their heads by 

wearing a helmet.

Army Col. Sidney R. Hinds, M.D. (2013-2016)

Neurologist and nuclear medicine specialist Hinds, along with previous 

DVBIC directors, served as an in-theater neurology consultant 

in Afghanistan, where he oversaw concussion care centers and 

three magnetic resonance imaging machines (MRIs) prior to his 

service at DVBIC. As DVBIC’s director, Hinds brought an integrated, 

multidisciplinary approach to carrying out the DVBIC mission that led 

to many accomplishments.

2013

n DVBIC developed 

and distributed clinical 

recommendations: Assessment 

and Management of Visual 

Dysfunction Associated with 

mTBI and Neuroimaging 

Following mTBI in NonDeployed Settings.

n DVBIC developed an online 

training course for clinical 

providers on deploymentrelated TBI and co-occurring 

conditions to meet DoD 

requirements for predeployment training.

n Defense Secretary Hagel hosted 

a TBI symposium to share 

recent advances in TBI with 35 

military and civilian leaders

2014

n The DoD designated DVBIC 

as the manager of the TBI 

Pathway of Care for the MHS.

n DVBIC hosted the second 

Global Synapse, a live and 

virtual symposium.

n DVBIC collaborated with the 

VA and National Institute on 

Disability and Rehabilitation 

Research (NIDRR) on a study 

titled Improved Understanding 

of Medical And Psychological 

Needs in Veterans and Service 

members with chronic TBI 

(IMAP) to examine disability 

care needs in the first five years 

after injury.

n Navy Medical Center San 

Diego received funding for two 

studies exploring neurological 

damage caused by low-level 

blast exposure.

n DVBIC released a clinical 

recommendation on 

progressive return to activity 

following acute concussion/

mild TBI in deployed and nondeployed settings.

n DVBIC received funding 

to evaluate the clinical 

recommendation on 

progressive return to activity. 

n DVBIC released a clinical 

recommendation on 

management of sleep 

disturbances following 

concussion/mild TBI.

n DVBIC presented training 

per DoD Instruction 6490.13 

on policy on neurocognitive 

assessments in the military 

services.

n DVBIC hosted 10 webinars 

providing education to over 

12,000 clinical providers and 

awarding over 3,000 hours of 

continuing education credits.

2015

n DVBIC partnered on the 

National Collegiate Athletic 

Association’s Mind Matters 

Challenge.

n DVBIC hosted more than 600 

events nationwide highlighting 

DoD efforts to prevent TBI 

and provide support to service 

members, veterans and their 

families during Brain Injury 

Awareness Month. 

n DVBIC collaborated with DCoE 

on a third live and virtual 

summit reaching 1,800 DoD 

and VA clinical providers.

n Camp Lejeune procured a 

grant for a comparative study 

of headache treatments.

n VA Palo Alto hosted its fifth TBI 

research forum.

n DVBIC released a new 

concussion/mTBI fact sheet for 

patients on help with ongoing 

symptoms

n “TBI 201: An Overview 

of TBI for Military Health 

Care Providers” presented 

an interactive web-based 

educational platform.

n DVBIC completed data 

collection for the congressionally 

mandated Study of Cognitive 

Rehabilitation Effectiveness for 

mild TBI (SCORE) and posted 

study manuals on the DVBIC 

website. 

n DVBIC published findings for 

the head-to-head study on 

the reliability and validity of 

computerized neurocognitive 

assessment tests.

The DVBIC Story

Timeline

DVBIC PSA plays in Times Square. (DVBIC photo)
18 DVBIC Annual Report 2017 DVBIC Annual Report 2017 19

Army Col. Geoffrey Grammer, M.D. 

(2016-2017)

Before becoming DVBIC national director, Grammer served as 

medical director for the 785th Combat Stress Control Company 

and as a psychiatrist at the combat support hospital at Contingency 

Operating Base Speicher and in Baghram. At DVBIC, Grammer led 

the transition to DHA, oversaw DVBIC expansion to new network 

sites, and supported new initiatives such as the launch of DVBIC’s 

first podcast series, along with other accomplishments.

2016

n DVBIC became DHA center of excellence.

n DVBIC added three network sites: Fort Drum, 

Fort Gordon and the Audie L. Murphy Memorial 

Veterans Hospital in San Antonio.

n Results of the Study of Cognitive Rehabilitation 

Effectiveness (SCORE) were published in 

September in the Journal of Head Trauma 

Rehabilitation demonstrating that therapistdirected methods most effectively improve 

functional cognitive abilities after TBI.

n DVBIC produced a report on existing and 

emerging TBI research gaps and priorities most 

relevant to the DoD and MHS. 

n DVBIC released the clinical recommendation 

Management of Headache Following 

Concussion/Mild TBI: Guidance for Primary Care 

Management in Deployed and Non-Deployed 

Settings.

n The DVBIC communications team launched a 

podcast for caregivers of service members and 

veterans with TBI called The TBI Family.

n DVBIC organized a national meeting bringing 

together staff members from across the DVBIC 

network sites for the first time in five years.

2017

n DVBIC added four new network sites: Fort Bliss, 

Fort Campbell, Joint Base Lewis-McChord, and 

U.S. Special Operations Command.

n DVBIC submitted a report to Congress 

summarizing findings from the past seven years 

of the 15-Year Study and the past two years 

of Improved Understanding of Medical and 

Psychological Needs in Service Members and 

Veterans with Chronic Traumatic Brain Injury 

(IMAP).

n Under the task direction of the deputy assistant 

secretary of defense for health affairs, DVBIC 

launched the TBI consensus statement project.

n DVBIC initiated a one-year outcomes support 

contract to obtain TBI outcomes information from 

the Intrepid Spirit Centers, advancing the goal of 

monitoring and tracking TBI outcomes.

The DVBIC Story

Timeline

Specialist Michael Ossa of Newark, Ohio, Headquarters and Headquarters Company, 1st Battalion, 327th Infantry 

Regiment, Task Force Bulldog points to the boots on the wall while Sergeant Raymond M. Borrego of Miami, Florida, 

Company C, 426th Brigade Support Battalion, mTBI clinic non-commissioned officer in charge, assists him to keep his 

balance on the balancing ball. (U.S. Army photo by Specialist Richard Daniels Jr.)
20 DVBIC Annual Report 2017 DVBIC Annual Report 2017 21

Fort Bliss

Sean C. Sebesta, M.D., site director 

“Being invited into the DVBIC team is a unique honor 

that allows us to move forward with our vision for 

the TBI and Intrepid Spirit Center programs. As 

a DVBIC site, we will receive the resources and 

expertise of a formidable research team to join other 

research endeavors and to initiate our own unique 

research projects to help provide evidence-based 

advances in care and knowledge. Being a DVBIC 

site allows us to collaborate with experts familiar 

with the unique medical needs of our warfighters. 

We are very much looking forward to all our future 

work with DVBIC.”

Fort Campbell

Bret W. Logan, M.D., site director 

“It is indeed a pleasure to be one of the newest 

DVBIC sites, and we look forward to great things 

to come!”

U.S. Special Operations Command

Navy Capt. Scott Cota, M.D., site director 

“We are very excited about the USSOCOM 

partnership with DVBIC. This is an opportunity 

that will support USSOCOM efforts to get “left of 

the boom” with regard to traumatic brain injury and 

blast exposure. I believe that through innovative, 

responsive, prehabilitative programs focusing on 

surveillance, education and research we will optimize 

our warfighters at the tip of the spear.”

Joint Base Lewis-McChord

Marine Corps Col. Beverly R. Scott, M.D., site director 

“Becoming the 19th DVBIC site will allow the team 

to match our successful clinical and educational 

advancements with growing research opportunities 

and initiatives. We are grateful for DVBICs support 

over the years and look forward to years of 

successful work and collaboration ahead.”

DVBIC maintains network sites at 17 miliary hospitals and 

clinics and five VA hospitals, anchored by headquarters in Silver 

Spring, Maryland. DVBIC added four sites in 2017 to engage 

TBI stakeholders where the need is greatest. With the addition 

of these sites, there are now DVBIC sites collocated at all nine 

Intrepid Spirit Centers.

NEW NETWORK SITES

Renee Reardon

To find a point of contact in your region, please visit

dvbic.dcoe.mil or email info@DVBIC.org

Defense and Veterans Brain Injury Center

DVBIC Sites

Joint Base 

Elmendorf-Richardson, AK

Joint Base Fort Carson, CO Minneapolis VA, MN Fort Drum, NY

Lewis-McChord, WA

Palo Alto VA, CA Walter Reed NMMC, MD

DVBIC Headquarters

Silver Spring, MD

Fort Belvoir, VA

Richmond VA, VA

Camp Lejeune, NC

Fort Gordon, GA

Fort Bragg, NC

Tampa VA, FL

USSOCOM

Camp Pendleton, CA Fort Bliss, TX San Antonio MMC, TX San Antonio VA, TX Fort Campbell, KY

Landstuhl RMC, 

Germany

NMC San Diego, CA Fort Hood, TX

National HQ New FY18 Sites

The Year in Review

Expansion

DVBIC added four new sites in 2017.

DVBIC Network Sites
22 DVBIC Annual Report 2017 DVBIC Annual Report 2017 23

15-Year Study

Background

The Studies

Findings to Date

On July 19, 2017, DVBIC submitted a report to Congress summarizing findings from the past seven years 

of the 15-Year Study and the past two years of Improved Understanding of Medical and Psychological 

Needs in Service Members and Veterans with Chronic Traumatic Brain Injury (IMAP).

The John Warner National Defense Authorization Act (NDAA) for Fiscal Year 2007, Section 721, directed 

the secretary of defense to “conduct a longitudinal study on the effects of traumatic brain injury incurred 

by members of the Armed Forces serving in Operation IRAQI FREEDOM or Operation ENDURING 

FREEDOM on the members who incur such an injury and their families.” Congress directed the research 

to occur for a period of 15 years, with reports to Congress on the third, seventh, 11th, and 15th years of 

the study. 

In 2009, the secretary of defense directed DVBIC to address the congressional mandate. This research is 

collectively known as the 15-Year Study, as is the first of the two component studies that DVBIC developed 

to comply with the directive: 

1) The 15-Year Study 

The 15-Year Study consists of three substudies: (1) the natural history study (comprehensive pathway 

and brief pathway); (2) the family caregiver study (longitudinal family caregiver study and traumatic brain 

injury caregiver quality of life [TBI-CareQOL] development study); and (3) archival studies. Each substudy 

addresses specific subsets of service members, veterans, and their families.

2) Improved Understanding of Medical and Psychological Needs in Service Members and Veterans 

with Chronic Traumatic Brain Injury (IMAP)

IMAP launched approximately two years ago. This study examines the rehabilitation and health care 

needs of service members and veterans with TBI and supplements the existing infrastructure of the VA 

Traumatic Brain Injury Model Systems Program lifetime study.

Since 2010, the 15-Year Study produced 81 peer-reviewed publications and 125 abstracts, as well as 

143 conference presentations (invited talks and posters). IMAP produced additional presentations and 

publications. The six major conclusions from this research summarized in the report to Congress were:

n The prevalence of posttraumatic stress disorder, acute stress, depression, and sleep disruption 

complicates TBI recovery and impacts prognosis.

n Wide variance exists in reporting patterns with self-report rating scales. Subjective symptoms after 

TBI occur in other injuries and illnesses, further confusing interpretation of these metrics.

n Women and men have different patterns of presentation and recovery after TBI.

n Patients recovering from moderate and severe TBI after discharge from the hospital need care 

for medical comorbidities and mental health symptoms, TBI rehabilitation, vocational training and 

support, caregiver assistance, and community reintegration services.

n Although most patients utilize programs and services after a TBI, some fail to engage in care despite 

their care needs and the availability of services.

n Family caregivers report a significant burden and many feel ill equipped to fulfill their role.

DVBIC has led efforts to advance TBI knowledge supporting 

state-of-the-science care for 25 years. As a longtime TBI thought 

leader, DVBIC supports clinical research across its network. 

DVBIC’s extensive internal and external research collaborations 

drive innovation along the entire continuum of TBI care from initial 

injury, whether in the deployed or non-deployed setting, through 

medical evacuation to acute and post-acute medical settings, 

rehabilitation, and ultimately a return to family, community and 

work or continued duty.

Advances

The Year in Review
24 DVBIC Annual Report 2017 DVBIC Annual Report 2017 25

Consensus Statement

Emergency Department TBI Care

Comprehensive Health Surveillance 

Capabilities-Based Assessment Under the task direction of the deputy assistant 

secretary of defense for health affairs, DVBIC 

launched a TBI consensus statement project. The 

project represents a significant step in DVBIC’s 

ongoing commitment to improve the health and 

quality of care for service members and veterans 

with TBI. The threefold goal of the project is to:

n Review the current state-of-the-science applicable 

to TBI clinical care.

n Inform knowledge translation efforts to transform 

recent TBI research findings into clinical practice.

n Identify areas deserving further investigation. 

This project extends the Defense Department’s 

longstanding commitment to investing in stateof-the-science TBI research supporting worldclass health care for TBI patients. Since DVBIC’s 

launch in 1992, the Defense Department has 

advanced clinical standardization and guidelines to 

address TBI. The TBI consensus statement project 

continues this work by reviewing, analyzing and 

synthesizing current MHS TBI research. 

Prioritizing blast and treatment-related research, 

the TBI consensus statement project will establish 

a body of evidence (published and unpublished) 

that further advances clinical standards of care for 

TBI. The final product will summarize actionable 

knowledge translation opportunities and identify 

continuing research gaps.

The consensus statement project made significant 

progress throughout 2017. DVBIC research staff 

conducted literature reviews and synthesized 

findings. They prioritized literature based on 

study type (systematic reviews over randomized 

controlled trials and observational studies), 

comprehensiveness, publication date, population 

(military or civilian), and other factors identified 

by each work group. Work groups dedicated to 

different topics conducted regular teleconferences 

to review evidence. Work group topics were:

n Prevention of TBI.

n Acute concussion.

n Peri-injury management.

n Biomarkers.

n Behavioral health.

n Rehabilitation.

n Long-term effects.

Looking ahead to 2018, the work groups will 

continue to gather evidence and review additional 

literature to fill gaps and ensure consideration of 

the most relevant and current information. Work 

groups will continue to meet, inviting additional 

subject matter experts to participate as appropriate. 

Once the consensus statement is finalized, work 

groups will produce manuscripts for publication in 

peer-reviewed, military relevant journals for wide 

distribution on the state of TBI science supporting 

actionable knowledge translation opportunities

DVBIC performed a random chart review of over 400 service members diagnosed with TBI in emergency 

departments to look for patterns in their pathways of care. The TBI Advisory Committee (TAC), chaired by 

DVBIC, coordinated and supported this effort. Findings showed variance in the TBI care provided by different 

emergency departments. DVBIC recommended developing tools and trainings to standardize evaluation by 

emergency department providers as well as patient education after TBI diagnosis. The DVBIC Clinical Affairs 

Division will continue to develop recommendations in 2018.

DVBIC provided critical input to the Comprehensive Health Surveillance (CHS) Capabilities-Based 

Assessment (CBA). The CHS CBA is an assessment process within the DoD. Recommendations approved 

during this process impact how DVBIC conducts surveillance. Input in the CHS CBA allowed the voice of 

TBI surveillance needs and challenges to be heard in a larger discussion of how to improve surveillance 

capabilities in the DoD.

Advances

The Year in Review

Dr. Maheen Mausoof Adamson (far left), senior scientific research director at DVBIC Palo Alto, presented at Brain 

Mapping Day, March 8, 2017 — an event cosponsored by the Congressional Neuroscience Caucus, the Society for Brain 

Mapping and Therapeutics (SBMT), the Brain Mapping Foundation and the National Center for NanoBioElectronics. 

(DVBIC photo)
26 DVBIC Annual Report 2017 DVBIC Annual Report 2017 27

Women and TBI

DVBIC has been on the forefront of the emerging 

issue of women and TBI. In December 2017, 

DVBIC participated in a workshop dedicated to 

two important goals: 

n Identify knowledge gaps, best practices and 

target populations in research focused on women 

and sex differences within the field of TBI.

n Share existing knowledge on sex differences in TBI 

research and identify how these differences can 

inform pre-clinical and clinical efforts going forward.

The workshop, called Understanding Traumatic 

Brain Injury in Women, was held December 18-19, 

2017, at the National Institutes of Health in Bethesda, 

Maryland. The National Institute of Neurological 

Disorders and Stroke organized and sponsored it. 

Collaborators besides DVBIC included the Center 

for Neuroregenerative Medicine, National Center 

for Medical Rehabilitation Research/National 

Institute of Child Health and Human Development 

(NICHD), and Office of Research on Women’s 

Health (ORWH).

In addition to attendance by numerous DVBIC 

staff members and an exhibit of materials from A 

Head for the Future, DVBIC took a leadership role 

presenting and moderating four sessions:

n Ms. Katherine Helmick, DVBIC acting director, 

chaired a session titled, Military Perspective: 

Sex Differences in TBI among Service Members 

and Veterans.

n Dr. Odette Harris gave a presentation titled, Sex 

Differences in Outcomes of Service Members 

after Polytrauma/TBI.

n Dr. Sara Lippa presented data from the 15-Year 

Study in her presentation, Sex Differences in PostConcussion Symptom Reporting among Service 

Members and Veterans.

n Dr. Don Marion moderated a breakout session on 

sex differences in TBI among service members 

and veterans.

As the TBI landscape changes, DVBIC efforts continually evolve 

to meet the needs of service members, veterans, families and 

providers. In 2017, DVBIC took on several emerging issues and 

new initiatives.

New Directions

Ms. Katherine Helmick, DVBIC acting director, received 

a Pink Concussions award for outstanding contributions 

in the field of military service. Ms. Katherine Snedaker, 

executive director of Pink Concussions, presented the 

award. (DVBIC photo)

The Year in Review

APAN Research Division Launch

All Partners Access Network (APAN) is an unclassified information sharing service for the DoD. The 

DVBIC Research Network Intranet launched on APAN in June 2017, connecting research staff at all of 

DVBIC’s network sites. APAN allows DVBIC researchers and headquarters staff to share information 

about upcoming conferences, grants and funding opportunities, the DVBIC research portfolio, sites 

and staff, discussion of relevant external concussion research (“Don’s Picks”), quad chart information, 

and DVBIC publications. APAN is an important resource supporting internal DVBIC Research Division 

communication, coordination and collaboration.

Data Collection and Surveillance Improvements

DVBIC updated and improved the reporting of TBI surveillance data to the services to include unique 

patients and to identify clinics where TBI care is provided. Previously, only the number of TBI-related 

medical encounters was reported, but this approach lacked important details. For example, someone 

looking at the data would not know whether there had been 30 encounters for 30 patients or 30 encounters 

for one patient. The new reporting system provides a more accurate picture of the impact of TBI on the 

health of the force.

Recovery Support

DVBIC assessed the feasibility and value of using DVBIC recovery support specialists to advance 

DVBIC’s outcomes mission. Staff obtained outcomes data from the Wounded Ill Injured Registry (WIIR), 

a viable platform to collect information. The assessment determined that recovery support specialists can 

support DVBIC’s outcomes mission in the future.
28 DVBIC Annual Report 2017 DVBIC Annual Report 2017 29

26,374

14,551 14,018 13,365 13,078 12,555

9,338 9,086 8,544

11,125

HEADS Card

MACE Pocket Card

Acute Concussion 

MACE Wallet Card

Educational Brochure

Improving Memory 

Fact Sheet

Healthy Sleep 

Fact Sheet

Ongoing Symptoms 

Fact Sheet

Concussion/PTSD

Fact Sheet

Signs and Symptoms 

Fact Sheet

Changes in Behavior 

Fact Sheet

Resources Total 2017 Distribution of DVBIC ‘s Top Ten Products

Print Products Distributed and 

Downloaded in 2017

New Print Products

DVBIC disseminated approximately 235,000 print 

copy TBI educational resources across the United 

States and overseas, including over 3,500 products 

distributed in-theater to service members and 

providers. The top 10 print products distributed were:

n HEADS – Protect Your Strongest Weapon (wallet card)

n Military Acute Concussion Evaluation (MACE) 

(pocket card)

n Acute Concussion Education (brochure)

n Ways to Improve Your Memory (fact sheet)

n Signs and Symptoms of Concussion/Mild 

Traumatic Brain Injury (fact sheet) 

n Military Acute Concussion Evaluation (MACE) 

(wallet card)

n Healthy Sleep: Mild TBI Symptom Management 

(fact sheet)

n Changes in Behavior, Personality or Mood 

(patient fact sheet) 

n Help with Ongoing Symptoms: Concussion/Mild 

Traumatic Brain Injury (fact sheet)

n Concussion/Mild Traumatic Brain Injury and 

Post-Traumatic Stress Disorder (fact sheet)

The total number of product downloads from the 

DVBIC website was almost 17,000. The top 10 

products downloaded were:

n Military Acute Concussion Evaluation (MACE) 

(pocket card)

n Traumatic Brain Injury Awareness (fact sheet)

n Ways to Improve Your Memory (fact sheet)

n Concussion/Mild Traumatic Brain Injury and 

Posttraumatic Stress Disorder (fact sheet)

n Changes in Behavior, Personality or Mood (fact 

sheet)

n Managing Headaches Following Concussion 

(fact sheet)

n Mild TBI Pocket Guide

n Signs and Symptoms of Concussion/Mild 

Traumatic Brain Injury (fact sheet)

n Concussion Management Algorithm (CMA) 

(pocket card)

n Healthy Sleep: Mild TBI Symptom Management 

(fact sheet)

To support outreach and keep health care providers informed and up to date on best clinical practices, 

DVBIC developed five major new clinical products:

n Electronic Clinical Support Tool (eCST) for Headache Management Clinical Recommendation (March 2017)

n Interactive Provider Training on the Management of Sleep Disturbances Following Concussion/Mild 

TBI Clinical Recommendation (March 2017).

n Training slide decks for REC network targeting health care providers and service members, veterans, 

family and community) (June 2017)

n Clinical training materials for the MACE (June 2017)

n Provider training slides for the Joint Trauma System’s clinical practice guideline on neurosurgery and 

severe head injury for the Education and Performance Improvement Directorate of the Joint Trauma 

System, Joint Base San Antonio (September 2017)

DVBIC also developed two new products for service members, veterans, family members and the community:

n Head Check — Know Your Helmet (flyers for skiing and snowboarding, baseball and football, 

and cycling and motorcycle riding) (July 2017).

n Management of Neck Pain Following Concussion (fact sheet) (March 2017)

Used by hundreds of thousands of service members, veterans, 

family members and health care providers each year, DVBIC 

resources fall into two major categories: clinical tools and patient 

education fact sheets. Many resources are available for download 

from the DVBIC website or can be ordered at no cost.
30 DVBIC Annual Report 2017 DVBIC Annual Report 2017 31

Webinars 

Revisions and Updates

Subject matter experts conducted six virtual webinars for 2,000 MHS health care providers, awarded 1,140 

continuing education units and 376 certificates of attendance. Webinar titles and speakers in 2017 were:

n TBI and Substance Use: This Is Your Injured Brain on Alcohol. Ezra J. Aune, MBA, ADCII, CCS. (January)

n Outcomes after Mild TBI in Soldiers Returning from OEF and OIF: Evidence Including the Warrior 

Strong Study. Karen A. Schwab, Ph.D. (March)

n Putting Clinical Recommendations into Practice: Progressive Return to Activity Following Acute 

Concussion/Mild Traumatic Brain Injury. Scott C. Livingston, Ph.D., P.T., ATC; Jessicah Ray, PA-C; 

Maryanne Sacco, M.A., OTR/L (May)

n Prevalence of and Screening for Neuroendocrine Dysfunction Post Mild Traumatic Brain Injury. Charles 

W. Wilkinson, Ph.D. (July)

n Emerging Technologies for Assessment and Rehabilitation of Traumatic Brain Injury. Mark L. Ettenhofer, 

Ph.D. (October)

n Understanding Behavioral Health Conditions Resulting from Traumatic Brain Injury. Army Captain John 

F. Chaves, M.D., CPT, MC (November)

In addition to developing new materials, DVBIC 

regularly updates existing resources.

Cognitive Rehabilitation Clinical Recommendation

Throughout 2017, the DVBIC Clinical Affairs Division 

devoted significant effort to revising cognitive 

rehabilitation clinical guidance for mild TBI. DVBIC 

published clinical guidance on this topic in 2009. 

Scientific updates since that time warrant review 

and revisions to these clinical documents. An expert 

workgroup supported the revision process. A report 

to Congress addressing cognitive rehabilitation and 

TBI incorporated some of these updates.

Specifically, the expert workgroup reviewed the 2009 

cognitive rehabilitation clinical package with the goal 

of building it into a clinical recommendation supporting 

standardization of cognitive rehabilitation for service 

members and veterans with mild TBI. The workgroup 

addressed clinical questions in the areas of:

n Cognitive rehabilitation interventions and strategies.

n Cognitive rehabilitation delivery.

n Special considerations for service members and 

veterans.

Expected deliverables include a functional, practical 

clinical tool plus a set of digital learning tools to support 

cognitive rehabilitation providers (e.g., speech 

language pathologists, occupational therapists and 

neuropsychologists). In order to accomplish this task, 

the workgroup convened a meeting in August during 

which clinicians and researchers from the Defense 

Department, VA and academia reviewed evidence 

produced since 2009, including findings from a 

congressionally mandated clinical trial called “Study 

of Cognitive Rehabilitation Efficacy,” or SCORE. The 

workgroup deliverables are still in progress at the 

time of this report. This major knowledge translation 

initiative will ensure continuing DoD leadership in 

developing TBI clinical standards of care.

Military Acute Concussion Evaluation

In 2017, DVBIC initiated its latest revision of the Military 

Acute Concussion Evaluation (MACE). The MACE is a 

concussion screening tool for the acute assessment of 

service members involved in a potentially concussive 

event. Initially developed in 2006, the MACE was last 

updated in 2012 by subject matter experts from the Army, 

Navy, Air Force and Marine Corps, as well as DVBIC 

and National Intrepid Center of Excellence to reflect the 

latest scientific research and enhance ease of use.

The 2017 MACE revision — and a corresponding 

training that DVBIC also concurrently began 

developing — will better address the needs of activeduty service members and the medical personnel 

who treat them. The 2017 revision process, which 

will continue into 2018, broke the tool into two parts 

— one for the medic/corpsman and the other for 

providers. The 2006 and 2012 iterations of the MACE 

targeted only the medic/corpsman. A major goal of 

the 2017/2018 revision is to support triage and rapid 

screening of suspected concussions by streamlining 

medic/corpsmen responsibilities and promoting use 

of the tool on the battlefield and in garrison.

Attesting to the value of the MACE as a concussion 

screening tool, DVBIC received a request from the 

commander of the U.S. Navy Ship Mercy to deliver 

MACE training to all deploying providers. Since the 

U.S. Navy Ship Mercy is a hospital ship, this training 

would take the form of live in-person or virtual 

training for all military medical personnel stationed 

aboard the ship prior to their deployment, including 

corpsman, nurses and providers. DVBIC leadership 

viewed this extraordinary request as the catalyst to 

modernize the existing MACE training. The resulting 

training guide will be used throughout the DoD, 

thereby providing a consistent baseline for the MACE 

across all deployed medical personnel. This guide 

consists of teaching materials, an instructor’s guide 

and student classroom materials to be distributed 

electronically and printed as needed at training sites.

The training covers:

n Events requiring MACE.

n Administering each of the MACE sections: 

concussion screening, cognitive exam, 

neurological exam and symptom screening.

n Scoring and recording MACE findings.

n Identifying and avoiding common problems in 

administering the MACE.

Mild TBI Pocket Guide

The Clinical Affairs Division completed a major 

overhaul of the Mild TBI Pocket Guide, a popular 

resource for health care providers. Since the pocket 

guide had not received an update since 2012, the 

revised version removed outdated material and 

incorporated new material, including information from 

several DVBIC clinical recommendations released 

after publication of the 2012 pocket guide.

Resources

This illustration is part of a DVBIC Interactive Provider Training (IPT) on headaches. DVBIC IPTs offer health 

care providers the opportunity to earn continuing education credits. This IPT began development in 2017 and is 

expected to be complete and available in 2018. (DVBIC illustration by Melanie F. Sexton)
32 DVBIC Annual Report 2017 DVBIC Annual Report 2017 33

Newsletters 

Podcasts

Research Reviews

DVBIC published two newsletters in 2017 intended 

as resources for health care providers.

Hot Topics

This newsletter contextualizes the latest scientific 

studies, advances and discoveries. DVBIC experts 

summarize and provide commentary on studies 

receiving attention in the popular press. Studies 

are selected by their media impact as determined 

through quantitative analysis of Google News and 

PubMed searches and qualitative assessment by 

DVBIC personnel. This newsletter also includes 

some news stories not derived from scientific 

studies but relevant to TBI stakeholders. 

DVBIC published three issues of Hot Topics in 

2017. Study topics included but were not limited to: 

early clinical predictors of five-year outcomes after 

blast TBI, a major consensus statement on sport 

concussion, direct brain stimulation, circadian 

rhythms in severe TBI patients, and saliva 

biomarkers. 

Tech Watch

This newsletter tracks the latest TBI technologies. 

DVBIC technology specialists summarize 

and provide commentary on news articles, 

trade publications and scientific studies about 

technological developments related to TBI research, 

diagnostics, treatment and rehabilitation. The 

articles included are selected based on a subjective 

evaluation of relevance, import and interest. 

DVBIC published one issue of Tech Watch in 2017. 

Topics included but were not limited to: blood and 

hearing tests for concussion, research on materials 

designed to protect against TBI, mechanisms for 

products needing FDA clearance, and a visual 

cortex implant that may improve vision in brain 

damaged patients. 

Podcasts are an increasingly popular form of audio media. They enable widespread information sharing 

across diverse audiences. DVBIC began producing podcasts in 2016 and expanded its offerings in 2017 to 

include new episodes of a podcast for family caregivers and a new podcast for health care providers

The TBI Family

Launched in November 2016, this podcast is for caregivers of service members and veterans with TBI. 

Each episode offers information, resources and tips for caregivers and shares caregiver stories. Topics 

discussed in 2017 include:

n Art as self-care for caregivers.

n Caregiver study.

n Brain Injury Awareness Month.

n Substance use and TBI.

n Medical foster homes.

n Cognitive rehabilitation.

n Driving after TBI.

n VA caregiver support program.

n Talking to kids about TBI.

Clinical Updates in Brain Injury Science Today (CUBIST)

Launched in May 2017, Clinical Updates in Brain Injury Science Today, or CUBIST, is a podcast for health care 

providers treating service members and veterans with TBI. Each episode offers a brief analysis of current research 

relevant to clinicians. Topics discussed include:

n Sport concussion consensus statement.

n Wearable sensors to detect head impact.

n Depression, gender and TBI.

n Cortical thickness, age and TBI.

n Roller coasters and TBI.

n Concussion, genetics and Alzheimer’s disease.

n Outcome predictors for blast TBI.

n Concussion and neurocognitive assessment tools (NCATs).

n Cortical thickness, age and TBI.

n Sport concussion and neuroimaging.

n Sport-related concussion and NCATs.

n Effect of memantine.

n Time trends in concussion symptom presentation 

and assessment methods in high school athletes.

DVBIC research reviews provide clarification on 

general topics of interest related to TBI. DVBIC subject 

matter experts produced one new research review 

and updated another in 2017. They are posted on the 

DVBIC website. 

Misuse and Abuse of Alcohol after Traumatic 

Brain Injury (January)

This new research review summarizes scientific 

literature addressing alcohol use disorder (AUD) after 

TBI. Civilian and military or veteran studies differ on the 

impact of TBI. Civilian studies show that alcohol use 

is typically lower during the first year after injury than 

prior to injury. Among military and veteran populations, 

some studies suggest the risk of AUD increases after 

military-related TBI, but results are not consistent. 

Posttraumatic stress disorder and combat exposure 

also correlate with alcohol misuse.

More studies are needed to determine the impact of 

social, medical, psychological and environmental factors.

Chronic Traumatic Encephalopathy (August)

This updated research review summarizes the 

available peer-reviewed scientific literature regarding 

the definition, epidemiology, risk factors, pathology 

and clinical manifestations for chronic traumatic 

encephalopathy (CTE). A list of specific gaps in 

understanding of the disease is provided that, 

if addressed, could inform the most appropriate 

prevention recommendations and allow clinicians to 

more effectively diagnose, manage and treat CTE.

Resources

DVBIC contract staff members (left to right) Drs. Don Marion, Anne Bunner 

and Deborah Bailin record a podcast. (DVBIC photo)
34 DVBIC Annual Report 2017 DVBIC Annual Report 2017 35

Ongoing Initiatives

As an established organization with a quarter century of 

experience supporting service members, veterans, family 

members and providers, DVBIC leads and collaborates on a 

number of ongoing projects and mission support activities. 

TBI Pathway of Care Manager

Surveillance

DVBIC has served as the manager of the DoD TBI Pathway of Care and chair of the DoD TBI Advisory 

Committee (TAC) since 2014. The Pathway of Care is a health policy-based algorithm for advancing the level 

of care across the MHS by synchronizing processes and transitions and improving outcomes and outcome 

metrics. The TAC is the DoD’s coordinating body chartered to promote organized and efficient TBI care from 

prevention and education through reintegration by adhering to Pathway of Care standards. 

A major 2017 accomplishment for DVBIC in its dual role as Pathway of Care manager and chair of the TAC 

was the renewal of the TAC’s charter. The renewed charter is effective for two years and requires several 

deliverables, including:

n Further advancing care by developing algorithm(s) to illustrate the Pathway of Care and the capabilities 

within the MHS from point of injury to reintegration.

n Standardizing terminology and TBI program definitions.

n Standardizing process and outcome metrics with a focus on health outcomes.

As the Defense Department’s office of responsibility for TBI data in the U.S. military, DVBIC analyzes data 

on the number of active-duty service members — anywhere U.S. forces are located — with a first-time TBI 

diagnosis since 2000 and reports this information in quarterly and annual reports Source: Defense Medical Surveillance System (DMSS), 

Theater Medical Data Store (TMDS) provided by the 

Armed Forces Health Surveillance Center (AFHSB)

Prepared by the Defense and Veterans Brain Injury Center (DVBIC) 2017, as of February 14, 2018

Penetrating 64

Severe 122

Moderate 2,442

Mild 15,042

Not Classifiable 37

Total - All Severities 17,707

2017 

84.9%

0.4% 0.2% 0.7%

13.8%

DoD Numbers for Traumatic Brain Injury

Worldwide — Totals

*Percentages may not add up to 100% due to rounding

Source: Defense Medical Surveillance System (DMSS), 

Theater Medical Data Store (TMDS) provided by the 

Armed Forces Health Surveillance Center (AFHSB)

Prepared by the Defense and Veterans Brain Injury Center (DVBIC) 2000-2017, as of February 14, 2018

Penetrating 5,175

Severe 3,974

Moderate 36,269

Mild 312,495

Not Classifiable 21,606

Total - All Severities 379,519

2000 - 2017 

82.3%

1.4% 5.7% 1.0%

9.6%

DoD Numbers for Traumatic Brain Injury

Worldwide — Totals

*Percentages do not add up to 100% due to rounding
36 DVBIC Annual Report 2017 DVBIC Annual Report 2017 37

Ongoing Initiatives

Outreach and Events

In addition to conducting quarterly trainings for recovery care coordinators through the Office of Warrior Care 

Policy, staff members from the Education Division regularly engage significant numbers of TBI stakeholders 

through a variety of events and other outreach activities.

Regional Education Coordinators

In 2017, regional education coordinators provided TBI educational outreach to over 388,456 stakeholders, 

participated in 3,960 education and outreach events, and conducted 482 in-person trainings and briefings 

to 36,032 service members and military and civilian health care providers.

A Head for the Future

A Head for the Future (AHFTF) is a DVBIC initiative focused on providing resources on TBI prevention, 

recognition and recovery. AHFTF creates videos, social media content and educational materials targeted to 

the military community, particularly service members, veterans and their families. 

In 2017, this DVBIC public awareness campaign:

n Increased Facebook page “likes” from 64,964 to 103,363 (37.15 percent) with a total reach of 2.4 million.

n Increased Twitter followers from 3,934 to 8,404 (113 percent) with over 325,000 total impressions.

n Generated 105,274 website visits.

n Generated 96,408 views of TBI Champion videos via social media.

Brain Injury Awareness Month 

March is nationally recognized as Brain Injury 

Awareness Month (BIAM). Every year, DVBIC 

collaborates with the TBI program directors of the 

Army, Navy, Marine Corps, and Air Force, as well 

as the VA on TBI educational efforts for this annual, 

month-long spotlight on TBI. The theme for BIAM 

2017 was THINK AHEAD: Be safe, know the signs 

and get help.

n The DVBIC network conducted 537 education, 

outreach and training events related to TBI, 

reaching a total audience of almost 46,000 service 

members, veterans, families, providers and the 

community. An additional 361,000 service members 

throughout EUROCOM were reached via Armed 

Forces Network.

n Over the 31-day period of BIAM, the #ThinkAhead 

campaign was mentioned 1,084 times in social 

media, an increase of 159 percent from March 2016

n A satellite media tour consisting of 28 interviews 

(18 television, nine radio and one online) with 

U.S. Army Col. Geoffrey Grammer of DVBIC and 

NFL player Alejandro Villaneuva of the Pittsburgh 

Steelers. The satellite media tour resulted in 262 

airings and a potential viewing/listening audience 

over 13 million.

n DVBIC senior leadership and staff participated 

in the Brain Injury Awareness Day on Capitol 

Hill which included a brain health fair and a 

congressionally-led panel discussion on TBI.

Alejandro Villanueva, offensive tackle for the Pittsburgh 

Steelers and former U.S. Army Ranger, poses with a 

DVBIC hashtag card for Brain Injury Awareness Month. 

(DVBIC photo)

Camp Lejeune RECs displayed DVBIC resources at Onslow County Fair, North 

Carolina. (DVBIC photo)

Working Groups and Committees

n TBI Model Systems

n Chronic Effects of Neurotrauma Consortium 

(CENC) Government Steering Committee and 

Scientific Advisory Board

n Target Endpoint Development Government 

Steering Committee (TED GSC)

n Combat Casualty Care Research Program 

Integrating Integrated Product Team

n Planning committees for the annual meeting of 

the International Brain Injury Association and the 

Military Health System Research Symposium 

n NonInvasive NeuroAssessment Devices 

Integrated Product Team

n Committee on Surgical Combat Casualty Care

n Linking Investigations in Trauma and 

Emergency Services (LITES)

In addition to the Pathway of Care and the TAC, DVBIC serves in 

leadership roles on a number of advisory boards and committees.
38 DVBIC Annual Report 2017 DVBIC Annual Report 2017 39

Partnerships

The 22 DVBIC network sites are essential to carrying out DVBIC’s 

mission, but DVBIC works with many other partners as well. 

Some of these partnerships have been formalized with memoranda 

of understanding. Others are more informal, collaborative 

relationships. Partnership highlights of 2017, described below, 

include research, education and clinical support efforts. 

Intrepid Spirit Centers 

A major goal for DVBIC, as manager of the TBI Pathway of Care, is monitoring and tracking TBI outcomes. 

With the addition of collocated DVBIC sites at Fort Campbell and Fort Bliss in 2017, DVBIC now maintains 

network sites at all nine Intrepid Spirit Centers. One important result of this multi-site partnership was the 

initiation of a one-year outcomes support contract to obtain TBI outcomes information from the Intrepid 

Spirit Centers. DVBIC identified three tools and several data points commonly collected in the Intrepid 

Spirit TBI clinics. In 2018, DVBIC will assess the value of collecting historical data from 2015-2017. This 

project supports the goal of monitoring and tracking TBI outcomes.

National Collaborative on Children’s Brain Injury

The National Collaborative on Children’s Brain Injury (NCCBI) is a national organization working 

to improve services and support for children with brain injury. NCCBI’s current focus is on improving 

educational services for students with TBI. The director of DVBIC’s Education Division served as the DoD 

representative and contributor to a consensus project led by NCCBI: NCCBI: Establishing Consensus for 

Essential Elements in Returning to Learn Following a Concussion.

Administration for Community Living

The Administration for Community Living (ACL) launched in 2012 to consolidate federal advocacy and 

support programs for older adults and people with disabilities. The agency helps people in these groups 

live independently in their communities. The Federal Traumatic Brain Injury State Grant Program is 

housed within the ACL. DVBIC participated in the 2017 ACL Traumatic Brain Injury Stakeholder Day by 

giving a presentation to a group of state-level TBI champions and stakeholders on TBI care within the 

DoD and how to access DoD TBI-related documents such as DVBIC clinical recommendations, fact 

sheets and other resources.

U.S. State Department 

The U.S. State Department reached out to the DVBIC Clinical Affairs Division to collaborate on concussion 

care. The agency has officers stationed in environments challenged by armed conflicts, often exposing 

them to threats similar to those faced by military service members. The State Department sought DVBIC’s 

TBI expertise to ensure up-to-date tools and training materials. DVBIC and State Department staff initially 

met in January 2017 and convened additional meetings and trainings during the spring of 2017 supporting 

the State Department’s review of concussion clinical tools.

National Endowment for the Arts

DVBIC participated in the Creative Forces Clinical 

Research Summit in September 2017 and contributed 

to the literature review for this conference. Hosted by 

the National Academies of Science in Washington, 

D.C., the event convened experts from the Defense 

Department and National Endowment for the Arts 

(NEA). Participants in the conference discussed 

clinical research investigating creative arts therapies 

and developed a five-year agenda for measuring 

their impact as part of a congressionally supported 

collaboration established in 2012 called Creative 

Forces: NEA Military Healing Arts Network.

VA Brain Trust: Pathways to 

InnoVAtions

DVBIC subject matter experts joined leading brain 

health researchers at the VA’s 2017 Brain Trust 

Pathways to InnoVAtions annual event. The purpose 

of this summit was to generate discussion and 

support broad, partnership-based, collaborative, 

innovative responses to mild TBI and posttraumatic 

stress disorder. In addition to leading VA brain 

researchers, participants included stakeholders 

from private industry, sports organizations, the 

government and academia, as well as health care 

providers, veterans and caregivers. The agenda 

included sessions on technological innovation, 

opportunities for collaborative research, advances in 

sports medicine, and veteran and caregiver stories.

The second day featured a working group session 

where groups collaborated to develop approaches 

and implementation plans to advance brain health. 

Participation helped DVBIC gain visibility on emerging 

technologies and clinical paradigms and network with 

other partners and potential partners in TBI care.

U.S. Air Force Center for Excellence 

in Medical Multimedia

DVBIC collaborated with U.S. Air Force Center for 

Excellence in Medical Multimedia (CEMM) to update 

and revise their TBI website for service members, 

veterans and their families. 

Collaboration with the CEMM included efforts by 

DVBIC to revise a resource called Traumatic Brain 

Injury: A Guide for Caregivers of Service Members and 

Veterans. Resulting from a congressional mandate 

and cooperation from a panel of TBI survivors, 

family members and experts appointed by the White 

House, as well as the Departments of Defense and 

Health and Human Services, this resource provides 

information for caregivers of service members and 

veterans with moderate to severe TBIs. 

Since the guide’s release in 2010, substantive 

information became outdated. For this reason, 

DVBIC devoted significant effort to reviewing and 

revising it throughout 2017. The review process 

entailed a detailed product assessment examining 

the guide’s usefulness and how to improve it. This 

work is expected to continue in 2018.

Other Partners

n Baylor College of Medicine

n Brainscope

n Center for Neuroscience and 

Regenerative Medicine 

n Children’s Medical Center of 

Philadelphia

n Craig Hospital

n David H. Murdock Research 

Institute

n Denver VA Medical Center

n DMC Rehabilitation Institute of 

Michigan

n Ibis Biosciences Inc.

n Iowa City VA

n Johns Hopkins University

n Kessler Foundation

n Madigan Army Medical Center

n Memorial Hermann Institute for 

Rehabilitation and Research 

n National Institutes of Health 

Clinical Center

n National Intrepid Center of 

Excellence

n Naval Special Warfare, Group 

One, Training Detachment 

(TRADET 1) School of Infantry

n Navy Experimental Diving Unit

n Neural Analytics

n Neuro-Kinetics

n Northwestern University

n Ohio State University

n Princeton Neuroscience Institute

n RTI International

n South Texas Veterans Health 

Care System 

n University of California, Irvine

n University of California, San 

Diego

n University of Central Florida

n University of Michigan

n University of North Carolina at 

Chapel Hill

n University of Pennsylvania

n University of Pittsburgh

n War Related Illness and Injury 

Study Center, VA Palo Alto

n Wayne State University
40 DVBIC Annual Report 2017 DVBIC Annual Report 2017 41

Camp Lejeune

Over the past year, Naval Medical Center Camp 

Lejeune Intrepid Spirit continued to expand research 

targeting two primary goals: 1) Securing a grant 

for the repetitive low level blast exposure (RLLBE) 

study and 2) publishing at least one article before 

the end of 2017. DVBIC Camp Lejeune received 

encouraging feedback indicating that the $1.7 million 

RLLBE grant had been tentatively approved pending 

release of funds. Recruitment of SOCOM and heavy 

weapons instructors at Camp Lejeune is expected 

to begin in 2018 to implement the RLLBE protocol. 

In addition to research funded by the RLLBE grant, 

Camp Lejeune had four active DVBIC protocols and 

applied with academic institutions for several other 

grants which, if funded, will greatly expand the active 

research footprint at Camp Lejeune. Among the active 

studies, the art therapy protocol will be part of the 

larger data repository amendment, and at least 100 

individuals are expected to consent to using their art 

for research. In terms of publications, a collaborative 

manuscript with the University of Pennsylvania on 

predictors of return to duty in blast-related mild TBI 

patients was accepted by the Journal of Neurotrauma.

Camp Lejeune also added a new regional education 

coordinator (REC) in January. Some REC highlights 

over the past year were an exhibition at the American 

Congress of Rehabilitation Medicine conference, 

the largest interdisciplinary rehabilitation research 

conference in the world, and a MACE training for 160 

providers. The DVBIC recovery support specialist 

attended the annual Brain Injury Association 

Conference in South Carolina, Life with Brain Injury, 

obtained resources to benefit service members and 

veterans, and manned (along with the REC) a display 

table at the annual PTSD/TBI Awareness Day 

Resource Fair at Wounded Warrior Battalion-East.

Camp Pendleton

Under the direction of Navy Cmdr. Paul Sargent, 

DVBIC Camp Pendleton site director, the latest 

building in the Intrepid Spirit network began 

construction in 2017. The new brain injury specialty 

center will begin serving Marines and other activeduty service members in the spring of 2018.

Collaborative research efforts on the neurological 

impact of occupational blast exposure resulted 

in substantial advances. Of particular note, the 

first peer-reviewed computational modeling of 

blast overpressure from shoulder mounted rocket 

launchers was published in the journal Shockwaves 

this year. Camp Pendleton also contributed six 

conference presentations demonstrating that lowlevel blast exposure from combat training can 

cause transient changes in neurological functioning.

In collaboration with DVBIC headquarters and sites 

at Fort Bragg and the Naval Medical Center San 

Diego, Camp Pendleton completed recruitment for 

a study examining the effectiveness of treatment 

guidelines for progressively returning a service 

member to activity following a concussion. The 

study resulted in a peer-reviewed publication and 

multiple presentations at scientific conferences.

Fort Belvoir

In 2017, The Intrepid Spirit Center (ISC) at Fort 

Belvoir focused on bringing in new research. The Fort 

Belvoir DVBIC research team has been encouraged 

to initiate and participate in research addressing 

military-relevant topics and DoD/MHS clinical 

research gaps for TBI identified by DVBIC. With the 

new senior research director, the team submitted a 

pre-application to the Defense Medical Research and 

Development Program’s Joint Program Committee 

on Clinical and Rehabilitative Medicine (JPC-8) 

to fund a research project on the effectiveness of 

integrative speech and music therapies on cognitive, 

health and functional outcomes in TBI patients. 

In addition, two of the research associates at the 

ISC began recruitment and referral process for 

Fort Belvoir ISC patients in the 15-Year Studies 

(natural history blood banking, brief pathway).

Network Site Updates

DVBIC is a joint collaboration between the DoD and VA. Essential 

partners are the 22 network sites located at military hospitals and 

clinics and VA hospitals across the United States and in Europe. 

At these sites, DVBIC provides personnel to perform research, 

clinical support and education for active-duty military, their 

dependents and veterans. The overall goal for both DVBIC and its 

partnering network sites is to return the brain injury survivor to 

the highest level of function and to educate family and caregivers.

Military Hospitals and Clinics

DVBIC sites are strategically located across the United States and abroad to engage patients and providers where 

they are. With the addition of new sites in 2017 at Fort Bliss, Fort Campbell and Joint Base Lewis McChord, 

DVBIC network sites are now collocated with all nine Intrepid Spirit Centers.

The first peer-reviewed computational modeling of 

blast overpressure from shoulder mounted rocket 

launchers was published in the journal Shockwaves.
42 DVBIC Annual Report 2017 DVBIC Annual Report 2017 43

Military Hospitals and Clinics

The Fort Belvoir recovery support specialist 

integrated new standardized protocols, procedures 

and policies for data entry into the Wounded, Ill and 

Injured Registry (WIIR) to strengthen outcomes and 

follow-up care for TBI health care delivery across 

the continuum of care. A focus on best practices for 

a seamless referral process for patients discharged 

at the Fort Belvoir ISC, Fort Belvoir Community 

Hospital Behavioral Health Department, Warrior 

Transition Unit and all military hospitals and clinics 

in the region resulted in an increased enrollment for 

the recovery support program and smooth process 

for service members transitioning out of the military.

This year, the REC focused on education, 

training and prevention topics on TBI for clinical 

providers at the Intrepid Spirit Center and the 

Fort Belvoir Community Hospital Behavioral 

Health Department. Additional focus was to 

increase awareness of the DVBIC provider 

resources on management of headaches and 

sleep disturbances following concussion/mild TBI.

Fort Bliss

Initiated in 2008, the Fort Bliss TBI program has 

progressively grown and improved. According 

to site director Sean C. Sebesta, it has been a 

singular honor for Fort Bliss to be chosen as an 

Intrepid Spirit Center. The vision of the Fort Bliss 

TBI program is to be recognized as the future 

model of patient-centered rehabilitative care to 

improve quality of life and readiness for active-duty 

service members through research, high quality 

health care, and excellent customer service.

As one of the newest DVBIC sites, the Warrior 

Care Clinic’s TBI program at Fort Bliss is 

dedicated to serving and improving the quality of 

life, function, and duty status of active-duty and 

reserve component soldiers with TBI and comorbid 

conditions through state of the art evaluation, 

treatment, education, and administration driven 

by a multidisciplinary, biopsychosocial approach.

Fort Bragg 

2017 proved an outstanding year for educational 

outreach activities. The DVBIC REC organized one 

of the most active and well-received Brain Injury 

Awareness months at Fort Bragg. The REC was 

also instrumental in getting brain injury incorporated 

into the #BeenThere campaign at Fort Bragg, which 

encourages service members to talk about and 

seek services for injuries and trauma they have 

experienced. Additionally, the number of clinicians 

across Fort Bragg receiving formal training on 

DVBIC’s clinical recommendations on progressive 

return to activity increased. In 2017, more than 150 

clinicians and medics received this training, now 

integrated into the medics’ standard annual training.

Fort Bragg’s recovery support specialist successfully 

on-boarded DVBIC’s TBI Recovery Support 

Program to the NCServes - Central Carolina 

network. NCServes - Central Carolina is part of 

AmericaServes, a network of public, private and 

non-profit organizations serving veterans, service 

members and their families in the Greensboro, 

Raleigh-Durham and Fort Bragg/Fayetteville areas. 

Through this partnership, the TBI Recovery Support 

Program is getting exposure to active-duty service 

members and veterans in the Central North Carolina 

area. To date, several clients from the NCServes 

Central Carolina network have been enrolled into the 

TBI Recovery Support Program from various branches 

of the Armed Forces including Navy and Air Force.

The research staff completed data collection for a 

study funded by Congressionally Directed Medical 

Research Programs (CDMRP) and initiated and 

completed data collection for a study funded by the 

Advanced Medical Technology Initiative (AAMTI).

Staff also initiated four additional studies — 

two CDMRP studies and two AAMTI studies, 

all of which continue to enroll and collect data.

Fort Campbell

The Intrepid Spirit Center at Fort Campbell joined DVBIC 

in October. The center operates in 37,000 square feet 

of clinical space with a staff of 65 personnel working 

in coordinated collaboration. The staff is composed 

of neuropsychologists, physiatrists, occupational 

therapists, physical therapists, speech and language 

therapists, pulmonologists, anesthesiologists, 

neurologists, neuro-optometrists, and mental health 

providers. The center sees 50 new patients per 

month with 3,500 patient encounters per month. 

A Brain Injury Awareness Month event is hosted by Fort Bragg. (DVBIC photo)

Coba Hoban of 103.9 KRXP-FM interviewed Robin Wininger, Fort Carson DVBIC regional education coordinator, during 

Brain Injury Awareness Month. (DVBIC photo)

Network Site Updates
44 DVBIC Annual Report 2017 DVBIC Annual Report 2017 45

Fort Carson

DVBIC Fort Carson welcomed Jorge I. Arango 

as clinical research director in 2017. Dr. Arango 

brings over 15 years of clinical research 

experience and extensive knowledge in 

research design, management and regulation, 

as well as research interests in acquired 

neuronal injury diagnostics and neuroplasticity.

U.S. Public Health Service Capt. Alicia Souvignier, 

Fort Carson’s DVBIC site director and a recognized 

expert in vestibular rehabilitation, began directing 

efforts to learn more about approaches to diagnose 

and measure treatment response in post-traumatic 

vestibular complications. The availability of an 

off-site facility for this research will enable the 

research team to use state-of-the-science devices 

to objectively test treatment response and compare 

findings with clinical measures and subject-reported 

changes. This work generated local and national 

collaborations resulting in five different research 

proposals. Collaborators include the University 

of Colorado at Colorado Springs, the University 

of Pittsburgh, the Oregon Health and Science 

University, and the United States Air Force Academy. 

These partnerships are expected to strengthen 

capacity to improve care for service members 

dealing with post-concussive complications.

The DVBIC research team has also been 

analyzing data from the recently completed 

neurofeedback study funded by the Telemedicine 

and Advanced Technology Research Center, as 

well as comparing military and civilian brain injury 

data through a partnership between the Warrior 

Strong study and Craig Hospital, one of the top 

brain injury rehabilitation hospitals in the country. 

Publications on these studies are expected in 2018.

Fort Drum

The TBI clinic at Fort Drum relaunched an intensive 

outpatient program for those affected by TBI. 

Called the Integrated Warrior Recovery Program, 

the program incorporates multidisciplinary, 

cohort-based treatment. To provide optimal 

care for service members, the DVBIC site 

director began Botox injections for migraines 

and Alpha-Stim therapy for reducing headaches. 

The site director and physical therapist also 

started implementing the Buffalo Concussion 

Treadmill Test (BCTT) in assessing patients.

The regional education coordinator began giving 

regular TBI education for incoming providers and 

to all mobilizing and demobilizing soldiers at 

Fort Drum’s soldier processing center. The 

REC established collaboration with Fort Drum’s 

motorcycle safety course by providing TBI 

prevention, safety tips and resources. The 

REC provided information about TBI to more 

than 18,000 service members, veterans, 

family members and medical providers.

Fort Gordon

Launched in 2016, the DVBIC network site at 

Fort Gordon, Georgia, is co-located with the 

Neuroscience and Rehabilitation Center at the 

Dwight D. Eisenhower Army Medical Center. 

The research team has been supporting two multisite, multi-year, multi-million dollar grant funded 

studies: 1) The Chronic Effects of Neurotrauma 

Consortium (CENC) study titled “Observational 

study on late neurological effects of combat,” and 

2) a Walter Reed study titled “A study of bilateral 

prefrontal transcranial magnetic stimulation to treat 

the symptoms of mild TBI and PTSD.” Since the site 

launched, the research team also has coauthored a 

grant submission currently under review, submitted 

two research posters for presentation at national 

level professional conferences and presented 

a research poster at a professional conference. 

Protocol development is underway for two new 

studies: investigating neuroendocrine dysfunction 

in a military mTBI population and comparing 

the relative efficacy of acupuncture and Botox 

in the treatment of post-traumatic headaches. 

The RSS enrolled more than 

250 service members into the 

Wounded, Ill and Injured Registry 

as part of a DVBIC TBI clinical 

care outcomes pilot project. 

The recovery support specialist 

continued to provide support to 

service members transitioning 

from active-duty to retirement 

and assisted in facilitating 

a successful Brain Injury 

Awareness month program, walk 

and community presentations.

Fort Hood

The DVBIC Fort Hood research 

team serves as the lead site on 

the post-traumatic headache 

clinical recommendation study. 

The team managed institutional 

review board submissions and 

cultivated relationships with 

Fort Hood’s clinical leadership 

to strengthen provider and 

patient recruitment. They also 

established relationships with 

other units across Fort Hood to 

facilitate access to more patients. 

The DVBIC regional education 

coordinator visited facilities in 

Oklahoma to educate personnel 

about DVBIC resources, 

programs, and activities. 

Other REC highlights include 

conducting briefings at the 

Soldier Readiness Processing 

(SRP) Center for mobilizing and 

de-mobilizing service members, 

organizing outreach events that 

reached more than two thousand 

people, assisting patients in the 

Recovery Support Program, 

and co-facilitating over 50 

classes for the Intrepid Spirit’s 

Intensive Outpatient Program.

Joint Base ElmendorfRichardson 

The Joint Base ElmendorfRichardson (JBER) Traumatic 

Brain Injury Clinic is DVBIC’s 

sole Air Force-based TBI facility. 

DVBIC JBER uses state-ofthe-science diagnostic and 

rehabilitative equipment and 

complementary interventions, 

such as acupuncture, to provide 

holistic care. In 2017, DVBIC 

JBER received over 200 new 

patient referrals and completed 

5,814 total patient visits. 

The clinic led the base-wide 

Automatic Neuropsychological 

Assessment Metric screening 

of 3,871 service members and 

civilians prior to deployment, a 

475 percent increase over 2016.

DVBIC JBER was one of 

five Department of Defense 

sites chosen by the National 

Endowment for the Arts in 

2016 to assist in adding art and 

music therapy services. Clinical 

music therapy services began 

in June 2017 and included 171 

patient encounters in individual 

or group sessions for the year. 

Among other highlights, the 

DVBIC REC reached more than 

36,000 Alaska and Hawaiibased stakeholders, a 44 percent 

increase over 2016. The site also 

began offering the sphenopalatine 

ganglion block (SPG) procedure 

to treat chronic headache.

Joint Base 

Lewis-McChord

The Intrepid Spirit Center opened 

December 18, 2017, with an 

expanding clinical team under 

the direction of Marine Corps 

Col. Beverly Scott, M.D., where 

both the TBI and Intrepid Spirit 

programs are housed. The TBI 

clinic at Madigan Army Medical 

Center became a DVBIC site in July 

2017, allowing Madigan to match 

successful clinical and education 

advancements within their 

programs with growing research 

opportunities and initiatives. Two 

research projects soon to launch 

include the use of Prazocin for 

post-traumatic headaches and the 

assessment of heart rate variability 

as a measure of autonomic 

functioning in service members.

National Intrepid Center of Excellence 

at Fort Hood.(DVBIC photo)

MACE training aboard U.S. Navy Ship Mercy. (U.S. Navy photo by Petty 

Officer 1st Class Ralph Doria, USNS Mercy)

Military Hospitals and Clinics

Network Site Updates
46 DVBIC Annual Report 2017 DVBIC Annual Report 2017 47

Landstuhl Regional Medical Center 

The Regional Health Command Europe 

(RHCE) DVBIC Landstuhl site serves the entire 

European theater including Africa and the 

Middle East. 2017 was a year of expansion with 

several performance improvement efforts on 

multidisciplinary care and pediatric concussion 

coming to fruition and several research protocols 

examining acute concussion incidence and 

multidisciplinary care models under development. 

Other 2017 accomplishments include presentations 

by Juan Rivera, DVBIC site director, and Kendra 

Jorgensen-Wagers, senior clinical research director, 

on their multidisciplinary outcome results at the 

DCoE summit in September. In addition, the RHCE 

efforts to improve pediatric guidelines for pediatric 

concussion in military dependents were presented 

at the International Brain Injury Conference in New 

Orleans, the American Congress of Rehabilitation 

Medicine Conference in Atlanta and the International 

Pediatric Brain Injury Symposium in Rome. 

Landstuhl remains focused on health outcomes 

to enhance warfighter return to duty and 

performance optimization involving emerging 

technologies and remote telehealth applications 

to enhance service delivery across a very broad 

geographic region. Clinical staff members have 

fully implemented the TBI data portal utilization 

across Europe for tracking TBI health outcome 

metrics. With the recent advent of new research 

staff, DVBIC Landstuhl anticipates even more 

evidence-based results for our TBI patients.

Naval Medical Center San Diego

DVBIC at Naval Medical Center San Diego 

(NMCSD) works collaboratively with the Office of 

Neurotrauma/Navy Medicine West and the TBI 

Program at NMCSD to improve access to care for 

Navy SEALs, sailors, Marines, and soldiers and 

provide them with education, clinical services, care 

coordination and opportunities to participate in 

TBI research. An early identification system was 

collaboratively developed with Comprehensive 

Combat and Complex Casualty Care (C5) staff 

to streamline access to care for elite forces with 

high operating tempos. DVBIC NMCSD has 

continued to lead efforts in collaboration with Camp

Pendleton to develop and refine the NeuroTRACT 

System — a state-of-the-art data registry that 

bridges the gap between researchers and clinicians. 

DVBIC at NMCSD’s primary mission is to conduct 

state-of-the-science research aimed at improving 

diagnostic and treatment algorithms for service 

members with TBI. This research mission is 

accomplished in collaboration with other DVBIC 

sites as well as through externally funded 

research initiated by local study investigators. 

DVBIC NMCSD is proud to announce that it has 

been invited to submit three full applications for 

Congressionally Directed Medical Research 

Programs consideration. The current clinical 

research portfolio includes studies that:

n Evaluate advanced technologies for assessment 

and rehabilitation of TBI such as mobile eye 

tracking, EEG, and virtual reality.

n Compare treatment as usual (speech therapy) 

with computer-based cognitive remediation, 

examining short- and long-term outcomes after 

TBI for patients and caregivers.

n Investigate the real-world implementation 

and impact of clinical practice guidelines for 

progressive return to activity after TBI.

DVBIC at NMCSD coordinates care for TBI 

patients and provides extensive educational 

services. This year staff conducted multiple 

trainings for medical providers aboard the USNS 

Mercy. This relationship continues to grow 

as DVBIC NMCSD is now slated to provide 

recurring TBI updates for staff aboard the ship. 

In addition, the regional education coordinator 

delivers weekly emails to over 400 members 

of the DVBIC NMCSD TBI listserv, keeping 

providers apprised of the latest research, 

webinars and conferences related to brain injury. 

Lastly, the fourth annual NMCSD TBI symposium 

had the highest participation numbers yet, with 

172 attendees — an increase of over 50 percent 

since the inaugural event and now reaching a 

nationwide audience by virtual broadcast. 

San Antonio Military Medical Center

DVBIC researchers at San Antonio Military Medical 

Center (SAMMC) published 10 peer-reviewed 

journal articles and gave 10 presentations at national 

meetings. Researchers began enrollment in a 

data repository study for military service members 

with orthopedic injuries and uninjured service 

members and developed an automated data entry 

and management system for their large TBI data 

repository. They continued recruitment and enrollment 

into ongoing studies involving fMRI, epigenetics 

and long-term outcomes following mild TBI. 

DVBIC SAMMC also maintained high involvement 

in military health care provider training. Over a 

thousand military providers at the U.S. Army Medical 

Department Center and School Health Readiness 

Center of Excellence received multifaceted TBI 

training from DVBIC SAMMC staff. The regional 

education coordinator continued to provide monthly 

education sessions reaching nearly 1,400 military 

health care professionals at SAMMC and over 

2,500 service members, veterans, and families.

United States Special Operations 

Command

United States Special Operations Command 

(USSOCOM) is the newest DVBIC network site. 

Navy Capt. Scott Cota serves as the USSOCOM 

DVBIC site director. Since 1987, USSOCOM 

has been a unified combatant command and is 

unique in that it performs combatant commandlike functions and has Title 10 military departmentlike responsibilities and authorities. USSOCOM 

is a global enterprise consisting of Army Special 

Operations Command, Naval Special Warfare 

Command, Air Force Special Operations Command, 

Marine Corps Special Operations Command, and 

Joint Special Operations Command, as well as seven 

Theater Special Operations Commands aligned 

with the Geographic Combatant Commands, two 

Joint Task Force Commands, and support to NATO 

Special Operations Forces (SOF) Headquarters. 

USSOCOM’s mission is to synchronize the 

planning of Special Operations worldwide and 

provide SOF to support persistent, networked, and 

distributed Global Combatant Command operations 

in order to protect and advance U.S. interests. 

The USSOCOM Command Surgeon supports SOF 

warriors and their families. Current USSOCOM 

research studies cover the use of transcranial 

magnetic stimulation for the treatment of TBI and 

post-traumatic stress and clinical evaluation of 

the use of transcranial electrical stimulation to 

modulate sleep and pain. USSOCOM also directly 

and indirectly support studies on low level blast 

effects and blast surveillance with the goal of rapidly 

operationalizing the results and recommendations.

Safety Day table displays DVBIC resources at San Antonio Military Medical Center. (DVBIC photo)

Military Hospitals and Clinics

Network Site Updates
48 DVBIC Annual Report 2017 DVBIC Annual Report 2017 49

Walter Reed National Military 

Medical Center

Walter Reed National Military Medical Center 

(WRNMMC) is the lead DVBIC site conducting 

the congressionally mandated 15-Year Study, a 

longitudinal research initiative comprised of several 

substudies. As the TBI-care and quality of life 

(TBI-Care-QOL) development study came to an 

end, the longitudinal caregiver study expanded in 

methodology, integrating the new TBI-Care-QOL 

short forms, validated Patient-Reported Outcomes 

Measurement Information System (PROMIS) 

measures, family functioning and relationship 

measures, and PROMIS pediatric parent proxy 

short forms. The natural history study completed 

all data entry backlog. Analyses with the blood, 

neuroimaging, neurobehavioral, and neurocognitive 

data were completed and memoranda of 

understanding and data sharing agreements were 

finalized with collaborating sites to commence 

sensory-motor data analyses. As of November 

2017, the natural history study completed 1,048 

baseline evaluations, and the longitudinal caregiver 

study completed 368 baseline evaluations.

In addition to research at WRNMMC, the 

Brain Fitness Center (BFC) continues to offer 

commercially available brain training and 

biofeedback programs to military service 

members and beneficiaries who have 

subjective cognitive complaints. In 2017, the 

BFC received over 400 referrals, conducted 

350 new participant evaluations, and 

completed over 2,800 total participant visits.

WRNMMC is collocated with the National Intrepid 

Center of Excellence (NICoE), and NICoE’s 

neuropsychology service continued to work 

collaboratively with providers both within and 

outside of WRNMMC to strengthen best patient 

practice and improve patient centered care. NICoE’s 

clinical operations department continued to focus 

collaborative efforts with other national Intrepid 

Spirit Centers to standardize outpatient/inpatient 

assessments and treatment. In addition to launching 

a 12-session speaker series offering continuing 

education units on TBI treatment, care and 

management, this department began to integrate 

and cross-train NICoE case managers and family 

therapists for better clinical operation feasibility. 

Minneapolis VAMC

Research staff in Minneapolis completed 

recruitment and enrollment for three CENC 

studies: “Longitudinal Multidomain Assessment 

of Neurodegeneration in Veterans,” “Visual and 

Sensory Impairments and Progression Following 

Mild TBI,” and “Retinal Imaging with Adaptive Optics.”

Staff presented results from studies in posters 

and talks at eight local, national, and international 

conferences, completed six grant submissions 

for external funding, developed three new 

protocols, and published a paper in the journal 

Brain Stimulation on the first study investigating 

an intervention combining cognitive training 

and transcranial direct current stimulation 

to reduce impulsivity in veterans. Staff also 

facilitated the first annual Traumatic Brain Injury 

Awareness Fair at the VA and participated 

in several other events including Caregiver 

Appreciation Day and Epilepsy Awareness Day.

Palo Alto VAMC

Dr. Maheen Mausoof Adamson, 

senior scientific research director 

at DVBIC Palo Alto and

clinical associate professor of 

neurosurgery, psychiatry and 

behavioral sciences at Stanford 

University School of Medicine, 

presented at the sixth annual Brain 

Mapping Day. Held March 8, 2017, 

at the Dirksen Senate Office 

Building in Washington, D.C., 

this event was organized by 

the Congressional Neuroscience 

Caucus, the Society for Brain 

Mapping and Therapeutics, the 

Brain Mapping Foundation and 

the National Center for 

NanoBioElectronics. The presentation

showcased a broad array of 

cutting edge neurotechnologies, 

translation neuroscience research, 

and clinical trials advancing 

prevention of and diagnostics 

and treatments for neurological 

and psychological disorders.

Gender and TBI was an important 

focus of attention for DBVIC. 

Dr. Odette Harris, principal 

investigator at DVBIC Palo Alto as 

well as the director of brain injury 

and a clinical associate professor 

in neurosurgery at Stanford 

University School of Medicine, 

presented as an invited expert 

on this issue at the Workshop on 

Female Brain Injury at the National 

Institutes of Health in December.

DVBIC Palo Alto also initiated a 

student summer volunteer/intern 

research assistant program. 

Students who completed this 

program represented medical 

schools including Stanford 

University, the University 

of Illinois, Chicago, and the 

University of Texas, as well as 

the Neurosurgery Research and 

Education Foundation. They 

performed data analysis resulting 

in posters and manuscripts.

Richmond VAMC

The Richmond DVBIC research 

team published three manuscripts, 

delivered 11 presentations using 

DVBIC study data, submitted 

a Congressionally Directed 

Medical Research Programs 

grant proposal, and obtained 

local regulatory approvals 

for a transcranial magnetic 

stimulation project funded 

by the Commonwealth of 

Virginia Department for Aging 

and Rehabilitative Services.

The recovery support specialist 

networked with colleagues 

and established connections 

with community partners at 

the Brain Injury Association of 

Virginia Annual Conference 

and Navy Safe Harbor Family 

Symposium. The recovery 

support specialist also expanded 

the catchment area, which now 

includes Virginia, West Virginia, 

Kentucky, Indiana and Michigan.

The REC networked with 

colleagues at the Society for 

Neuroscience Annual Meeting, 

provided outreach services at 

several local veteran and service 

member events, and established 

an important connection and 

working relationship with the 

Warrior Concussion Clinic at 

Portsmouth Naval Hospital.

San Antonio VAMC

Several longitudinal studies on 

neurotrauma continued to enroll 

subjects and gather data at the 

San Antonio VAMC. The studies 

recruited over one hundred new 

participants in 2017. Using data 

from those and other studies, 

researchers published 11 

peer-reviewed journal articles 

and two book chapters and 

presented six abstracts at the 

Military Health Symposium 

and the American Academy 

of Physiatrist Annual Meeting.

This is the first year that DVBIC 

personnel were assigned directly 

to the San Antonio VA Polytrauma 

Rehabilitation Center. The new 

research assistant and senior 

clinical research director will 

help the San Antonio VA fulfill its 

TBI research mission. Already 

assisting with the DVBIC supported 

studies, establishing connections 

with several organizations 

throughout San Antonio to 

facilitate recruitment, and planning 

for future studies, the DVBIC team 

is rapidly becoming an important 

asset to the San Antonio VA. The 

senior clinical research director’s 

knowledge of capabilities and 

assets at the San Antonio Military 

Medical Center will enable greater 

collaboration between the two 

facilities and generate multiple 

possibilities across the network. 

Tampa VAMC

This year, the DVBIC Tampa team 

collectively gave 35 presentations, 

published 24 papers, and 

maintained nine active research 

grants related to TBI. Among 

highlights, members of the DVBIC 

Tampa team presented the 

Smart Home project at the VA 

Center for Innovation Demo Day 

in Washington, D.C. The team 

placed second out of over 100 

presentations and was picked up 

by the Office of VA Connected Care 

for the mobile app development. 

DVBIC and the Tampa VA worked 

hard this year to continue the 

strong alliance with SOCOM 

headquarters at MacDill Air Force 

Base. This collaboration resulted 

in the development of SOCOM 

as a new DVBIC site. In addition, 

DVBIC Tampa and its coordination 

with SOCOM led to new DVBIC 

staff, a symbiotic research 

partnership on a grant proposal, 

and numerous combined efforts 

aimed at optimizing performance 

of the SOF warfighter. 

VA Medical Centers

Connie Du, DVBIC research assistant, shares DVBIC 

materials at the 2017 TBI Symposium hosted by DVBIC at 

the Minneapolis VA Health Care System. (DVBIC photo)

Military Hospitals and Clinics

Network Site Updates
Cook, P. A., Johnson, T. M., Martin, S. G., Gerhman, P. R., Bhatnagar, S., & Gee, J. C. (2017). A retrospective study of 

predictors of return to duty vs medical retirement in an active duty military population with blast-related mild traumatic 

brain injury. Journal of Neurotrauma. doi: 10.1089/neu.2017.5141

Cripps, A., Livingston, S.C. (2017). Differentiating concussion from intracranial pathology in athletes. Journal of Sports 

Rehabilitation, 26, 101-108.

Cripps, A., Livingston, S.C.(2017). The Head Shake Sensory Organization Test (HS-SOT): Normative Data and 

Correlation with Dynamic Visual Acuity Testing. Journal of Sports Medicine and Allied Health Sciences, 3(2). doi: 

10.25035/jsmahs.03.02.03 

Dillahunt-Aspillaga, C., Nakase-Richardson, R., Hart, T., Powell-Cope, G., Dreer, L. E., Eapen, B. C., . . . Silva, M. A. 

(2017a). Predictors of employment outcomes in veterans with traumatic brain injury: A VA traumatic brain injury Model 

Systems study. The Journal of Head Trauma Rehabilitation. doi: 10.1097/htr.0000000000000275

Dillahunt-Aspillaga, C., Pugh, M. J., Cotner, B. A., Silva, M. A., Haskin, A., Tang, X., . . . Nakase-Richardson, R. 

(2017b). Employment stability in veterans and service members with traumatic brain injury: A VA traumatic brain 

injury Model Systems study. Arch Phys Med Rehabil. doi: 10.1016/j.apmr.2017.05.012

Dretsch, M. N., Lange, R. T., Katz, J. S., Goodman, A., Daniel, T. A., Deshpande, G., . . . Robinson, J. L. (2017). 

Examining microstructural white matter in active duty soldiers with a history of mild traumatic brain injury and 

traumatic stress. Open Neuroimag J, 11, 46-57. doi: 10.2174/1874440001711010046

Finkel, A. G., Ivins, B. J., Yerry, J. A., Klaric, J. S., Scher, A., & Sammy Choi, Y. (2017a). which matters more? A 

retrospective cohort study of headache characteristics and diagnosis type in soldiers with mTBI/concussion. Headache. 

doi: 10.1111/head.13056

Finkel, A. G., Klaric, J. S., Yerry, J. A., & Choi, Y. S. (2017b). Staying in service with posttraumatic headache: A 

retrospective cohort study of patient outcome. Neurology, 89(11), 1186-1194. doi: 10.1212/WNL.0000000000004358

Finn, J. A., Lamberty, G. J., Tang, X., Saylors, M. E., Stevens, L. F., & Kretzmer, T. (2017). Postrehabilitation mental 

health treatment utilization in veterans with traumatic brain injury: A VA TBI Model Systems study. The Journal of 

Head Trauma Rehabilitation. doi: 10.1097/HTR.0000000000000357

Gray, M., Chung, J., Aguila, F., Williams, T. G., Teraoka, J. K., & Harris, O. A. (2017). Long-term functional outcomes 

in military service members and veterans after traumatic brain injury/polytrauma inpatient rehabilitation. Archives of 

Physical Medicine and Rehabilitation. doi: 10.1016/j.apmr.2017.08.465

Gregory, E., West, T. A., Cole, W. R., Bailie, J. M., McCulloch, K. L., Ettenhofer, M. L., . . . Qashu, F. M. (2017). 

Use of a multi-level mixed methods approach to study the effectiveness of a primary care progressive return to activity 

protocol after acute mild traumatic brain injury/concussion in the military. Contemporary Clinical Trials, 52, 95-100. 

doi: 10.1016/j.cct.2016.11.005

Hershaw, J. N., Barry, D. M., & Ettenhofer, M. L. (2017). Increased risk for age-related impairment in visual attention 

associated with mild traumatic brain injury: Evidence from saccadic response times. PLoS One, 12(2), e0171752. doi: 

10.1371/journal.pone.0171752

Janak, J. C., Cooper, D. B., Bowles, A. O., Alamgir, A. H., Cooper, S. P., Gabriel, K. P., . . . Orman, J. A. (2017). 

Completion of multidisciplinary treatment for persistent postconcussive symptoms is associated with reduced symptom 

burden. The Journal of Head Trauma Rehabilitation, 32(1), 1-15. doi: 10.1097/htr.0000000000000202

Lange, R. T., & Lippa, S. M. (2017). Sensitivity and specificity should never be interpreted in isolation without 

consideration of other clinical utility metrics. Clin Neuropsychol, 1-14. doi: 10.1080/13854046.2017.1335438

Agoston, D., Arun, P., Bellgowan, P., Broglio, S., Cantu, R., Cook, D., . . . Smith, D. (2017). Military Blast injury 

and chronic neurodegeneration: Research presentations from the 2015 international state-of-the-science meeting. 

Journal of Neurotrauma, 34(S1), S6-S17. doi: 10.1089/neu.2017.5220

Aldag, M., Armstrong, R. C., Bandak, F., Bellgowan, P. S. F., Bentley, T., Biggerstaff, S., . . . Zheng, J. (2017). 

The biological basis of chronic traumatic encephalopathy following blast injury: A literature review. Journal of 

Neurotrauma, 34(S1), S26-S43. doi: 10.1089/neu.2017.5218

Armistead-Jehle, P., Cole, W. R., & Stegman, R. L. (2017a). Performance and symptom validity testing as a function 

of medical board evaluation in U.S. Military service members with a history of mild traumatic brain injury. Archives 

of Clinical Neuropsychology, 1-5. doi: 10.1093/arclin/acx031

Armistead-Jehle, P., Cooper, D. B., Grills, C. E., Cole, W. R., Lippa, S. M., Stegman, R. L., & Lange, R. 

T. (2017b). Clinical utility of the mBIAS and NSI validity-10 to detect symptom over-reporting following 

mild TBI: A multicenter investigation with military service members. J Clin Exp Neuropsychol, 1-11. doi: 

10.1080/13803395.2017.1329406

Armistead-Jehle, P., Soble, J. R., Cooper, D. B., & Belanger, H. G. (2017c). Unique aspects of traumatic brain injury 

in military and veteran populations. Physical medicine and rehabilitation clinics of North America, 28(2), 323-337. doi: 

10.1016/j.pmr.2016.12.008

Arrieux, J. P., Cole, W. R., & Ahrens, A. P. (2017). A review of the validity of computerized neurocognitive 

assessment tools in mild traumatic brain injury assessment. Concussion, 31, 1-23. doi: 10.2217/cnc-2016-0021

Bailey, E. K., Nakase-Richardson, R., Patel, N., Dillahunt-Aspillaga, C., Ropacki, S. A., Sander, A. M., . . . Tang, X. 

(2017). Supervision needs following veteran and service member moderate to severe traumatic brain injury: A VA 

TBI Model Systems study. J Head Trauma Rehabil, 32(4), 245-254. doi: 10.1097/HTR.0000000000000317

Bjork, J. M., Burroughs, T. K., Franke, L. M., Pickett, T. C., Johns, S. E., Moeller, F. G., & Walker, W. C. (2017). 

Rapid-response impulsivity predicts depression and PTSD symptomatology at 1-year follow-up in blast-exposed 

service members. Archives of Physical Medicine and Rehabilitation. doi: 10.1016/j.apmr.2017.03.022

Brickell, T. A., French, L. M., Lippa, S. M., & Lange, R. T. (2017). The impact of deployment and traumatic brain 

injury on the health and behavior of children of US military service members and veterans. Clin Child Psychol 

Psychiatry, 1359104517740405. doi: 10.1177/1359104517740405

Cole, W. R., Arrieux, J. P., Ivins, B. J., Schwab, K. A., & Qashu, F. M. (2017). A Comparison of four computerized 

neurocognitive assessment tools to a traditional neuropsychological test battery in service members with and without 

mild traumatic brain injury. Archives of Clinical Neuropsychology, 1-18. doi: 10.1093/arclin/acx036

Cole, W. R., Gregory, E., Arrieux, J. P., & Haran, F. J. (2017). Intraindividual cognitive variability: An examination 

of ANAM4 TBI-MIL simple reaction time data from service members with and without mild traumatic brain 

injury. Journal of the International Neuropsychological Society, 1-7. doi: 10.1017/S1355617717001187

50 DVBIC Annual Report 2017 DVBIC Annual Report 2017 51

Publications

Since 1992, DVBIC staff members have published more than 480 

peer-reviewed manuscripts and regularly serve on the editorial 

boards of major journals in the field of TBI including the Journal 

of Neurotrauma and Journal of Head Trauma Rehabilitation. In 

2017, DVBIC staff members published 53 peer-reviewed papers. 

This list includes some print publications that may have appeared 

electronically ahead of print in 2016.
Leary, J., Kim, G. Y., Bradley, C. L., Hussain, U. Z., Sacco, M., Bernad, M., Collins, J., Dsurney, J., Chan, 

L. (2017). The Association of Cognitive Reserve in Chronic-Phase Functional and Neuropsychological 

Outcomes Following Traumatic Brain Injury. Journal of Head Trauma Rehabilitation, (33)1. doi: 10.1097/

HTR.0000000000000329

Lippa, S. M., Brickell, T. A., Bailie, J. M., French, L. M., Kennedy, J. E., & Lange, R. T. (2017a). Postconcussion 

Symptom reporting after mild traumatic brain injury in female service members: impact of gender, posttraumatic 

stress disorder, severity of injury, and associated bodily injuries. The Journal of Head Trauma Rehabilitation. doi: 

10.1097/HTR.0000000000000353

Lippa, S. M., Lange, R. T., Bhagwat, A., & French, L. M. (2017b). Clinical utility of embedded performance validity 

tests on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) following mild traumatic 

brain injury. Applied neuropsychology: Adult, 24(1), 73-80. doi: 10.1080/23279095.2015.1100617

Lippa, S. M., Lange, R. T., French, L. M., & Iverson, G. L. (2017c). Performance Validity, neurocognitive disorder, 

and post-concussion symptom reporting in service members with a history of mild traumatic brain injury. Archives of 

Clinical Neuropsychology, 1-13. doi: 10.1093/arclin/acx098

Main, K. L., Soman, S., Pestilli, F., Furst, A., Noda, A., Hernandez, B., . . . Adamson, M. M. (2017). DTI measures 

identify mild and moderate TBI cases among patients with complex health problems: A receiver operating 

characteristic analysis of U.S. veterans. Neuroimage Clin, 16, 1-16. doi: 10.1016/j.nicl.2017.06.031

Manchester, J., Eshel, I., & Marion, D. W. (2017). The benefits and risks of energy drinks in young adults and 

military service members. Military Medicine, 182(7), e1726-e1733. doi: 10.7205/MILMED-D-16-00339

McCulloch, K. L., Cecchini, A. S., Radomski, M. V., Scherer, M. R., Smith, L., Cleveland, C., . . . Weightman, M. 

M. (2017). Military-civilian collaborations for mTBI rehabilitation research in an active duty population: lessons 

learned from the assessment of military multitasking performance project. J Head Trauma Rehabil, 32(1), 70-78. doi: 

10.1097/HTR.0000000000000272

Miller, K. J., Kennedy, J. E., & Schwab, K. A. (2017). Long-term outcomes and needs of military service 

members after noncombat-related traumatic brain injury. Military Medicine, 182(S1), 137-146. doi: 10.7205/

MILMED-D-16-00175

Moy Martin, E. M., & Langbein, J. (2017). A needs review of caregivers for adults with traumatic brain injury. 

Federal Practitioner, 34(12), 42-48.

Nakase-Richardson, R., Stevens, L. F., Tang, X., Lamberty, G. J., Sherer, M., Walker, W. C., . . . Garofano, 

J. S. (2017). Comparison of the VA and NIDILRR TBI Model System cohorts. The Journal of Head Trauma 

Rehabilitation, 32(4), 221-233. doi: 10.1097/HTR.0000000000000334

Pogoda, T. K., Levy, C. E., Helmick, K., & Pugh, M. J. (2017). Health services and rehabilitation for active duty 

service members and veterans with mild TBI. Brain Injury, 31(9), 1220-1234. doi: 10.1080/02699052.2016.1274777

Reid, M. W., Hannemann, N. P., York, G. E., Ritter, J. L., Kini, J. A., Lewis, J. D., . . . Tate, D. F. (2017). 

Comparing two processing pipelines to measure subcortical and cortical volumes in patients with and without mild 

traumatic brain injury. Journal of Neuroimaging. doi: 10.1111/jon.12431

Rhea, C. K., Kuznetsov, N. A., Ross, S. E., Long, B., Jakiela, J. T., Bailie, J. M., . . . Duckworth, J. L. (2017). 

Development of a portable tool for screening neuromotor sequelae from repetitive low-level blast exposure. Military 

Medicine, 182(S1), 147-154. doi: 10.7205/MILMED-D-16-00140

Scherer, M. R., Weightman, M. M., Radomski, M. V., Smith, L., Finkelstein, M., Cecchini, A., . . . McCulloch, 

K. (2017). Measuring soldier performance during the patrol-exertion multitask: preliminary validation of a 

postconcussive functional return-to-duty metric. Arch Phys Med Rehabil. doi: 10.1016/j.apmr.2017.04.012

52 DVBIC Annual Report 2017 DVBIC Annual Report 2017 53

Schulz-Heik, R. J., Poole, J. H., Dahdah, M. N., Sullivan, C., Adamson, M. M., Date, E. S., . . . Harris, O. (2017). 

Service needs and barriers to care five or more years after moderate to severe TBI among Veterans. Brain Injury, 1-7. doi: 

10.1080/02699052.2017.1307449

Schwab, K., Terrio, H. P., Brenner, L. A., Pazdan, R. M., McMillan, H. P., MacDonald, M., . . . Scher, A. I. (2017). 

Epidemiology and prognosis of mild traumatic brain injury in returning soldiers: A cohort study. Neurology, 88(16), 

1571-1579. doi: 10.1212/WNL.0000000000003839

Seifert, T., Sufrinko, A., Cowan, R., Scott Black, W., Watson, D., Edwards, B., . . . Kontos, A. P. (2017). Comprehensive 

headache experience in collegiate student-athletes: An initial report from the NCAA headache task force. Headache, 

57(6), 877-886. doi: 10.1111/head.13104

Silverberg, N. D., Crane, P. K., Dams-O’Connor, K., Holdnack, J., Ivins, B. J., Lange, R. T., . . . Iverson, G. L. (2017). 

Developing a cognition endpoint for traumatic brain injury clinical trials. Journal of Neurotrauma, 34(2), 363-371. doi: 

10.1089/neu.2016.4443

Soman, S., Bregni, J. A., Bilgic, B., Nemec, U., Fan, A., Liu, Z., . . . Wang, Y. (2017). Susceptibility-based neuroimaging: 

Standard methods, clinical applications, and future directions. Curr Radiol Rep, 5(3). doi: 10.1007/s40134-017-0204-1

Stevens, L. F., Lapis, Y., Tang, X., Sander, A. M., Dreer, L. E., Hammond, F. M., . . . Nakase-Richardson, R. (2017). 

Relationship stability after traumatic brain injury among veterans and service members: A VA TBI Model Systems study. 

The Journal of Head Trauma Rehabilitation, 32(4), 234-244. doi: 10.1097/HTR.0000000000000324

Sullivan, K. A., Edmed, S. L., Greenslade, J. H., White, M., Chu, K., Lukin, B., . . . Lurie, J. K. (2017). Psychological 

predictors of postconcussive symptoms following traumatic injury. The Journal of Head Trauma Rehabilitation. doi: 

10.1097/HTR.0000000000000347

Tate, D. F., Gusman, M., Kini, J., Reid, M., Velez, C. S., Drennon, A. M., . . . York, G. E. (2017). Susceptibility 

Weighted imaging and white matter abnormality findings in service members with persistent cognitive symptoms 

following mild traumatic brain injury. Military Medicine, 182(3), e1651-e1658. doi: 10.7205/MILMED-D-16-00132

Toyinbo, P. A., Vanderploeg, R. D., Belanger, H. G., Spehar, A. M., Lapcevic, W. A., & Scott, S. G. (2017). A Systems 

science approach to understanding polytrauma and blast-related injury: Bayesian network model of data from a survey of 

the Florida National Guard. American journal of epidemiology, 185(2), 135-146. doi: 10.1093/aje/kww074

Tran, J., Hammond, F., Dams-O’Connor, K., Tang, X., Eapen, B., McCarthy, M., & Nakase-Richardson, R. (2017). 

Rehospitalization in the first year following veteran and service member TBI: A VA TBI Model Systems study. The 

Journal of Head Trauma Rehabilitation. doi: 10.1097/HTR.0000000000000296

Walker, W. C., Franke, L. M., Sima, A. P., & Cifu, D. X. (2017). Symptom trajectories after military blast 

exposure and the influence of mild traumatic brain injury. J Head Trauma Rehabil, 32(3), E16-E26. doi: 10.1097/

HTR.0000000000000251

Waltzman, D., Soman, S., Hantke, N. C., Fairchild, J. K., Kinoshita, L. M., Wintermark, M., . . . Furst, A. J. (2017). 

Altered microstructural caudate integrity in posttraumatic stress disorder but not traumatic brain injury. PLoS One, 

12(1), e0170564. doi: 10.1371/journal.pone.0170564

Weightman, M. M., McCulloch, K. L., Radomski, M. V., Finkelstein, M., Cecchini, A. S., Davidson, L. F., . . . Scherer, 

M. R. (2017). Further development of the assessment of military multitasking performance: iterative reliability testing. 

PLoS One, 12(1), e0169104. doi: 10.1371/journal.pone.0169104

Wolf, G. K., Mauntel, G. J., Kretzmer, T., Crawford, E., Thors, C., Strom, T. Q., & Vanderploeg, R. D. (2017). 

Comorbid posttraumatic stress disorder and traumatic brain injury: Generalization of prolonged-exposure PTSD 

Treatment outcomes to postconcussive symptoms, cognition, and self-efficacy in veterans and active duty service 

members. The Journal of Head Trauma Rehabilitation. doi: 10.1097/HTR.0000000000000344
54 DVBIC Annual Report 2017 DVBIC Annual Report 2017 55

DVBIC subject matter experts across the network actively 

shared their research throughout 2017. They gave presentations 

at multiple conferences across the U.S. and internationally.

Presentations

Military Health System Research 

Symposium

Of particular note was DVBIC’s presence at the 

Military Health System Research Symposium 

(MHSRS), the premier DoD scientific meeting, 

which took place August 27-30, 2017, in Kissimmee, 

Florida. MHSRS provided a venue for DVBIC 

to present new scientific knowledge resulting 

from military-unique research at the only military 

or civilian meeting focused specifically on the 

unique medical needs of the warfighter. While in 

attendance, DVBIC presented 42 research posters 

and conducted six oral presentations. Additionally, 

DVBIC served as the lead for the plenary session 

“Recovery Trajectory in Acute Concussion: 

Importance of Adherence to Progressive Return to 

Activity Guidelines for Activity.” DVBIC’s efforts at 

MHSRS culminated in the presentation of 80 draft 

MHS consensus statements on the prevention, 

diagnosis and treatment of TBI. A complete list of 

DVBIC presentations at MHSRS is provided in the 

comprehensive table of DVBIC presentations below.

Defense Centers of Excellence 

for Psychological Health and 

Traumatic Brain Injury Summit

The annual Defense Centers of Excellence for 

Psychological Health and Traumatic Brain Injury 

(DCoE) Summit was held September 19-21, 2017. 

This virtual conference offered 28 educational 

sessions, including 14 sessions in the TBI Track. 

The total number of attendees was 1,567, with 9,002 

continuing education units awarded and 1,422 

certificates of attendance. TBI topics and speakers 

included:

n Long-term impact of traumatic brain injury: The 

15-year longitudinal TBI studies and IMAP study. 

(Risa Nakase-Richardson, Ph.D., FACRM, 

Polytrauma Rehabilitation Program, James A. 

Haley Veterans’ Hospital; and Louis French, 

Psy.D., NICoE, WRNMMC)

n Evidence from the Warrior Strong longitudinal 

study: Post-concussive symptoms common in 

soldiers who have returned home. (Karen Schwab, 

Ph.D., DVBIC, and Donald Marion, M.D., DVBIC)

n Gender differences in TBI. (Anne Bunner, Ph.D., 

DVBIC, and Katherine Helmick, M.S., CRNP, 

ANP-BC, CNRN, DVBIC)

n Management of acute concussion from injury to 

return to duty: Using the Military Acute Concussion 

Evaluation (MACE), clinical management 

algorithm (CMA) & progressive return to activity 

(PRA) algorithms. (Keith Stuessi, M.D., and Clint 

Pearman, M.S., CBIS, Naval Hospital, Camp 

Pendleton)

n Bees in my helmet: Role of chronic traumatic 

encephalopathy in mild memory impairment: A 

practical guide to treatment. (George Charpied, 

M.A., SLP-CC, Canandaigua Veterans 

Administration Medical Center)

n Filling the gaps: Capturing the ‘whole story’ 

following traumatic brain injury. (Col. Beverly 

Scott, M.D., Madigan Army Medical Center)

n Adding insult to injury: Traumatic brain injury and 

substance use. (Lars Hungerford, Ph.D., ABPPCN, Naval Medical Center San Diego)

n Outcomes of training service members with 

a history of mTBI in assistive technology for 

cognition.” (Carole Roth, Ph.D., CCC, BCANCDS, 

Naval Medical Center San Diego)

n Visual dysfunction in traumatic brain injury: An 

interdisciplinary approach to care. (Robin Winslow, 

O.D., and Abby Wicks, O.D., FAAO, NICoE)

n Investigation and treatment of military related 

traumatic brain injury. (Cmdr. Josh Duckworth, 

M.D., USUHS)

n Evaluation and treatment of behavioral health symptoms in TBI patients. (Jonathan P. Wolf, M.D., NICoE, 

WRNMMC)

n Unraveling the Gordian knot of TBI, polytrauma, and chronic pain. (Edison Wong, M.D., M.S., DVBIC)

n Interdisciplinary care: The trifecta for patient quality outcomes, medical readiness and return on investment. 

(Kendra Jorgensen-Wagers, Ph.D., LCMHC, CRC, and Juan Rivera, M.D., FACS, MBA, U.S. Army Landstuhl 

Regional Medical Center)

MACE training at Camp Lejeune. (DVBIC photo)
56 DVBIC Annual Report 2017 DVBIC Annual Report 2017 57

DVBIC 2017 Presentations, 

Posters and Abstracts

Name of Conference Site Lead Title Type

1. DCoE PH/TBI Summit 

2. Minneapolis VA Research Day

Minneapolis 

VA

Transcranial direct current stimulation (TDCS) paired 

with a cognitive task reduces impulsivity in a clinical 

population of veterans

1. Poster 

2. Poster

2017 National Capital Area (NCA) TBI 

Research Symposium

Richmond VA Olfactory and taste disturbances among Iraq and 

Afghanistan U.S. military veterans with a history of mild 

traumatic brain injury

Presentation

2nd International Brain Stimulation 

Conference

Minneapolis 

VA

Combining TDCS with a task to reduce impulsivity in a 

clinical population

Poster

31st Annual Meeting of the Associated 

Professional Sleep Societies

Tampa VA Sleep apnea severity is associated with motor recovery 

and processing speed in acute TBI rehabilitation 

admissions: A VA TBI model system study

Presentation

31st Annual Meeting of the Associated 

Professional Sleep Societies

Tampa VA Sleep stages, total sleep time, and arousals in acquired 

brain injury rehabilitation patients with and without sleep 

apnea

Poster

32nd Annual Academic Research 

Competition in San Diego, CA

NMCSD Retrospective analysis: Using lumosity in the treatment 

of mild traumatic brain injury

Abstract

45th Annual Meeting of the 

International Neuropsychological 

Society

NMCSD Neurocognitive eye tracking in moderate-to-severe 

traumatic brain injury: evidence for enhanced sensitivity 

to impairment

Poster

7th Naval Hospital Camp Lejeune 

Regional Research Symposium

Camp Lejeune Blast gauges, firecrackers and a high school mentally: 

using simple tools to foster scientific curiosity

Presentation

7th Naval Hospital Camp Lejeune 

Regional Research Symposium

Camp Lejeune Enhancing data analysis with software Poster

7th Naval Hospital Camp Lejeune 

Regional Research Symposium

Camp Lejeune In the rear with the gear: Insight into repetitive low level 

blast exposure

Poster

7th Naval Hospital Camp Lejeune 

Regional Research Symposium

Camp Lejeune Mitigating confounding factors in gear efficacy; Mapping 

overpressure at a blast plagued range: operation 

significance

Poster

American Academy of Clinical 

Neuropsychology

Camp 

Pendleton

Classification of alcohol use and misuse among active 

duty service members referred for traumatic brain injury 

evaluation

Poster

American Academy of Clinical 

Neuropsychology

Fort Bragg Cognitive test scores as a function of word memory test 

performance

Abstract

Name of Conference Site Lead Title Type

American Academy of Clinical 

Neuropsychology

Fort Bragg Examination of MMPI-2-RF validity scales in disability 

evaluations: Comparison between orthopedic and 

behavioral health conditions

Abstract

American Academy of Neurology 

Sports Concussion 

HQ Clinical Recommendations for Progressive Return to 

Activity Following Acute Concussion

Poster

American Academy of Neurology 

Sports Concussion 

HQ Differentiating Concussion from Intracranial Pathology 

in Athletes: A Critically Appraised Topic

Poster

American Academy of Physical and 

Medicine Rehabilitation 

Tampa VA Improving care for persons with disorders of 

consciousness (DOC): An introduction to minimal 

competency recommendations for doc programs

Presentation

American Academy of Physical and 

Medicine Rehabilitation 

Richmond VA Predicting long-term global outcome after traumatic 

brain injury (five year data): Development of a practical 

prognostic tool using the TBI Model Systems National 

Database

Poster and 

presentation

American Congress of Rehabilitation 

Medicine 

Palo Alto Functional network dysfunction in chronic symptom 

traumatic brain injury 

Poster

American Congress of Rehabilitation 

Medicine 

WRNMMC “I can’t sleep”: quality of sleep in caregivers of service 

members and veterans with traumatic brain injury

Abstract and 

poster

American Congress of Rehabilitation 

Medicine 

Fort Bragg Improving recognition and treatment of sleep apnea in 

the rehabilitation setting to improve outcome

Instructional 

course 

abstract

American Congress of Rehabilitation 

Medicine 

Palo Alto Reliability of telephonic neuropsychological assessment 

post traumatic brain injury

Poster

American Physical Therapy 

Association Combined Sections 

Meeting

NMCSD Primary care provider practices and perceptions of care 

for service members with concussion: Pre-intervention 

qualitative analysis of interview data

Poster

American Psychological Association Fort Bragg Primary care practices and perceptions in care for 

service members with acute concussion: Does reflection 

in a mixed-method study modify practice? 

Poster

American Speech-Language Hearing 

Association 

SAMMC Completion of multidisciplinary treatment for persistent 

postconcussive symptoms is associated with reduced 

symptom burden

Presentation

American Speech-Language Hearing 

Association 

HQ Practical applications of cognitive rehabilitation 

principles: motivational interviewing and goal attainment 

scaling.

Presentation

Association of Military Surgeons of the 

United States (AMSUS)

Camp Lejune Effectiveness of a mindfulness-based group therapy 

(mbgt) integrative restoration (iREST) fpr active duty 

personnel with mild traumatic brain injury

Poster
58 DVBIC Annual Report 2017 DVBIC Annual Report 2017 59

Name of Conference Site Lead Title Type

AMSUS Camp Lejune Illustration of ISCRC recovery process at naval hospital 

camp lejeune using the neuroplasticity model

Presentation 

AMSUS HQ, NICoE Military Health System Consensus Statement on the 

Prevention, Diagnosis and Treatment of Traumatic Brain 

Injury

Presentation 

AMSUS Camp Lejune Operation return to force for special operators with mild 

traumatic brain injury (mTBI)

Presentation 

Annual Meeting of the National 

Academy of Neuropsychology

Camp 

Pendleton

Accuracy of self-reported questions for assessment of 

tbi history

Annual Meeting of the North American 

Neuro-Ophthalmology Society

Minneapolis 

VA

Evaluating Multiple Sclerosis and Traumatic Brain Injury 

using OCT-based quantification of visual fixation

Poster

Annual Meeting of the Society for 

Biological Psychiatry

Minneapolis 

VA

Reducing impulsivity with transcranial direct current 

stimulation (tDCS) and a cognitive task

Poster

Annual Meeting of the Society for 

Biological Psychiatry

Minneapolis 

VA

Engagement in a visual task increases postural stability 

in veterans with mild traumatic brain injury

Poster

Association of Military Osteopathic 

Physicians & Surgeons

HQ Traumatic Brain Injury and Clinical Tools and 

Recommendations; Defense and Veterans Brain Injury 

Center Progressive Return to Activity (PRA) Following 

Acute Concussion/Mild Traumatic Brain Injury Clinical 

Recommendation

Presentation

Biennial Meeting of the Society for 

Research in Child Development

Fort Bragg The relationship between maternal obesity and 

neurodevelopmental disorders: A meta-analysis

Poster

BrainBox Initiative Conference Palo Alto Improvement of functional connectivity with rTMS in 

Veterans with brain injury

Presentation 

and poster

Chronic Effects of Neurotrauma 

Consortium (CENC) Annual Meeting

Richmond VA CENC multicenter observational study: Characteristics 

of early participants and future directions

Presentation

Clinical Transcranial Magnetic 

Stimulation (TMS) Society

Minneapolis 

VA

Identifying predictors of clinical response of medication 

refractory depression with comorbid mild TBI to deep 

TMS

Poster

Current Concepts in Sleep Tampa VA Traumatic brain injury and sleep Presentation

DCoE Webinar Series NMCSD Emerging technologies for assessment and 

rehabilitation of traumatic brain injury

Webinar

DCoE Webinar Series Fort Carson Mild TBI in soldiers returning from Iraq or Afghanistan Webinar

Faculty Research Meeting 

(Neurosurgery, Stanford Medicine)

Palo Alto Advanced diagnostics and non-invasive treatments for 

brain injury

Presentation

Name of Conference Site Lead Title Type

Health Measures User Conference WRNMMC “Real-time” short form development: Applying item 

information to obtain “live” score-level reliability 

estimates for evaluating expected short form 

performance

Poster

Health Measures User Conference WRNMMC The reliability and validity of PROMIS in caregivers of 

individuals with civilian- or military-related traumatic 

brain injury

Poster

International Brain Injury Association Fort Carson Lifetime history of TBI among soldiers returning from 

OEF/OIF Deployments

Presentation

International Brain Injury Association Fort Carson Effects on mTBI and PTSD on ANAM performance in 

OEF/OIF active duty soldiers

Presentation

International Brain Injury Association NMCSD Self-reported alcohol use among active duty service 

members referred traumatic brain injury screening

Poster

International Brain Injury Association WRNMMC Factors affecting burden in family caregivers of military 

service members with traumatic brain injury

Poster

International Brain Injury Association WRNMMC Health-related quality of life following severe and 

penetrating traumatic brain injury in U.S. military service 

members

Poster

International Brain Injury Association WRNMMC Mild neurocognitive disorder and diffusion tensor 

imaging in military service members following mild 

traumatic brain injury

Poster

International Brain Injury Association WRNMMC The influence of caregiver burden on health status and 

perceived role efficacy in caregivers of U.S. military 

service members with traumatic brain injury

Poster

International Brain Injury Association WRNMMC The influence of traumatic brain injury severity on 

health-related quality of life in caregivers of a service 

member or veteran with traumatic brain injury

Poster

International Brain Injury Association WRNMMC The relationship between perceived burden and healthrelated quality of life in caregivers of military service 

members with traumatic brain injury

Poster

International Brain Injury Association WRNMMC The relationship between plasma amyloid and 

neurocognition following mild traumatic brain injury

Abstract

International Brain Injury Association WRNMMC The relationship between PTSD symptoms and tau and 

amyloid levels in U.S. military service members with and 

without mild-moderate traumatic brain injury

Abstract and 

poster

International Brain Injury Association WRNMMC Family caregiver proxy report of the impact of 

deployment and traumatic brain injury on the health and 

behavior of children of U.S. military service members

Poster
60 DVBIC Annual Report 2017 DVBIC Annual Report 2017 61

Name of Conference Site Lead Title Type

International Brain Injury Association WRNMMC The relationship between white matter hyperintensities, 

neurocognitive performance, and white matter integrity 

following mild traumatic brain injury

Poster

International Brain Injury Association Fort Bragg Cognitive test performance and evaluation context in 

U.S. military service members with a history of mild TBI

Poster

International Brain Injury Association Fort Bragg Performance and symptom validity testing as a function 

of medical board evaluations in U.S. military service 

members with a history of mild tbi

Poster

International Brain Injury Association NMCSD A mixed methods approach to study the effectiveness 

of a primary care progressive return to activity protocol 

after acute mild traumatic brain injury/concussion in the 

military

Poster

International Brain Injury Association Tampa VA Competitive employment outcomes in veterans with 

traumatic brain injury: A VA traumatic brain injury model 

system study

Presentation

International Brain Injury Association Tampa VA Employment stability in veterans and service members 

with traumatic brain injury: A VA traumatic brain injury 

model system study

Presentation

International Brain Injury Association Tampa VA Extending our knowledge of the long-term outcomes of 

disorders of consciousness

Invited 

Symposium

International Brain Injury Association Tampa VA Implications of key differences in military and civilian 

TBI cohorts admitted for inpatient rehabilitation: A VA 

and NIDILRR TBI Model System study

Presentation

International Brain Injury Association Tampa VA Incidence and trajectory of obesity in veterans and 

service members with TBI: A VA TBI Model System 

study

Presentation

International Brain Injury Association Tampa VA Minimal competency recommendations for disorder of 

consciousness rehabilitation

Instructional 

course

International Brain Injury Association Tampa VA Relationship of mental healthcare utilization and suicidal 

behaviors and ideation at 1-year post traumatic brain 

injury (TBI): A VA TBI Model Systems study (VA TBIMS)

Poster

International Brain Injury Association Tampa VA Sleep architecture in acquired brain injury rehabilitation 

patients with mild, moderate and severe sleep apnea. 

brain injury

Poster

International Brain Injury Association Tampa VA The influence of traumatic brain injury severity on 

health-related quality of life in caregivers of a service 

member or veteran with traumatic brain injury

Poster

International Brain Injury Association SAMMC Diffusion imaging findings in U.S. service members with 

mild traumatic brain injury and post-traumatic stress 

disorder

Poster

Name of Conference Site Lead Title Type

International Brain Injury Association SAMMC Local diffusion imaging connectometry in United States 

service members with mild TBI and PTSD

Abstract

International Neuropsychological 

Society

WRNMMC A Cross-sectional perspective of neurocognitive 

outcome from military-related mild-moderate TBI in the 

sub-acute recovery period and 1-year post-injury

Poster

International Neuropsychological 

Society

WRNMMC Case series analysis of the natural history of 

neurocognitive performance following moderate, severe, 

and penetrating traumatic brain injury in U.S. military 

service members

Poster

International Neuropsychological 

Society

WRNMMC Comparing neuropsychological outcome in active duty 

soldiers following complicated, uncomplicated, and 

equivocal mild traumatic brain injury

Poster

International Neuropsychological 

Society

WRNMMC Neuropsychological outcome following moderate, 

severe, and penetrating traumatic brain injury in U.S. 

military service members

Poster

International Neuropsychological 

Society

WRNMMC Predictors of neurobehavioral outcome 2 years following 

mild-moderate traumatic brain injury

Poster

International Neuropsychological 

Society

WRNMMC The natural history of psychological symptoms following 

moderate, severe, and penetrating traumatic brain injury 

in military service members: A case series analysis

Poster

International Neuropsychological 

Society

WRNMMC The relationship between self-reported postconcussion 

symptoms with tau and amyloid-beta 42 levels following 

military-related mild-moderate traumatic brain injury

Poster

International Neuropsychological 

Society

Fort Bragg Percentage of low neurocognitive scores as a useful 

embedded performance validity measure

Poster

Kaiserslautern High School Resiliency 

Forum

LRMC BIAM presentation on thinking ahead to build a better 

brain presentation

Presentation

Military Health System Research 

Symposium (MHSRS)

Camp 

Pendleton

Acute, sub-acute, and chronic effects on neuromotor 

performance after repeated low-level blast exposure

Poster

MHSRS Camp Lejeune Analyze predict overcome: Using analytics to improve 

outcomes

Poster

MHSRS Minneapolis 

VA

Assessment of neural dynamics in severe traumatic 

brain injured patients with disorders of consciousness

Presentation

MHSRS Camp 

Pendleton

Assessment of neurological changes and monitoring of 

blast exposure in combat training environments

Poster

MHSRS Minneapolis 

VA

Assessment of progressive neuron loss in veterans with 

mild TBI by optical coherence tomography (OCT) of 

inner retinal layer thickness over time

Poster
62 DVBIC Annual Report 2017 DVBIC Annual Report 2017 63

Name of Conference Site Lead Title Type

MHSRS Richmond VA Characterizing improvement profiles in the prospective 

clinical tracking form study at one and two years postinjury

Abstract and 

presentation

MHSRS Camp 

Pendleton

Comparison of health outcome measures in service 

members at the national intrepid center of excellence 

(NICoE) and concussion care clinic (CCC), Naval 

Hospital Camp Pendleton (NHCP)

Poster

MHSRS SAMMC Depression among military service members with a 

history of mild TBI

Poster

MHSRS Tampa VA Do civilian epidemiologic studies inform military TBI 

epidemiology? A comparison of the VA and NIDILRR 

TBI Model System cohorts

Presentation

MHSRS Camp Lejeune Effectiveness of a mindfulness-based group therapy 

(MBGT) integrative restoration (iRest) for active duty 

personnel with mild traumatic brain injury

Poster

MHSRS Camp 

Pendleton

Effectiveness of cognitive behavioral therapy for 

insomnia (CBT-I) in mTBI

Poster

MHSRS Tampa VA Employment stability in veterans and service members 

with TBI

Poster

MHSRS Camp Lejeune Environmental monitoring in training settings: Readings 

from blast sensors data from multiple SMAW training 

sessions

Poster

MHSRS Fort Carson Epidemiology and prognosis of mild traumatic brain 

injury in returning soldiers: A cohort study

Poster

MHSRS Fort Bragg Examining new composite scores for the ANAM4 TBIMIL batteryPoster

MHSRS Minneapolis 

VA

Executive functioning is associated with levels of 

symptom reporting in veterans with mild traumatic brain 

injury

Poster

MHSRS Camp Lejeune Getting away from it: The use of blast sensors to 

monitor overpressure in breaching range training

Poster

MHSRS Camp Lejeune Healing traumatic memories of war through art therapy Poster

MHSRS SAMMC Impact of pre- and post-injury socioeconomic and 

psychosocial adversity on symptoms and symptom 

severity following mild traumatic brain injury

Poster

MHSRS SAMMC Impact of resilience and pre- and post-injury 

socioeconomic and psychosocial adversity on 

symptoms and symptom severity following mild 

traumatic brain injury

Poster

Name of Conference Site Lead Title Type

MHSRS Fort Bragg Impact of sleepiness on visuomotor processing speed 

in service members with and without a mild traumatic 

brain injury

Poster

MHSRS Tampa VA Incidence, trajectory, and predictors of obesity in 

Veterans and Service Members with TBI: A VA TBI 

Model Systems study

Poster

MHSRS Camp 

Pendleton

Intercorrelation between sleep quality, neurobehavioral 

symptoms, and PTSD in a clinical sample of traumatic 

brain injury patients

Poster

MHSRS Tampa VA Interim analysis of volumetric and diffusion imaging 

findings from 287 Veterans participating in the Chronic 

Effects of Neurotrauma Consortium (CENC) study

Poster

MHSRS WRNMMC 

and Camp 

Pendleton

Intracranial abnormalities are associated with reduced 

reporting of neurobehavioral symptoms among active 

duty service members with moderate-to-severe 

traumatic brain injury

Presentation

MHSRS NMCSD Primary care practices and perceptions in care for 

service members with acute concussion: Does reflection 

in a mixed-method study modify practice?

Poster

MHSRS NMCSD Progressive return to activity after concussion: The 

evolution of training to primary care providers in a mixed 

method study

Presentation

MHSRS NMCSD Recovery trajectory in acute concussion: importance of 

adherence to progressive return to activity guidelines for 

activity

Presentation

MHSRS Tampa VA Relationship stability after traumatic brain injury among 

Veterans and Service Members: A VA TBI Model 

Systems study

Poster

MHSRS NMCSD Retrospective analysis: Using lumosity in the treatment 

of mild traumatic brain injury

Poster

MHSRS Camp 

Pendleton

Self-Reported Alcohol Use Among Active Duty Service 

Members Referred Traumatic Brain Injury Screening

Poster

MHSRS Tampa VA Suicide-related ideation and attempts at 1-year post 

traumatic brain injury (TBI): A VA TBI Model Systems 

study

Poster

MHSRS Tampa VA Supervision needs following Veteran and Service 

Member moderate to severe traumatic brain injury: A VA 

TBI Model Systems study

Poster

MHSRS LRMC TBI - rehab management of concussion/mTBI - Pediatric 

Concussion Evaluation in Europe: Military Medical 

Providers Leading The Way

Abstract
64 DVBIC Annual Report 2017 DVBIC Annual Report 2017 65

Name of Conference Site Lead Title Type

MHSRS LRMC Telehealth/virtual health/remote monitoring in the MHS: 

Pilot for TBI telehealth management

Abstract

MHSRS Palo Alto Telomere length is an indicator of complex mental health 

symptoms in Veterans

Poster

MHSRS Richmond VA The Chronic Effects of Neurotrauma Consortium 

(CENC) multi-center observational study: Interim, crosssectional analysis comparing participants with and 

without historical mTBI

Presentation

MHSRS Camp 

Pendleton

The effect of repetitive low level blast exposure on 

executive functioning

Presentation

MHSRS NMCSD The fusion project: Multi-modal neurocognitive 

assessment of traumatic brain injury

Presentation

MHSRS Camp 

Pendleton

The impact of lifetime traumatic brain injury and lifetime 

blast exposure history on neurobehavioral symptoms 

and neuropsychological functioning of special operation 

military personnel

Poster

MHSRS SAMMC The influence of medical evaluation board status on 

symptom reporting among service members with 

traumatic brain injury

Poster

MHSRS Fort Bragg The relationship between low scores on ANAM-4 

TBI-MIL and the total score from the neurobehavioral 

symptom inventory (NSI)

Poster

MHSRS Fort Carson To exclude or not to exclude: The conundrum of effort 

measures in mTBI populations

Poster

Minneapolis VA Research Day Minneapolis 

VA

Identifying predictors of clinical response to deep 

transcranial magnetic stimulation in medication 

refractory depression with co-morbid traumatic brain 

injury

Poster

National Academy of Neuropsychology Fort Bragg Challenges associated with TBI research and clinical 

practice in the DoD and VA: Diagnostics, pathology, and 

ethics

Presentation

National Academy of Neuropsychology Fort Bragg Results from the Defense and Veterans Brain 

Injury Center’s Head to Head Study comparing four 

computerized neurocognitive assessment tools 

(NCATs): ANAM4, CNS-VS, CogState, and ImPACT

Presentation

National Academy of Neuropsychology WRNMMC The Relationship between plasma tau and 

neurocognition following mild traumatic brain injury: A 

longitudinal Analysis

Poster

National Academy of Neuropsychology WRNMMC The relationship between self-reported cognitive 

recovery following injury and neuropsychological test 

results

Poster

Name of Conference Site Lead Title Type

National Academy of Neuropsychology WRNMMC The relationship between white matter hyperintensities, 

neurocognitive performance, and white matter integrity 

following mild traumatic brain injury

Poster

National Capital Area TBI Research 

Symposium

Richmond VA Blast versus non-blast traumatic brain injury: 

Comparison of following inpatient rehabilitation 

functional outcomes

Poster

National Capital Area TBI Research 

Symposium

Richmond VA Motor impulsivity predicts worsening depression and 

PTSD symptomatology at 1-year follow-up in blastexposed service members

Poster

National Capital Area TBI Research 

Symposium

Fort Bragg & 

Fort Carson

Predictors of post-concussion symptoms (PCS) 

12-months post-deployment in soldiers with and without 

mild traumatic brain injury (mTBI): A prospective cohort 

study

Presentation

National Capital Area TBI Research 

Symposium

Camp Lejeune Software enhanced data analysis Poster

Rehabilitation Psychology Annual 

Conference

Tampa VA Relationship of sleep apnea severity and Outcome: A 

VA TBI Model System study

Poster

Special Operations Medical 

Association Scientific Assembly

NMCSD A multi-level mixed methods approach to study the 

effectiveness of a primary care progressive return to 

activity protocol after acute mild traumatic brain injury/

concussion in the military

Poster

TBI Research Forum:

Detection and Treatment of Sensory 

Deficits

Palo Alto Peripheral neurotrophic factor Signaling with chronic 

mild traumatic brain injury

Poster

The American College of Rehabilitation 

Medicine Annual Meeting

Camp 

Pendleton

The effect of repetitive low level blast exposure on 

memory

Presentation

The Annual Meeting of the American 

Academy of Clinical Neuropsychology

Minneapolis 

VA

Symptom validity screening measures in non-treatment 

seeking veteran samples

Poster

The Annual Minneapolis VA Research 

Symposium

Minneapolis 

VA

The VA traumatic brain injury Model Systems: 2017 

update

Poster

The National Academy of 

Neuropsychology

Fort Bragg Examining a new ANAM4 TBI-MIL composite score in 

soldiers with and without mTBI

Abstract

The National Academy of 

Neuropsychology

Fort Bragg Using postconcussive symptoms as a grouping variable 

to compare performance on one of four computerized 

neurocognitive assessment tools (NCAT) in soldiers with 

and without mild traumatic brain injury (mTBI)

Abstract

Uniformed Services Academy of 

Family Physicians

HQ Brain Injury - The Visible ‘Invisible’ Wound Presentation
66 DVBIC Annual Report 2017 DVBIC Annual Report 2017 67

Name of Conference Site Lead Title Type

University of Minnesota Clinical and 

Translational Science Institute (CTSI)

Minneapolis 

VA

Non-invasive brain stimulation modifies a brain network 

that supports abstinence during alcohol use disorder 

recovery

Poster

University of Minnesota Institute 

for Engineering in Medicine (IEM) 

Neuromodulation Symposium

Minneapolis 

VA

Reducing impulsivity with transcranial direct current 

stimulation (tDCS) and a cognitive task

Poster

University of Minnesota 

Neuromodulation Symposium

Minneapolis 

VA

Identifying predictors of clinical response of medication 

refractory depression with comorbid mild TBI to deep 

TMS

Poster

USUHS Research Day Fort Carson Predictors of post-concussion symptoms (PCS) 

12-months post-deployment in soldiers with and without 

mild traumatic brain injury (mTBI): A prospective cohort 

study

Poster

VA Center for Innovation Demo Day Tampa VA VA SmartHome app Presentation

VA Health Services Research and 

Development

Tampa VA Advances in TBI care resulting from VA and TBI Model 

Systems collaboration

Cyberseminar

VA SLP HQ Development of the clinical recommendation update 

for rehabilitation of cognitive dysfunction in service 

members and veterans with mild to moderate TBI

Virtual 

presentation

VISN 21 Palo Alto Accurate diagnostics and innovative treatments for TBI Presentation

Womack Army Medical Center 

Research Symposium

Fort Bragg A comparison of ANAM4 performance between soldiers 

with and without post-concussive symptoms

Poster

Womack Army Medical Center 

Research Symposium

Fort Bragg Agreement between methods of calculating 

“impairment” on the ANAM4

Poster

Womack Army Medical Center 

Research Symposium

Fort Bragg Does it matter? The relationship between subjective 

test-taking experiences and overall performance on 

neurocognitive assessment tools in service members 

with mild traumatic brain injury

Poster

Womack Army Medical Center 

Research Symposium

Fort Bragg Primary outcomes from Fort Bragg’s Head to Head 

Study of four computerized neurocognitive assessment 

tools (NCATS) in service members with and without mild 

traumatic brain injury

Presentation

Womack Army Medical Center 

Research Symposium

Fort Bragg Which test do you prefer? Differential satisfaction 

measures of testing experience across computerized 

neurocognitive assessments in service members with 

mild traumatic brain injury

Poster

Womack Army Medical Center 

Research Symposium

Fort Bragg Does the type of computer used affect reaction time 

measurement error on the ANAM4? A comparison of 

three computer platforms

Poster

Many people at DVBIC’s headquarters, across its network sites, 

and in partnerships with other agencies and organizations 

contributed knowledge, experience and expertise to DVBIC over 

the past 25 years. Their contributions supported research, clinical 

affairs, education, operations, communications and administration. 

DVBIC’s success would not have been possible without them. 

Acknowledgements

■ Abbott, Zack

■ Abdullah, Alla

■ Adams, Hannah

■ Adamson, Maheen

■ Agimi, YII

■ Aheart, Ivon

■ Ahn, Chung

■ Ahrens, Angelica

■ Aiken, Merrie

■ Albott, Sophia

■ Alcorta, Melissa

■ Alexander, Michael 

■ Alfano, Keith

■ Allen, John

■ Alloka, Joyce

■ Almendarez, Cristina

■ Alvarado, Myrlyn 

■ Alvarez, John

■ Alvarez, Maria 

■ Amador, Ricardo

■ Amick, Melissa

■ Amos, Tiffany

■ Anderson, Mary-Lin

■ Andrews, Anne

■ Andrews, Taylor

■ Andrews, Melissa

■ Arango, Jorge

■ Arasin, Gary

■ Armondo, Rocco

■ Armstrong, Michael

■ Armstrong, Regina

■ Arrieux, Jacques

■ Atkinson, Steve

■ Aune, Ezra

■ Avery, Eleanor 

■ Avery, Jack

■ Baah, Emmanuel

■ Babakhanyan, Ida

■ Baggett, Patricia 

■ Bailie, Jason

■ Bailin, Deborah

■ Baker, Gayle

■ Ball, Stephanie

■ Baloun, Chantel 

■ Bamdad, Michael 

■ Barak, Jeff

■ Bardossek, Stephanie

■ Barnhart, Elizabeth

■ Barrett, Laura 

■ Barth, Jeffrey

■ Barton, Tina

■ Basham, Angela

■ Bastolla, Angela

■ Baugh, Laura

■ Baxter, Marian 

■ Beach, Margaret

■ Beasley, Paulette 

■ Belanger, Heather 

■ Belard, Jean-Louis

■ Bell, Kathleen

■ Bell, Linda

■ Bell, Randy

■ Bellini, Paula

■ Belt, Carlena

■ Benson, Mark

■ Benton, Danielle

■ Berman, Scott

■ Berry, Tiaisha

■ Bestman, William 

■ Betthauser, Lisa

■ Betts, Aaron 

■ Bhagwat, Adit

■ Bhatti, Elena

■ Bhowmik, Rahul

■ Black, Catherine

■ Black, Natalia 

■ Blahnik, Melanie 

■ Blankenship, James 

■ Bleiberg, Joseph

■ Blough, Adrian 

■ Boddie, Daryl 

■ Bohensky, Eileen

■ Bond, Marcia 

■ Bondarenko, Jennifer

■ Bondon, Cori

■ Bookwalter, Alissa

■ Bowles, Amy

■ Bowman, Angela 

■ Boyce, Jennifer

■ Boyd, Cynthia

■ Boyd, Gillian

■ Braatz, Samantha

■ Bradley, Dawn

■ Branson, Mariah

■ Braue, Rose

■ Braverman, Steve

■ Brazaitis, Katherine

■ Breaux, Kenneth

■ Brenner, Lisa 

■ Bressler, Karen

■ Brewer, Karl

■ Brickell, Tracey

■ Bridge, Tisha 

■ Brierley-Bowers, Patricia 

■ Briscoe, Shelly

■ Britigan- MacLennan, 

Diane 

■ Brodd, Ed 

■ Brogdon, Latoya

■ Brookwalter, Allisa

■ Brown, Dennis

■ Brown, Fred 

■ Brown, Herbert 

■ Brown, Marice

■ Brown, Melissa

■ Browne, Richard 

■ Bruno, John

■ Budd, LaVerne 

■ Buenaver, Luis 

■ Bunce, Lisanne

■ Bunner, Anne

■ Burgos, Spencer 

■ Burke, Theresa

■ Byrd, Kenna

■ Cabansagan, Mary-Anne

■ Cabelka, Carrie

■ Caldwell, Katherine

■ Callaway, Abigail

■ Camasta, Timothy

■ Camelo Lopez, Vanessa

■ Cameron, Kenneth

■ Camilletti, Sandra

■ Camp, Brittany

■ Campbell, Leonard

■ Campbell-Kotler, 

Margaret

■ Cardona, Lia

■ Carne, William 

■ Carson, Molly

■ Cartier, Joel 

■ Cartwright, Grace

■ Casey, Kaitlyn

■ Castaneda, Annabel

■ Castillo, Tina

■ Catalan, Roberto

■ Cathlin, Charles 

■ Caudill, Telina

■ Cecchini, Amy

■ Ceita, Miguel

■ Cernich, Alison

■ Cerullo, Tina

■ Cervantes, Raymond 

■ Chae, Heechin

■ Chase, Carla 

■ Chavarria, Jennifer

■ Chavez, Bianca

■ Chavez, Javier

■ Chervinsky, Alexander 

■ Cheselka, Janelle

■ Cheung, Carrie

■ Cheung, Catherine

■ Chiasson, Sheryl

■ Chidumeokoro, Nkeena

■ Childs, Emily 

■ Choi, Min Jin

■ Choi, Stacy 

■ Christ, Penny

■ Chronis, Mark

■ Cifu, David 

■ Clancy, Doris

■ Clark, Tamara

■ Clarke, Margaret
68 DVBIC Annual Report 2017 DVBIC Annual Report 2017 69 ■ Clawson, Lance ■ Clegg, Rhonda ■ Clory, Tiffany ■ Coats, Michael ■ Cockrill, Jerry ■ Cohen, Jessica ■ Cohn, Bob ■ Cole, Danielle ■ Cole, Reginald ■ Cole, Wesley ■ Collins, Billy ■ Collins, Dawn ■ Collins, Rose ■ Comins, Kara ■ Commock-Proctor, 

Nadine

■ Conard, Jessica ■ Concklin, Brent ■ Conley, Tyjen ■ Conrad, Amy ■ Conrad, Tia ■ Cooper, Douglas ■ Corcoran, Jennifer ■ Cordry, David ■ Corin, Nina ■ Cornish, Brant ■ Cornis-Pop, Micaela ■ Cornwell, Robin ■ Coronel, Helen ■ Corrigan, John ■ Cottingham, Maria ■ Coyle, Mary ■ Cozzarelli, Tara ■ Craig, Amy ■ Criglar, Darren ■ Cripps-Wasmer, 

Antonia 

■ Crocker, Stanley ■ Crocker, Jillian ■ Cross, Betty ■ Crowder, Alicia ■ Crowley, John ■ Cullen, Karen ■ Cullen-Schreiber, 

Maren

■ Cummings, Shannon ■ Curley, Kenneth ■ Curtiss, Glenn ■ Dahdah, Marie ■ Dale, Mary-Alice ■ Dame, Kathryn ■ Dandenault, Michael ■ Dandurand, Lisa ■ Daniel, Shirley ■ Darkangelo, Barbara ■ Darlene, Zeckser ■ Date, Elaine ■ Daugherty, Richard ■ DaVanzo, John ■ David, Panakkal ■ David, Williams ■ Davies, Cathleen ■ Davis, Brenda ■ Davis, Doris

■ Davis, Sydney ■ Davis-Scott, Sylvia ■ Dawn, Collins ■ Day, Brandy ■ De Mayo, William ■ Dean, April ■ DeBiase, Debra ■ DeCicco, Vincent ■ DeGraba, Thomas ■ Delacruz, Aracelis ■ Dell, Kristine ■ Dennis, Donna ■ Dennison, Elizabeth ■ Deressa, Tesfaye ■ Dickerson, Donald ■ Dickerson-Odoms, Lori ■ Dickmann, Patricia ■ Diego-Monasterio, 

Carlos

■ Dierker, Melissa ■ Dietz, Megan ■ Dilay, Angelica ■ DiPatrizio, Pamela ■ Dixon, Kedisha ■ Doble, Nathan ■ Donahue, Carolyn ■ Doncevic, Selina ■ Donnell, Allison ■ Donovan, Mary ■ Donovan, Michelle ■ Doolitte, Kellie ■ Dorsey, Wanda ■ Dos Passos, Jordan ■ Doucette, Brittany ■ Dougherty, David ■ Dowler, Kristina ■ Doyle, Kat ■ Dozier, Monique ■ Drake, Angela ■ Drennon, Ann Marie ■ Driscoll, Angela ■ Du, Connie ■ Dubrow, Anne ■ Duckworth, Josh ■ Dugan, Sean ■ Dunford, John ■ Dunkelberg, Martha-Jo ■ Durr, Jessica ■ Dyrek, Amanda ■ Eapan, Blessen ■ Earyes, Lauren ■ Echols, Ruthetta ■ Ecklund, James ■ Ecklund, Sally ■ Eddings, Rory ■ Eden, Adina ■ Edmonson, Laurie ■ Edson, Roslyn ■ Edwards, Ian ■ Edwards, Julian ■ Edwards, Tamika ■ Eggen-Thornhill, Sarah ■ Ehlers, Stephanie ■ Ekanayake, Vindhya

■ Ellenbogen, Richard ■ Ellicott, Alex ■ Ellis, Lisa ■ Elzie, Dale ■ Engel, Scot ■ Eppan, Blessen ■ Erickson, Marleigh ■ Escolas, Sandra ■ Eshel, Inbal ■ Eshera, Yasmine ■ Ettenhofer, Mark ■ Evans, Maisha ■ Fairbank, Dylan ■ Faison, Derrick ■ Fanello, Tina ■ Fargus, Jamie ■ Feliciano, Mary ■ Fender, Alex ■ Ferdosi, Hamid ■ Ferramosca, Mary ■ Ferrigno, Lisa ■ Festoff, Barry ■ Fideli, Ulgen ■ Fields, Kelly ■ Fildman, Danielle ■ Finch, Kimberly ■ Finkel, Alan ■ Finn, Jacob ■ Finstad, Samantha ■ Firestone, Amy ■ Fischer, Michael ■ Fiscus, Timothy ■ Fishel, Mark ■ Fisher, Mary ■ Fisher-Herbst, Mindy ■ Fitzpatrick, Pamela ■ Fitzpatrick, William ■ Fleming-Kieffer, 

Kathryn 

■ Fobbs, Archie ■ Forbes, Leila ■ Foreman, James ■ Fortier, Frank ■ Foster, John ■ Fraley, Tracy ■ Fram, Sheila ■ Francisco, Dorcas ■ Franke, Laura ■ Franklin, Melissa ■ Frankowski, Ralph ■ Fraser, Jamie ■ Frazier, Mallory ■ Frederick, Anthony ■ French, Louis ■ Freud, Jennifer ■ Friend, Chantele ■ Friend, Lauren ■ Friss, Carli ■ Fryer, Jay ■ Fuentes, Andrea ■ Full, Jan ■ Furst, Janice ■ Fyock, Maureen ■ Fyock, Patricia

■ Gajer, Arielle ■ Gall, Sarah ■ Gallager, Jennifer ■ Gallardo, Susan ■ Gano, Amanda ■ Garcia, Olivia ■ Garifo, Richard ■ Gartman, Truman ■ Gartner, Rachel ■ Garvin, Avila ■ Geer, Michelle ■ Gentz, Carolyn ■ George, Karyn ■ Gephart, Douglas ■ Gibbons, Sarah ■ Gierke, Molly ■ Gil, Evelyn ■ Gilbreath, Jessica ■ Gill, Ranjodh ■ Gillow, Kelly ■ Gilmore, Casey ■ Girard, Philip ■ Glazer, Megan ■ Glenn, Scott ■ Gold, Joanne ■ Goldin, Ruth ■ Goldman, Sarah ■ Gomez, Laticia ■ Gonzalez, Gabriel ■ Gonzalez, Gina ■ Goode, Marina ■ Goodrich, Lorraine ■ Goudy, Lauren ■ Gourdin, Kelly ■ Grafman, Jordan ■ Graham, Ashley ■ Grajzel, Katalin ■ Grammer, Geoffrey ■ Grants, Joy ■ Grass, Eileen ■ Graves, Marie ■ Gray, Carlson ■ Gray, Max ■ Green, Eric ■ Green-Oakes, Gabrielle ■ Gregory, Emma ■ Gregory, Marcelia ■ Grieger, Thomas ■ Grimes, Jamie ■ Grinnon, Stacie ■ Grissom, Joyce ■ Gross, Randal ■ Groswasser, Zeev ■ Groves, Kenesha ■ Gruber, Jon ■ Grudzien, Kathleen ■ Guffey, Sumer ■ Guidibande, Radha ■ Guise, Natalie ■ Gulish, Tina ■ Gunn Westland, Amber ■ Halverson, Marjorie ■ Hammer, Mike ■ Handelman, Todd■ Hardiman , Jim ■ Hardy, Tiffany ■ Hargadon, Janet ■ Harris, Ervin ■ Harris, Odette ■ Harris, Barbara ■ Harvey, Sally ■ Haskin, Adam ■ Hawkins, Chelsa ■ Heard, Patricia ■ Heck, Stephen ■ Heesakker, Justin ■ Heilman, Kerri ■ Heim, Sherri ■ Heimiller, Jerry ■ Heintz, Brooke ■ Helmick, Katherine ■ Hendrix-Bennet, Felicia ■ Henry, Deborah ■ Hershorin, Jacob ■ Herzog, Maya ■ Hill, Candace ■ Hill-Pryor, Crystal ■ Hilton, Mark ■ Hinderlander, Katheleen ■ Hinds, Sidney II ■ Hinds, Sidney III ■ Hintz, Cindy ■ Hoffman, Stuart ■ Holland, Sherray ■ Hollman, Marquita ■ Hollnagel, Caroline ■ Holt, Ashley ■ Holt, Shealyn ■ Holzinger, Jayne ■ Hoot, Michelle ■ Hopewell, Alan ■ Hopewell, Clifford ■ Hosadurga, Kiran ■ Hovda, David ■ Hsu, Tracy ■ Hu, Vince ■ Hubbard, Ada ■ Huckabay, Jessica ■ Huey, Judith ■ Huffman-Cerullo, Tina ■ Hughes, Latressa ■ Hungerford, Lars ■ Hursey, Melodee ■ Hursey, Karl ■ Husain, Marie ■ Hussain, Miriam ■ Hutchens, Landon ■ Hutchinson, Jamel ■ Ibie, Monica ■ Ibrahim, Angela ■ Ivany, Christopher ■ Iverson, Grant ■ Ivins, Brian ■ Jablon, Jeff ■ Jacobs, William ■ Jaffee, David ■ Jaffee, Michael ■ Jahosky, Jeanne■ Jain, Anjali ■ James, Crystal ■ Janik, William ■ Janos, Alicia ■ Jensen, Michelle ■ Jnolewis, Julian ■ Johnson, Felicia ■ Johnson, Thomas ■ Johnson, Wayne ■ Johnson, Lauren ■ Johnson, Nicolle ■ Johnson, Tiffany ■ Johnson-James, Denise ■ Johnstone, George ■ Jolly, Marianna ■ Jonas, Bruce ■ Jones, Darrin ■ Jones, Linda ■ Jones, Thomas ■ Jones, Jamesia ■ Jones, Lynn ■ Jones, Thomas ■ Jones-Gurga, Jean ■ Jordan, Bernice ■ Jorgensen-Wagers, 

Kendra

■ Jung, Corinne ■ Kahn, Idith ■ Kaltenbaugh, Shanna ■ Kamal, Sianat ■ Kamaleddine, Mariana ■ Kane, Robert ■ Kang, Xiaojian ■ Kaplan, Dorothy ■ Kardon, Randy ■ Karl, Maryanna ■ Karpel, Heather ■ Kawahara, Renee ■ Kean, Jacob ■ Kelley, Elizabeth ■ Kelly, Charles ■ Kelly, Nichole ■ Kemmer, Sara ■ Kendall-Robbins, Athena ■ Kennedy, Jan ■ Kennedy, Susan ■ Kent, Charo ■ Khanna, Ashwani ■ Khohkar, Bilal ■ Kielbasa, Alicia ■ Kilada, Sandy ■ Kim, Daniel ■ Kim, Michael ■ Kim, Nari ■ Kim, Yeon Ho ■ Kirk, Susan ■ Kirsh-Darrow, Lindsey ■ Kitchen, Deniz ■ Klataska, Katherine ■ Klimas, Joseph ■ Kluckman, James ■ Knapp, Patricia ■ Knoll, Alex ■ Knuti, Mary Ellen

■ Kofford-Barrow, Shalece ■ Kohn, Sarah ■ Konchan, Carol ■ Kopf, Heather ■ Kostelnik, Claire ■ Kovach, Thomas ■ Kovachick, Mary ■ Kowler, Daniel ■ Kraft, Joan ■ Kreutzberger, Melissa ■ Krishnaswamy, Jennifer ■ Kuhn, Charlene ■ Kuhn, Terry ■ Kukola, James ■ Kusar, Larisa ■ Kvandal, Aimee ■ Labatte, Lawrence ■ Labbs, Megan ■ LaBrecque, Fred ■ Labutta, Robert ■ Lacassin, Lara ■ Lam, Annemarie ■ Lam, Charles ■ Lamberty, Greg ■ Landolo-Wix, Ronell ■ Langbein, Jean ■ Lange, Rael ■ Langon, Dytrea ■ Lara, Maria ■ Larin, Enrique ■ LaRuffa, Gia ■ Lastra, James ■ LaTour, James ■ Lattimore, Theresa ■ Laurenson, Nancy ■ Law, Wendy ■ Lawrence, Gloria ■ Lazarus, Rachel ■ Leake, L. G. ■ Leal, Felix ■ Lee, Phoebe ■ Lee, Eunha ■ Leggieri, Michael ■ Leonard, Patricia ■ Letlogetswe, Naledi ■ Levie, Katie ■ Levin, Harvey ■ Levine, Gary ■ Levreault, Laura ■ Lew, Henry ■ Lewis, Jeffrey ■ Lewis, Kyle ■ Lewis, Micheal ■ Lewis, Sonya ■ Lewis, Steven ■ Lewis, Tiffany ■ Li, Zoe ■ Licona, Nytzia ■ Lillie, Aimee ■ Lim, Kelvin ■ Lind-Zajac, Tara ■ Ling, Geoff ■ Lipinski, Mary Fran ■ Lippa, Sarah■ Lita, Daniela ■ Little, Reanetta ■ Litzinger, Brandy ■ Liu, Kristina ■ Livingston, Scott ■ Llewellyn, David ■ Lockwood, Courtney ■ Loftin, Megan ■ Logan, Sherry ■ Long, Margret ■ Lord, Jean ■ Losonky, Ryan ■ Lott, Zakia ■ Loughlin, Jennifer ■ Lowe, Cecile ■ Lowe, Lynne ■ Loyola, Laura ■ Lu, Lisa ■ Lu, Wei ■ Lundgren, Sandra ■ Luo, Qian ■ Luton, Margie ■ Lutumba, Lukondi ■ Lux, Warren ■ Lynn, Emily ■ Lynwood, Jhaminique ■ MacAulay, Jim ■ MacDonald, Margaret ■ Mack, Evelyn ■ MacLennan, Donald ■ Mafnas, Jennifer ■ Magee, James ■ Maggi, Frank ■ Magruder, Susannah ■ Mahatan, Heidi ■ Main, Keith ■ Majolagbe, Folayemi ■ Majors, Patricia ■ Malik, Saafan ■ Mallory, Helen ■ Manchester, Julianne ■ Manion, Sean ■ Mann, Carmelinda ■ Manning-Franke, Laura ■ Mansfield, Jay ■ Manthie, Martha ■ Manza, Emily ■ Marden, Tara ■ Marion, Donald ■ Marks, Jenny ■ Marshall, Kathyrn ■ Marshall, Scott ■ Marshall, Michael ■ Martin, Alex ■ Martin, Kyle ■ Martin, Suzanne ■ Martinez, Ashley ■ Martinez, Kristina ■ Martinez-Sanchez, Rocio ■ Maryniak, Thomas ■ Mason, Randall ■ Massengale, Jill ■ Massetti, Silvia ■ Masterson, Lauren
70 DVBIC Annual Report 2017 DVBIC Annual Report 2017 71

■ Maxfield-Panker, 

Stephanie

■ Mayes, Zaida

■ McBride, Kathryn

■ McCall, Toni

■ McClean, Jeffrey 

■ McCrea, Michael 

■ McDonald, Scott

■ McEntire, B. Joseph

■ McGann, Linda 

■ McGee, James

■ McGee, Stacy

■ McGee, Wesley

■ McGuire, Dawn

■ McGuire, Kathryn

■ McGuire, Steve

■ McIntosh, Elfina

■ McKenzie-Hartman, 

Tamara

■ McKinney, Gary

■ McKnight, Pamela

■ McLaughlin, Erin

■ McMillan, Henry 

■ McNamee, Shane

■ McQueen, Luke

■ Mealey III, John

■ Medellin, Reyna

■ Mehr, Julie

■ Melin, Mattie

■ Mellin, Laura

■ Mells, Chanedra

■ Messer, Tracy

■ Metharu, Tegh

■ Meyer, Kimberly 

■ Michael, P. Lynn 

■ Miles, Wanda

■ Miles-Mooney, Mikelle

■ Miller, Bridget

■ Miller, Cate

■ Miller, Kelly

■ Miller, Ladonna

■ Miller, Leigh

■ Mills, Chmaika

■ Mills, Bethanne

■ Mincher, Robyn

■ Mizrahi, Trina

■ Mohres, Kim

■ Molchan, Deidre

■ Molock, Timothy

■ Montgomery, Ambi 

■ Montgomery, Meagan

■ Montgomery, Richard

■ Montgomery, Solomon

■ Mooney, Scott

■ Moore, Celine

■ Moore, David 

■ Morales, Maritza

■ Morgan, Jessica

■ Morris, Patricia

■ Mortensen, Johnnie

■ Moses, Jason

■ Mosley, Angela

■ Mosley, Lanesha

■ Moy Martin, Elisabeth

■ Muehling, Lauren

■ Mueller, Sarah

■ Mullins, Keri

■ Mullins, Lynita

■ Mullins, Rebecca

■ Mullins, Stuart 

■ Muncy, Cynthia

■ Munns, Lura

■ Murray, Bridget

■ Myhre, Betsy

■ Myhres, David

■ Nacev, Vladimir

■ Nakano, Erline

■ Nance, Timothy 

■ Nasah, Erika

■ Nasr, Melodie

■ Ndege, Vanessa

■ Neal, Beth

■ Neeley, Thomas

■ Neely, Edward

■ Neher, Roger

■ Neiderer, Cecilla

■ Nelson, Brent

■ Nelson, Lonnie

■ Nelson, Rachel 

■ Nevo, Lev

■ Newcomb, Joseph

■ Nguyen, Ryan

■ Nicholas, Christopher

■ Nichols, Michelle

■ Nidiffer, Donald

■ Niner, Denise 

■ Noon, Rose

■ Nora, Diana

■ Notyce, Corina

■ Oakes, Karen

■ Oberst, Richard

■ Oden, KaSaundra

■ Odukoya, Keandra

■ Ofili, Nneka

■ O’Hehir, Lori

■ Ommaya, Alexander

■ Orand, Janet 

■ Oribabor, Jessica

■ Orsargos, Melissa

■ Otero, Jose

■ Page, Sandra

■ Pai, Ajit

■ Pajak, Thaddeus

■ Pancholi, Sonal

■ Panetti, Leigh

■ Pansegrau, Morgan

■ Parecki, Karen 

■ Paredes, Aida

■ Parham, Cheryl

■ Parkins, Maya

■ Parkinson, Glenn

■ Pasquel, Tamara

■ Pasquina, Paul 

■ Paul, Cheryl

■ Pazdan, Renee

■ Pearman, Clinton

■ Peck, Sharon

■ Pegg, Phil

■ Percy, Julian

■ Perdigon, Melben

■ Perez Licona, Nytzia

■ Perta, Angela

■ Peters Hyde, Julianne

■ Peterson, Michelle

■ Petro, Barbara

■ Pfalz, Ashley

■ Pfannenstiel, William 

■ Pickett, Patrick

■ Pickett, Treven

■ Picon-Nieto, Linda 

■ Pigford, Nakita

■ Pike, Darlene

■ Pine, Mary 

■ Pingel, Karyn

■ Pink-Golden, Judie

■ Pinkney, Gerald

■ Piper, Benjamin

■ Pitotti, Rebecca

■ Pitsch, Deborah

■ Pittman, Beth 

■ Pizzano, Brittany

■ Plankers, Alexia 

■ Plata, Michelle

■ Plautz-Linner, Rhonda 

■ Pletcher, Elizabeth

■ Podraza, Bonnie

■ Polite, LaTonya

■ Polite, Loretta 

■ Pond, Kathleen

■ Pons Valerio, Jamie 

■ Poole, John

■ Pope, Jamie

■ Potts, Ashley

■ Powell, John

■ Pramuka, Michael

■ Price, Mia

■ Price, Renee

■ Pridgen, Anthony

■ Pritchett, Tasha

■ Prokhorenko, Olga

■ Pronai, Caroline

■ Pruitt, Deanna

■ Punch, Winston

■ Purohit, Maulik

■ Qashu, Felicia

■ Quinene, Meredith

■ Ragunathan, Uma

■ Ramareddy, Manjula

■ Ramin, Daniel

■ Ramirez, Jordan

■ Ramirez, Michelle 

■ Ramirez, Stephanie

■ Ramsey, Kathryn

■ Rassmusen, Todd

■ Rasti, Theresa

■ Rauch, Terry

■ Ray, Jessicah

■ Raymond-Turner, 

Patricia

■ Reardon, Renee

■ Rebar, Betty

■ Redland, Tom

■ Reese, Maryetta

■ Reese, Randy

■ Reeves, Dennis

■ Regasa, Lemma

■ Reichter, Ron

■ Reid, Matthew

■ Remian, Katie

■ Rentas, Julio

■ Revesz, Joseph

■ Reyes, Ana

■ Reynolds, David

■ Rice, Ana 

■ Richardson, Kristy

■ Richardson, Nancy

■ Richardson, Risa

■ Rider, Sheila

■ Ried, Matthew

■ Riedy, Gerald

■ Rigg, John

■ Riggs, Jack

■ Rish, Berkley

■ Ritner, Andrea

■ Ritter, Anne

■ Ritter, John 

■ Rivera, Juan

■ Rob, James

■ Robarts, Stacie

■ Roberson, Brittney

■ Roberts, Kerri

■ Roberts, Jonathan 

■ Robertson, Gwendolyn

■ Robinson, Gabrielle

■ Rodriguez, Leila

■ Rodriquez, Robin

■ Rogers, Rene

■ Rolli, Michael

■ Rolls, Lynn

■ Romeo, Carole

■ Rooths, Joycelyn

■ Rosner, Mary

■ Ross-Mitchell, Lakisha

■ Rowe, Erin

■ Royer, Amanda

■ Rumph, Adrienne

■ Ruskin, David

■ Russell, Katie

■ Rutledge, Larry

■ Ryan, Laurie

■ Sacco, Maryanne

■ Sacre, Meghan

■ Sahota, Gurvaneet

■ Said, Farah

■ Sakura, Sara

■ Salazar, Andres

■ Salerno, Rose Marie 

■ Samuel, Jennie

■ Sandhu, Amy

■ Sargent, Paul

■ Sartori, Roberto 

■ Satariano, Angela

■ Satre, Joseph

■ Sauter, Susan

■ Scarfone, Rachelle

■ Schaefer, Laurel

■ Schaper, Ashley

■ Schardin, Karen

■ Schept, Susan

■ Scher, Ann

■ Schettler, Sarah

■ Schmeider, Jullian

■ Schmid, Suzanna

■ Schmidt, Ameila

■ Schneider, Jillian 

■ Schulz-Heik, Jay

■ Schulz-Heik, Robert

■ Schwab, Karen

■ Schwandt, Don

■ Sclafani, Frank

■ Scogin, Marjorie

■ Scott, Steven

■ Scruggs, Brooke

■ Sedigh, Randi

■ Seel, Ron

■ Seibert, Laura

■ Seiverd, John

■ Sekiguchi, June

■ Senhouse, Jacqueline

■ Settles, Shawn

■ Sexton, Melanie

■ Shapiro, Rita

■ Sharpe, Robert

■ Shaw, Dennis

■ Shaw, Scott

■ Shawna, Scully

■ Shear, Deborah

■ Sheeley, Enid

■ Shelton, Rose

■ Shelton, Janel

■ Shenouda, Christian

■ Shephard, James

■ Sherman, Annette

■ Shesko, Kristina

■ Shields-Hebb, Carolyn

■ Shupenko, Leslie

■ Sigford, Barbara

■ Silk, Connie

■ Sills, Cheryl

■ Silver, Timothy 

■ Simon, Charline

■ Simpson, Jelani

■ Sjolinder, Pam

■ Slatcoff, Amber 

■ Slattengren, Wendi 

■ Slusser, Renee

■ Sluss-Yiller, Melissa 

■ Smaldino-Bennett, 

Joanne

■ Smirniotopolous, James 

■ Smith, Arnette

■ Smith, Austin

■ Smith, Johanna

■ Smith, Shannon

■ Snelling, Alana

■ Snyder, Jeffrey

■ Soloman, Benjamin

■ Sonnet, Evan

■ Souder, Michael

■ Sousa, Tiffany

■ Souviginier, Alicia

■ Sparling, Molly

■ Spatz, Michael

■ Spector, Jack

■ Spells, Cynthia 

■ Spencer, Donald

■ Stamps, Lauren

■ Stanton, Daniella

■ Stape, Jennifer

■ Staudenmeir, James 

■ Stauffer, Tracy 

■ Staver, Tara

■ Stephenson, Pamela

■ Stevens, Alice-Marie

■ Stevens, Gretchen 

■ Stewart, Kerry-Ann

■ Stidham, Brenda

■ Stillman, Anna

■ Stinson, Jordan

■ Stokes, Alan

■ Stokes, James

■ Stone, Robert

■ Storms, Jill

■ Storms, Russell

■ Stout, Katharine

■ Strang, Jennifer

■ Strasser, Denise

■ Strenn, Diane

■ Strychacz, Chris 

■ Stuessi, Keith 

■ Sucher, Lauren

■ Sullivan, Katherine

■ Sullivan, Jaime

■ Sumaida, Dena

■ Swasey, Scott

■ Tate, David

■ Tackitt, Patricia

■ Taylor, Samuel

■ Teegarden, Lisa

■ Tejada, Erin

■ Tejidor, Shirley

■ Tepper, Stacy 

■ Teraoka, Jeff

■ Terrio, Heidi 

■ Tessari, Megan

■ Thatcher, Robert 

■ Thibodeaux, Harold

■ Thilmany, Helen

■ Thomas, Kenneth

■ Thomas, Kimberly

■ Thomas, Mike

■ Thompson, Danielle 

■ Thorsrud, Gavin

■ Timberlake, Kasey

■ Tincher, Marsheila

■ Tippett, Corie

■ Tisinger, Sharteake

■ Titanwa, Florence 

■ Tolchin, Margeret

■ Toll, Katie

■ Tong, James

■ Torres, Tammy

■ Tortella, Frank

■ Toth, Julie

■ Traylor, Kevin

■ Trimmer, Karen

■ Trotz, William 

■ Trudel, Tina

■ Tsagaratos, Jennifer

■ Tsao, Jack

■ Turner, Ed

■ Uddin, Nabila

■ Ungrady, Sharon

■ Urban, Misty

■ Valez, Carmen

■ Valls, Jose

■ Vandergriff, Teresa

■ Vanderploeg, Rodney

■ Vanharlinger, Wanda

■ VanScoyoc, Troy

■ Vara, Maria

■ Varbedian, Nicole

■ Vasconcelos, Olavo

■ Verive, Jessie

■ Verma, Ajay

■ Vogt, Megumi

■ Von Kamrath, Gerald

■ Voydetich, Deborah 

■ Vrabel, Mark

■ Waisman, Marina

■ Walker, Hannah

■ Walker, William

■ Walls, Rachel

■ Walsh, Allison

■ Walter, Francine

■ Walter, Joan

■ Ward, Elise

■ Warden, Deborah

■ Wardle, Lisa

■ Warren, Cynthia

■ Warren, Joseph

■ Watts, Shandi

■ Waun, Deborah

■ Way, Tameika

■ Wedlake, Tiffany

■ Weingarten, Loren

■ Weintraub, Jenna

■ Welch, Jana

■ Welch, Terry

■ Weldon, Susan

■ Wells, Rachel

■ Wells, Rosemary 

■ Wells-Gray, Elaine

■ West, Barbara

■ West, Patricia

■ West, Therese

■ Wheeler, Scott

■ Wheeler, Sharon

■ Whitaker, Jennifer

■ White, Carol

■ Widener, Anmarie

■ Wiggins, Bernetta

■ Wilkes, Bailey

■ Wilkinson, Jehue 

■ Williams, Ben

■ Williams, Grenay

■ Williams, Isaac

■ Williams, Karen

■ Williams, Kimberly

■ Williams, Kristin

■ Wilmore, Michael

■ Wilson, Andrea 

■ Wilson, Matthew

■ Wininger, Robin

■ Winters, Anne

■ Wion, Leigh

■ Witt, Cecilie 

■ Wittig, Becky

■ Wolf, Laura

■ Wolf-Chiovaro, Abby 

■ Wong, Edison

■ Wong, Kathy

■ Wood, Colleen

■ Woodfill, Thomas

■ Woods, Sharon

■ Wright, Karen

■ Wright, Megan

■ Wylie, William

■ Yan, Kun

■ Yanos, Brenton

■ Yocholson, Michael 

■ Yoho, Beth

■ York, Gerald 

■ Young, Eric 

■ Yu, Mina

■ Zeckser, Darlene

■ Zeiner, Harriet 

■ Zick, Kori

■ Zitelman, Derik

■ Zitnay, George

■ Zongo, Colette

Back cover photo: U.S. Marines with Weapons Company, 3rd Battalion, 3rd Marine Regiment, and Afghan Border 

Police rush off a CH-53D Sea Stallion helicopter during Operation Shahem Tofan (Eagle Storm) on February 10, 

2012. (U.S. Marine Corps photo by Cpl. Reece Lodder)
Defense and Veterans Brain Injury Center

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