Defense and Veterans Brain Injury Center

Annual Report

2016
Table of Contents

About DVBIC................................................................................................................................. 3

Letter from the National Director ................................................................................................... 4

Leadership .................................................................................................................................... 5

Divisions ....................................................................................................................................... 6

Expansion ..................................................................................................................................... 8

Advances ....................................................................................................................................10

New Directions.............................................................................................................................14

New Products...............................................................................................................................16

Ongoing Initiatives........................................................................................................................18

National Meeting ..........................................................................................................................24

Network Site Updates ..................................................................................................................26

External partnerships ...................................................................................................................32

Publications................................................................................................................................. 34

Presentations .............................................................................................................................. 38

Front Cover: MRI Image by iStock
DVBIC 2016 ANNUAL REPORT | 3

About DVBIC

24 Years of Service

As manager of the Pathway of Care, the Defense and Veterans 

Brain Injury Center (DVBIC) promotes access to state-of-thescience care for service members, veterans, and their families 

to prevent and mitigate the consequences of traumatic brain 

injury (TBI). 

Since 1992, DVBIC has served military and civilian TBI 

stakeholders through a network of medical sites across the 

Departments of Defense (DoD) and Veterans Affairs (VA) that 

conduct research, support clinical care, provide education 

and advance policy. DVBIC has evolved as its network of care 

and treatment sites has grown to meet the changing needs 

of the Military Health System (MHS).

 Today, DVBIC has 18 network sites and is the TBI operational 

component of the Defense Centers of Excellence for Psychological 

Health and Traumatic Brain Injury (DCoE). DCoE is a division 

of the Defense Health Agency (DHA) Operations directorate. 

DHA is a joint, integrated combat support agency that supports 

the MHS.
4 | DVBIC 2016 ANNUAL REPORT

Letter from the National Director

Dear Colleagues:

Thank you for your hard work and dedicated efforts over the past year. 2016 saw many successes within the organization 

despite challenges associated with changes in leadership and the transition to DHA. Your efforts advanced the state of 

the science for TBI care, led to new, evidence-based clinical guidelines, and produced training curricula for practitioners, 

patients, family members and TBI stakeholders. 

Our relationship with the TBI community of interest is stronger than ever. We remain unified in our mission to help mitigate 

the effects of brain injury on service members, veterans and their families and committed to managing the Pathway of 

Care. With the TBI service leads and other stakeholders, we agreed upon a definition of the Pathway of Care in 2016 and 

began to develop policies promoting excellence in care not contingent upon geographic organizational affiliations. We will 

continue leading this policy effort in 2017 as chair of the TBI Advisory Committee, an entity through which all stakeholders 

promote policies advancing our collective goals. TBI program leads from the Army, Air Force, Navy, Marine Corps and DHA 

work within this committee and through subgroups to expedite review, consensus and implementation of new policies and 

products across the enterprise. 

In the past year, our network grew to 18 sites with new teams at Fort Gordon, Fort Drum, and the San Antonio VA hospital. 

Our network sites collaborated with local commands to advance TBI research, education and clinical support. By working 

closely with the Joint Program Committees at Medical Research and Materiel Command and the J9 (research) in DHA, we 

continued to assess research gaps and deploy new research efforts driven by requirements. 

2016 highlights from DVBIC divisions include publishing 45 peer-reviewed papers advancing TBI science (Research Division), 

releasing an invaluable guide on post-traumatic headache (Clinical Affairs Division), and refining our product pipeline and 

lifecycle management (Education Division). Our efforts to inform providers about TBI care included collecting metrics to 

determine our impact beyond the use of materials, and we actively engaged national experts to refresh existing clinical 

support tools. In addition to expanding our social media presence, direct marketing and trainings, we also released our first 

podcast in 2016. Called “The TBI Family,” the podcast informs caregivers about resources available through the DoD and 

VA. All of these efforts were driven by requirements determined, in part, by our surveillance team which made great strides 

not only in tracking prevalence but also in collecting more granular data on patients and families affected by TBI. 

DVBIC’s 2016 accomplishments are the result of cumulative, collaborative, successful service to the military and veteran TBI 

communities. In 2017, DVBIC will celebrate its 25th anniversary. As we reach this important milestone, we will continue to 

make the bold decisions that directly benefit patients and their families. We look forward to working with the National Intrepid 

Center of Excellence and the Center for Neuroscience and Regenerative Medicine to leverage our collective expertise to 

improve efficiencies to best accomplish our missions. 

I am honored to have served with DVBIC, and I look forward to witnessing amazing accomplishments yet to come.

Sincerely

Army Col. (Dr.) Geoffrey G. Grammer
DVBIC 2016 ANNUAL REPORT | 5

Leadership

Army Col. (Dr.) Geoffrey G. Grammer

National Director

Army Col. (Dr.) Geoffrey G. Grammer is the national director of DVBIC. He oversees all aspects 

of the organization’s mission, which is to serve active-duty service members, veterans and 

their family members with traumatic brain injury through state-of-the-science medical care 

and care coordination, and innovative clinical research and educational programs.

Until recently, Grammer was the department chief of research at the National Intrepid Center 

of Excellence. Prior to that, he served for eight years as the chief of inpatient psychiatric 

services at Walter Reed National Military Medical Center in Maryland.

Grammer completed two deployments to Iraq. During his first deployment, he served as the medical director for the 785th Combat 

Stress Control Company; during his second deployment, he served as a psychiatrist at the combat support hospital at Contingency 

Operating Base Speicher. He also deployed to Afghanistan as a psychiatrist at the combat support hospital in Bagram.

Grammer completed his Bachelor of Science in Biology at Virginia Polytechnic Institute in Blacksburg, Virginia. In 1996, he 

graduated from the Uniformed Services University of the Health Sciences in Bethesda, Maryland, with his medical degree. 

Subsequently, he completed his residency in internal medicine and general psychiatry at Walter Reed National Military 

Medical Center, followed by a fellowship in geriatric psychiatry.

Grammer currently holds board certification in psychiatry, geriatric psychiatry, and behavioral neurology and neuropsychiatry. 

He is also currently an assistant professor of psychiatry at the Uniformed Services University of the Health Sciences.

Grammer’s military awards include the Bronze Star Medal, Meritorious Service Medal, Army Commendation Medal (three 

awards), Army Achievement Medal (three awards), Army Superior Unit Award, National Defense Service Medal (two awards), 

Afghanistan Campaign Medal, Iraq Campaign Medal (three stars), Global War on Terrorism Service Medal, Army Service 

Ribbon, Overseas Service Ribbon (three awards), and NATO International Security Assistance Force Medal.

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

Deputy Director

Ms. Katherine Helmick is the deputy director of DVBIC. She brings considerable clinical, 

educational and research experience in the field of neuroscience to include more than 100 

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 DCoE, 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 bachelor’s and master’s degrees in nursing from Virginia Commonwealth University, as well as a Bachelor 

of Science 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.
6 | DVBIC 2016 ANNUAL REPORT

Divisions

DVBIC accomplishes its mission through its divisions. 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.

Clinical Affairs

Mission: To provide state-of-the-science TBI 

knowledge by developing clinical recommendations, 

analyzing outcomes and providing subject matter 

expertise on TBI-related matters, 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. Through 

the work of DVBIC’s 

Clinical Affairs 

Division, we hope to 

support clinicians 

treating some of 

the most complex 

patients. We work 

closely with DVBIC’s 

other divisions to equip clinicians across 

the DoD and VA with the most relevant and 

up-to-date information to provide the best 

care to our service members.”

Katharine Stout, PT, DPT, NCS, MBA

Director, Clinical Affairs Division

Research

Mission: To provide evidence-based knowledge 

by conducting and supporting clinically-focused 

research that improves treatment and outcomes 

for service members, veterans and beneficiaries 

affected by a TBI.

“DoD requirementsdriven TBI clinical 

research is one of the 

foundational building 

blocks of DVBIC’s

25-year history. 

DVBIC has 

successfully supported 

numerous high 

visibility clinical 

research studies 

resulting in evidencebased knowledge that informs the clinical care of 

service members and veterans affected by TBI. 

DVBIC’s current research portfolio supports 

known MHS TBI research gaps and priorities, 

significantly raising return-on-investment 

compared to other traditional research models. 

This speaks highly of DVBIC’s clinical research 

expertise and our responsiveness supporting a 

medically ready force.”

Saafan Malik, M.D.

Director, Research Division 
DVBIC 2016 ANNUAL REPORT | 7

Education

Mission: To provide evidence-based knowledge 

about TBI through implementing educational 

programs, activities and resources along the 

continuum of care for health care providers; 

performing outreach and education to service 

members, veterans, caregivers, family members 

and providers; and producing state-of-the-science 

education and training resources. 

“Through the education and training of 

health care providers, service members, 

veterans and family members, we are 

changing the notion that traumatic brain 

injury is an ‘invisible injury’ of war. 

Through our awareness, outreach and 

multifaceted educational activities, TBI is 

becoming the visible invisible wound.”

Scott Livingston, Ph.D., PT, ATC

Director, Education Division

Image by iStock

Chief of Staff

Mission: To provide support to advance top DVBIC 

priorities and ensure infrastructure, regulatory 

compliance and financial accountability are 

consistent with DHA and DCoE guidance and 

DVBIC mission and strategic direction.

“As DVBIC approaches a quarter century 

as a center of excellence, our longevity 

can be attributed to 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.”

Captain Charles Cathlin, USPHS, MPH

Chief of Staff
8 | DVBIC 2016 ANNUAL REPORT

Expansion

Three new DVBIC network sites launched in 2016: Fort Drum, Fort Gordon and the 

Audie L. Murphy Memorial Veterans Hospital in San Antonio. DVBIC network sites 

now total 18 military treatment facilities and VA facilities that conduct research and 

support military and veteran TBI patients across the United States and abroad. More 

information about the new sites and the rest of the DVBIC network is in the network 

sites section of this report (see page 26).

Fort Drum

“Joining DVBIC is an essential part 

of our strategy forward,” said Dr. 

Thaddeus Pajak, medical director 

of the Fort Drum TBI Clinic. “We 

are the TBI home to one of the 

Army’s most deployed divisions. 

The resources DVBIC provides give 

us another tool to accomplish our 

mission of improving readiness 

of the 10th Mountain Division 

(Light Infantry) and to ensure that 

the mind, body and spirit of our 

soldier warriors are prepared for 

the fight ahead.”

Major (Dr.) Thaddeus Pajak

DVBIC Site Director

U.S. Army Medical 

Department Activity

Fort Drum, New York
Renee Reardon

Joint Base 

Elmendorf-Richardson, AK

Joint Base 

Lewis-McChord, WA

Walter Reed NMMC,

MD

Landstuhl RMC, 

Germany

DVBIC Headquarters

Silver Spring, MD

Fort Belvoir, VA

Richmond VA, VA

Camp Lejeune, NC

Minneapolis VA, MN

Tampa VA, FL Fort Gordon, GA

Fort Bragg, NC

Fort Carson, CO Fort Drum, NY

Camp Pendleton, CA San Antonio MMC, TX San Antonio VA, TX Fort Hood, TX

Defense and Veterans Brain Injury Center

DVBIC Sites

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

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

NMC San Diego, CA

HI

Palo Alto VA, CA

DVBIC 2016 ANNUAL REPORT | 9

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

Fort Gordon

“Being part of a bigger team presents 

opportunities for discussion of and 

collaboration around new ideas, 

allowing us to reap the benefits of other 

members’ discoveries and contribute 

our experiences, ultimately resulting 

in better understanding and treatment 

of the unique medical issues facing our 

service members.” 

John L. Rigg, M.D.

DVBIC Site Director

Dwight D. Eisenhower 

Army Medical Center

Fort Gordon, Georgia

San Antonio VA

“Although we have already been working 

with the San Antonio Military Medical 

Center, DVBIC team and other sites, 

having boots on the ground will solidify 

and enrich collaboration and allow our 

facility and staff to develop additional 

relevant research translating 

into better patient care.” 

Blessen C. Eapen, M.D.

DVBIC Site Director

Audie L. Murphy Memorial 

VA Hospital

San Antonio, Texas
10 | DVBIC 2016 ANNUAL REPORT

Advances

As a TBI thought leader, DVBIC supports researchers across its network sites developing and 

conducting clinical investigations on TBI. DVBIC’s extensive internal and external collaborations 

(see page 32) allow for clinical innovation and research 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.

Study of Cognitive Rehabilitation Effectiveness (SCORE) team members in a lighthearted moment spelled out S-C-O-R-E. 

(DVBIC photo)

Study of Cognitive Rehabilitation Effectiveness

DVBIC and the Brooke Army Medical Center’s Brain Injury 

Rehabilitation Service led the congressionally mandated 

“Study of Cognitive Rehabilitation Effectiveness,” or SCORE. 

The results of SCORE, published in September 2016 in 

the Journal of Head Trauma Rehabilitation, demonstrated 

that therapist-directed methods most effectively improve 

functional cognitive abilities, including memory and attention. 

The SCORE study supported a report to Congress responding 

to section 723 of the National Defense Authorization Act of 

2010 on the efficacy of cognitive rehabilitation. The report 

will be submitted to Congress in 2017. Following the SCORE 

milestone, researchers will continue to study cognitive 

rehabilitation therapy with “Imaging Support of the Study 

of Cognitive Rehabilitation Effectiveness in Mild Traumatic 

Brain Injury,” or iSCORE. With iSCORE, researchers will 

try to measure physical brain changes that may occur as a 

result of cognitive rehabilitation.

The SCORE research project evaluated three common 

methods of delivering cognitive rehabilitation therapies. The 

goal of the study, which started in late 2010, was to identify 

and validate cognitive rehabilitation interventions to improve 

the health and quality of life for service members with 

concussions. Although previous research had investigated 

cognitive rehabilitation for patients with moderate to severe 

TBI, SCORE was the first study to examine cognitive 

rehabilitation for mild TBI.

DoD TBI Research Gaps and Priorities Report

In 2016, DVBIC formed an internal research gaps committee 

to conduct a review of guidance documents, examine the 

most recent peer-reviewed literature, assess the current state 

of TBI science, and produce a list of existing and emerging 

TBI research gaps and priorities most relevant to the DoD 

and MHS. The committee’s assessment, strengthened by 

stakeholder considerations, supports a better understanding 
Science & Technology Efforts & Programs

PREVENTION, MITIGATION, AND 

TREATMENT OF BLAST INJURIES

REPORT TO THE EXECUTIVE AGENT

DoD Blast Injury Research Program Coordinating Office US Army Medical Research & Materiel Command

FY16

DVBIC 2016 ANNUAL REPORT | 11

of how TBI research could best address 

current and emerging clinical research 

needs for the military and veteran 

populations in order to optimize stateof-the-science TBI care. In addition, 

DVBIC produced a report describing 

its process for determining these 

gaps and priorities. The report was 

submitted to DCoE leadership and 

DHA’s J9 research directorate.

The determination of 2016 gaps and 

priorities was part of a larger, ongoing 

process. Every year, DVBIC assesses 

the field of TBI research for the Defense 

Department and MHS to determine 

existing and emerging research gaps 

and priorities. Through continuous 

involvement in this ongoing assessment 

process, DVBIC leadership, research 

staff and subject matter experts ensure 

that military-relevant research initiatives 

incorporate feedback and lessons 

learned. 

Such initiatives involve complex 

collaborative efforts: TBI research 

work groups, joint review and analysis 

meetings, integrated product teams 

(IPTs), in-progress reviews, ongoing 

capability-based assessments, 

government steering committees for 

various TBI consortia, and interagency 

TBI research conferences. These 

conferences include the Military Health 

System Research Symposium and the 

meetings of the Association of Military 

Surgeons of the United States.

RAND Study on Mild TBI

DVBIC collaborated with the RAND 

Corporation to review the treatment of 

mild TBI across the MHS. Specifically, 

the DVBIC outcomes team, part of the 

Clinical Affairs Division, contributed 

knowledge and expertise. RAND 

published the findings in a 2016 report 

entitled “Understanding Treatment 

of Mild Traumatic Brain Injury in the 

Military Health System.” This research 

addressed a major gap. Previously, no 

large-scale studies had considered 

how service members who had been 

diagnosed with a concussion used 

health care after their injuries. The 

goal of the report was “to provide 

timely information to DoD that can be used to help assess and improve care” 

for service members with a mild TBI.

Blast-Related TBI Research

Acknowledging DVBIC’s research expertise in the area of blast-related TBI, the 

DoD Blast Injury Research Program invited DVBIC to contribute a chapter to 

the program’s 2016 annual report. The purpose of the report is to describe DoD 

efforts to address the full range of blast injuries, highlighting accomplishments 

and challenges. DVBIC submitted content in 2016 highlighting DVBIC publications 

on blast-related TBI in 2016. All DVBIC research published in 2016 included 

blast-related TBIs in the population studied. However, four studies specifically 

addressed blast-related findings:
12 | DVBIC 2016 ANNUAL REPORT

U.S. Army photo by Spc. Luke Austin
DVBIC 2016 ANNUAL REPORT | 13

Impulsivity and Depression

Bjork, J., Burroughs, T., Franke, L., Pickett, 

T., Johns, S., Moeller, F., & Walker, W. (2016). 

Laboratory impulsivity and depression 

in blast-exposed military personnel with 

post-concussion syndrome. Psychiatry 

Research, 246, 321-325. http://dx.doi.

org/10.1016/j.psychres.2016.10.008

Service members with blast-related TBI 

may experience a collection of symptoms 

known as post-concussive syndrome. 

Cognitive dysfunction is common in 

these patients, but they may also display 

increased impulsivity and impaired 

mood regulation. These factors may 

increase the risk of substance abuse 

and suicidal behavior. This research 

assessed the relationship between 

depressive symptoms and behavioral 

inhibition among 117 service members 

with blast-related TBI and a diagnosis 

of post-concussive syndrome. The 

results are consistent with previous 

research demonstrating impaired mood 

regulation and behavioral inhibition 

in military TBI patients. TBI not only 

affects thinking but also mood and 

inhibition. This research may prove 

useful in identifying TBI patients with 

affective and inhibition problems.

Headache and Mild TBI

Finkel, A., Yerry, J., Klaric, J., Ivins, B., 

Scher, A., & Choi, Y. (2016). Headache in 

military service members with a history 

of mild traumatic brain injury: A cohort 

study of diagnosis and classification. 

Cephalalgia, 37(6), 548-559. http://dx.doi.

org/10.1177/0333102416651285

Post-injury headache is a common 

symptom after mild TBI. However, no 

instrument currently exists to categorize 

or track this symptom. In this study, 

researchers collected information on 

demographics, injuries and headache 

characteristics for 95 patients seen 

between August 2008 and December 

2009 at Womack Army Medical Center, 

Fort Bragg, North Carolina. Patients 

reported a total of 166 headaches. The 

most common type of injury reported 

was blast (53.7 percent).

The most frequently diagnosed headache 

type was continuous with migraine 

features (18.7 percent), then chronic 

migraine (8.4 percent), migraine with 

aura (6 percent), hemicrania continua (7.2 

percent), chronic cluster (3.6 percent), 

and non-classifiable (3 percent). The 

frequency of migraine headache among 

patients with concussion appears higher 

than expected, but this finding necessitates 

further research. Headache is a common 

symptom after concussion. However, 

less is known about its variation among 

TBI patients. This research impacts 

the service member by describing the 

frequency and type of headaches in a 

military TBI patient population.

Chronic Mild TBI and PTSD

Franke, L.M., Walker, W.C., Hoke, K.W., & 

Wares, J.R. (2016). Distinction in EEG slow 

oscillations between chronic mild traumatic 

brain injury and PTSD. International Journal 

of Psychophysiology. 106:21-29. doi: 

10.1016/j.ijpsycho.2016.05.010

Resting state electroencephalogram 

(EEG) information differs between patients 

with mild TBI and healthy controls. 

However, experts disagree on whether this 

change is stable. In addition, comorbid 

psychiatric conditions such as PTSD 

may contribute to long-term changes in 

EEG patterns. Recognizing the potential 

for comorbidity is particularly relevant in 

combat veterans who often experience 

post- deployment stress. This research 

addressed the problem of comorbidity 

by measuring spectral power (type of 

EEG information) in a large sample of 

service members with blast exposure 

but varying degrees of TBI and PTSD 

severity. Results indicated that EEG 

may help to track neurophysiological 

effects and monitor recovery after TBI 

and differentiate pathophysiologies 

associated with TBI and PTSD. This 

research impacts the service member by 

identifying spectral patterns distinctive 

of TBI and PTSD.

Postconcussion Symptoms

O’Neil, M., Callahan, M., Carlson, K., 

Roost, M., Laman-Maharg, B., & Twamley, 

E. (2016). Postconcussion symptoms 

reported by Operation Enduring Freedom/

Operation Iraqi Freedom veterans with and 

without blast exposure, mild traumatic brain 

injury, and posttraumatic stress disorder. 

Journal of Clinical and Experimental 

Neuropsychology, 39(5), 449-458. http://

dx.doi.org/10.1080/13803395.2016.1232699

The 10th Edition of the International 

Statistical Classification of Diseases 

and Related Health Problems (ICD-10) 

outlines criteria for post-concussive 

syndrome. This study addressed the 

validity of these criteria among veterans 

of Operation Enduring Freedom and 

Operation Iraqi Freedom by identifying 

relevant subscales from the British 

Columbia Postconcussion Symptom 

Inventory (BC-PSI) and examining 

group differences between veterans 

with and without blast exposure, mild 

TBI and PTSD. Vestibular, affective, 

and somatic factors were significantly 

higher for veterans with blast exposure 

plus mild TBI than for controls but not 

significantly different for those with blast 

exposure but no mild TBI. These results 

remained significant when PTSD symptom 

severity was included as a covariate. In 

addition, cognitive, anger, and somatic 

subscales were higher for veterans with 

PTSD, though there was no interaction 

effect of PTSD and mild TBI or blast 

history. The study demonstrates that 

the BC-PSI subscales can differentiate 

veterans based on blast exposure, mild 

TBI history and PTSD. The BC-PSI 

inventory may prove useful in categorizing 

the symptoms experienced by service 

members with TBI.
14 | DVBIC 2016 ANNUAL REPORT

New Directions

As the TBI landscape has changed, DVBIC efforts have evolved to meet the needs of service 

members, veterans, families and providers. In 2016, DVBIC took on several emerging issues 

described below.

Women and Concussions

DVBIC staff were invited 

and represented at the PINK 

Concussions Symposium 

on Female Brain Injury held 

October 6-7, 2016, and hosted 

by the VA Palo Alto Health Care 

System. DVBIC subject matter 

experts gave keynote remarks 

and presented, moderated, 

and facilitated workshops 

over the two-day symposium. 

Over 120 participants attended 

the symposium that featured 

researchers and clinicians from 

around the country. Presenters 

shared brain injury research 

focused on females through 

presentations, work groups and 

poster sessions. A reception 

showcased and honored the 

efforts of several community 

members who focused their 

efforts on female TBI from sports, 

domestic violence, trauma and 

military service.

DVBIC staff also hosted the 6th Annual TBI Research Forum on March 18, 2016, at the Palo Alto VA. This event highlighted 

the theme of “TBI and the Female Veteran.” Over 150 researchers and clinicians networked, presented new clinical updates 

and increased awareness of recent innovations in TBI research. Twenty-four posters represented abstracts submitted 

from a wide region both within and outside northern California, including large academic and community hospitals. The 

DVBIC Palo Alto recovery support specialist hosted a DVBIC education booth, and an exhibitor session showcased many 

VA and community stakeholders who came to support DVBIC’s work and women veterans.

Research published by DVBIC in 2016 suggests that recovery and reintegration may benefit from gender-specific 

guidance. For example, bias inherent in self-reporting (women report more symptoms than men) supports development 

of more objective measures of reporting following concussion. Since women comprise 16 percent of the armed forces, 

including the military service academies, a commitment to conducting research that includes a female cohort is important.

Kathy Helmick, DVBIC deputy director, spoke at a Pink Concussions event during Brain 

Injury Awareness Month 2016. Pink Concussions is a nonprofit organization dedicated to 

improving pre-injury education and post-injury medical care for women who have 

sustained a TBI. (DVBIC photo by Carlson Gray)
DVBIC 2016 ANNUAL REPORT | 15

1

A Parent ’s Guide to 

Returning Your Child to 

School After a Concussion

FAM IL IES

DVBIC National Director U.S. Army Col. (Dr.) Geoffrey 

Grammer participated in “Empowering Hidden Heroes: 

Pathways to Innovation” conference. (DVBIC photo by 

Terry Welch)

Caregivers

According to a recent study by RAND Corporation, there 

are 5.5 million military family caregivers in the United 

States and 29 percent of them are helping someone who 

experienced a TBI. Although DVBIC has always included 

caregivers in its mission, outreach to this group broadened 

significantly in 2016. To support military and veteran 

caregivers and help drive their recognition, appreciation 

and empowerment, DVBIC partnered with the Elizabeth 

Dole Foundation in 2016. This partnership advanced 

DVBIC’s A Head for the Future public awareness, social 

media initiative, as well as the production of a caregiver 

podcast DVBIC launched in 2016. DVBIC also represented 

DoD at the Elizabeth Dole Foundation’s Hidden Heroes 

Campaign for Military Caregivers. Col. Grammer, DVBIC 

national director, spoke about the future needs of military 

caregivers. In addition, DVBIC’s congressionally mandated 

research on long-term TBI outcomes (“15-year longitudinal 

studies on TBI”) is generating extensive information about 

caregiver needs and challenges.

Children and Concussions

DVBIC served as the DoD representative to the National 

Collaborative on Children’s Brain Injury. In this capacity, 

DVBIC education staff collaborated with other stakeholders 

such as the National Institute on Disability and Rehabilitation Research and the Centers for Disease Control and 

Prevention to develop the first national “Return-to-Learn 

Consensus Statement” for children with concussions. As 

a content reviewer, DVBIC also supported the Centers for 

Disease Control and Prevention (CDC) in the development 

of guidance for treating children with concussion. This 

guidance, entitled “Report from the Pediatric Mild Traumatic 

Brain Injury Guideline Workgroup,” when finalized, will 

provide the CDC’s recommendation for a standardized 

approach for health care providers for the diagnosis and 

management of mild TBI among children.

There are 5.5 million military family 

caregivers in the United States and 29 

percent of them are helping someone who 

experienced a TBI.
16 | DVBIC 2016 ANNUAL REPORT

New Products

2016 marked the release of numerous state-of-the-science education and training products. In 

addition to print, new products this year included new media platforms such as podcasts. This 

expanded portfolio of production and distribution methods enhanced DVBIC’s ability to reach 

target audiences.

Clinical Recommendations

Clinical recommendations (CRs) provide TBI guidance to 

health care providers. In February 2016, DVBIC released one 

CR: “Management of Headache Following Concussion/Mild 

TBI: Guidance for Primary Care Management in Deployed 

and Non-Deployed Settings.” Known as the headache CR, 

this clinical recommendation addressed the number one 

symptom following concussion. DVBIC received a grant from 

the U.S. Army Medical Research and Materiel Command to 

test the effectiveness of the headache CR among primary 

care providers. 

In addition to releasing and beta testing the headache 

CR, DVBIC initiated a research pilot study to evaluate the 

effectiveness of a face-to-face provider training education 

program on another CR: “Progressive Return to Activity 

following Acute Concussion/Mild TBI: Guidance for the 

Primary Care Manager.”

Periodically, CRs need revision to reflect the latest science. 

In 2016, the TBI Advisory Committee — the DoD entity 

chaired by DVBIC that coordinates how to address TBI 

issues — approved a revision plan for CRs. Revisions on 

five DVBIC CRs began in 2016 and were at various stages 

of completion and approval at the end of December.

Provider Training and Education

DVBIC regularly produces education and training materials 

for health care providers:

■ Training curriculum to support face-to-face health care 

provider training on the CR “Progressive Return to Activity 

following Concussion/Mild Traumatic Brain Injury Guidance 

for the Primary Care Manager” 

■ Fact sheet and provider training slides for the CR “Headache 

Management Following Concussion/Mild TBI” 

■ ICD-10 diagnostic coding guidance for TBI fact sheet

Total TBI product downloads from the DVBIC website increased 

by almost 21 percent from 12,200 in 2015 to 17,340 in 2016. 

The top 10 downloaded products were:

■ MACE: Military Acute Concussion Evaluation Pocket Card

■ Concussion Signs and Symptoms Fact Sheet 

(English version)

■ Management of Headache Following Concussion/Mild 

TBI: Guidance for Primary Care Management in Deployed 

and Non-Deployed Settings Clinical Recommendation 

■ ICD-10 Diagnostic Coding Guidance for Traumatic Brain 

Injury Training Slides

■ Mild TBI Symptom Management Fact Sheet: Healthy Sleep

1

DoD Clinical Recommendation | February 2016

Management of Headache Following Concussion/

Mild Traumatic Brain Injury: Guidance for Primary Care 

Management in Deployed and Non-Deployed Settings

Introduction

More than 339,000 service members sustained a traumatic brain injury (TBI) between 2000 and third quarter 

2015. Most (approximately 82 percent) were classified as mild traumatic brain injury (mTBI) also known as 

concussion.1

 Headache is the most common symptom reported following a concussion.2,3,4,5,6 In a study of 

Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans, 74 percent reported post-traumatic 

headaches (PTH) occurring within 30 days of sustaining a concussion.7

Current Department of Defense (DoD) guidance on the acute management of headaches following concussion is 

briefly addressed in the deployed clinical management algorithms (CMA) and the Army Concussion Management 

in the Garrison Setting Algorithm.8

 The assessment and management of sub-acute and chronic PTH is provided 

in the “Department of Veterans Affairs (VA)/DoD Clinical Practice Guideline (CPG) for the Management of 

Concussion/Mild Traumatic Brain Injury.”9

 These recommendations were developed to provide comprehensive 

guidance for acute, sub-acute and chronic PTH based on current criteria from the “International Classification 

of Headache Disorders,” 3rd edition,10 as well as recent research and expert contributions.11 This CR provides 

updated state-of-the-science information with an emphasis on non-pharmacologic, as well as pharmacologic, 

treatment of PTH. This clinical recommendation (CR) identifies best practices and provides clinical guidance 

for the primary care manager (PCM) in deployed and non-deployed settings for the assessment, diagnosis and 

treatment of PTH.

Background

This CR, companion clinical support tool (CST) and patient fact sheet were created following a review of 

currently published literature and expert contributions from the Defense Centers of Excellence for Psychological 

Health and Traumatic Brain Injury (DCoE) in collaboration with clinical subject matter experts representing the 

academic, research and civilian sectors; the DoD Armed Forces; and the VA. Representatives from the DoD TBI 

Quad Services — Army, Navy, Marine Corps, Air Force — Defense and Veterans Brain Injury Center (DVBIC), 

Army Medical Research and Materiel Command, Joint Trauma Analysis and Prevention of Injury in Combat 

program, National Intrepid Center of Excellence Institute, U.S. Central Command, Readiness Division of the 

Defense Health Agency, the Coast Guard and VA have reviewed and approved this recommendation. A full list of 

working group participants may be viewed at: https://dvbic.dcoe.mil/cr-working-groups/headache-clinical-suite.

This CR is in accordance with DoD TBI policy. However, service-specific requirements regarding concussion 

or the management of PTH may exist, and provider judgment and operational requirements supersede any of 

these recommendations for an individual patient.

Summary

PTH may occur from injury to the head, neck or face. PTH is classified as acute or persistent based on duration 

of the headache.10 Headaches that occur in the first three months after injury are considered acute. 

Headaches that continue beyond three months are considered persistent.

The diagnosis of PTH depends largely on the temporal relationship between the trauma or injury and headache 

onset. Four of the most common types of headaches following concussion are covered in this CR 

and include migraine, tension-type, cervicogenic and headache related to neuropathic pain.

4,6,12,13

The differential diagnosis of PTH type is based on a focused headache history and physical examination, which 

include a detailed description of the characteristics of the headache (Tables 1.0 and 2.0). These may include 

inciting events, prodromal signs or symptoms, features of the pain, and associated visual or other sensory 

symptoms. In some cases, the individual may have headaches with characteristics of more than one type of 

PTH.14 Differentiating between headache types may be facilitated through use of Table 5.0, Characteristics of 

Headache Types. 

Migraine F Tension-Type G Cervicogenic H Neuropathic I

Patient presents with headache after a concussion

Review diagnostic criteria and determine headache type E 

Yes Emergent or specialty 

referral as indicated C, D

Concussion or 

headache red flags 

present? C, D

No

Perform focused headache 

history and assessment A, B

Management of Headache Following Concussion/mTBI: 

Guidance for the Primary Care Manager in Deployed and Non-Deployed Settings

DVBIC illustration by Melanie Sexton
DVBIC 2016 ANNUAL REPORT | 17

■ Concussion/Mild Traumatic Brain 

Injury and Posttraumatic Stress 

Disorder Fact Sheet

■ Traumatic Brain Injury Awareness 

Fact Sheet

■ Mild TBI Symptom Management Fact 

Sheet: Managing Headaches

■ Mild TBI Symptom Management Fact 

Sheet: Ways to Improve Your Memory

■ Moderate or Severe Traumatic Brain 

Injury Fact Sheet 

Research Reviews

DVBIC research reviews summarize 

relevant scientific literature pertaining to 

specific issues. In 2016, the Research 

Division developed three new research 

reviews available on the DVBIC website:

TBI, Irritability and Aggression 

(February)

■ Provides a summary of recent research 

on relationships between TBI, irritability 

and aggressive behavior

■ Describes findings on prevalence 

and risk factors

■ Discusses risk factors for aggressive 

behavior in non-clinical military, 

veteran and civilian populations as 

well as findings regarding TBI and 

legal involvement potentially due to 

aggressive behavior

Acute Management of Intracranial 

Pressure in Severe TBI (February)

■ Provides an update on acute treatment 

of severe closed-head TBI in adults

■ Discusses issues on the forefront 

of research inquiry related to 

management of intracranial pressure: 

therapeutic hypothermia, effectiveness 

of hypertonic saline, and whether 

decompressive craniectomy improves 

patient outcomes 

Mild TBI and Posttraumatic Stress 

Disorder (April)

■ Provides an overview of comorbid 

mild TBI and posttraumatic stress 

disorder (PTSD)

■ Focuses on symptoms, diagnosis 

and treatment of PTSD and mild 

TBI symptoms in patients with mild 

TBI history

Caregiver Podcast

In recognition of Warrior Care Month 

and National Family Caregivers Month, 

DVBIC launched a new podcast for 

family caregivers of service members 

and veterans with a TBI. Called “The TBI 

Family,” the 10-episode podcast shares 

caregiver stories and provides information 

about TBI relevant to family members 

and caregivers. 2016 content covered 

topics such as practicing mindfulness, 

dealing with balance issues, caregiver 

respite programs, caregiver training and 

coming to terms with the caregiver role.

Newsletters

DVBIC launched two quarterly newsletters 

in 2016 intended as resources for health 

care providers. DVBIC will continue to 

publish these newsletters in 2017.

TBI Hot Topics 

This newsletter brings context to discussion surrounding the latest scientific 

studies, advances and discoveries. 

DVBIC experts summarize studies that 

receive attention in the popular press 

and provide brief comments. The specific 

studies included are selected by their 

media impact as determined through 

quantitative analysis of Google News 

and PubMed searches. Final determination includes qualitative assessment by 

DVBIC personnel. This newsletter also 

includes some news stories not derived 

from scientific studies, but nonetheless 

relevant to TBI stakeholders. News 

stories are selected based in part on 

the quantity of news coverage, and in 

part on a subjective evaluation of story 

relevance and import.

TBI 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. 

TBI Tech Watch is not intended as a 

comprehensive report on all TBI-related 

scientific technical advancements. The 

articles included are selected based on 

a subjective evaluation of relevance, 

import and interest.

Dr. Samantha Finstad, DVBIC chief of 

strategy, plans and programs, was the 

first host of DVBIC’s The TBI Family 

podcast. (DVBIC photo by Terry Welch)

Army Research Laboratory photo by 

David McNally
18 | DVBIC 2016 ANNUAL REPORT

Ongoing Initiatives

In 2017, DVBIC will celebrate its 25th anniversary. As an established organization with more than 

two decades of experience supporting service members, veterans, family members and providers, 

DVBIC leads and collaborates on a number of long-term projects and mission support activities. 

Below are 2016 highlights from these initiatives.

TBI Surveillance

DVBIC is the Defense Department’s office of responsibility for TBI data in the U.S. military. DVBIC produces annual and 

quarterly reports that provide data on the number of active-duty service members — anywhere U.S. forces are located 

— with a first-time TBI diagnosis since 2000.

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) 2000-2016 Q4, as of Feb 17, 2017

Penetrating 5,065

Severe 3,770

Moderate 32,951

Mild 297,478

Not Classifiable 21,828 

Total - All Severities 361,092

2000-2016 Q4 

82.4%

1.4% 6.0% 1.0%

9.1%

DoD Numbers for Traumatic Brain Injury

Worldwide — Totals

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

Effective October 2015, the International Classification of Diseases was updated. With the improved 

information, more moderate traumatic brain injuries can be counted. Previously, some cases were 

categorized as “unclassifiable” severity due to more limited surveillance information. Also in 2015, 

the Assistant Secretary of Defense clarified the TBI case definition. A subsequent review found that 

some of the remaining “unclassifiable” cases were likely moderate TBI. This change also will contribute to higher counts of moderate TBI surveillance cases.
DVBIC 2016 ANNUAL REPORT | 19

TBI Pathway of Care

The DoD TBI Pathway of Care provides an evidence-based, clinically-focused process advancing high clinical standards 

and decreasing variance across the DoD through continuous performance improvement.

The TBI Advisory Committee (TAC) is the chartered entity that addresses issues related to the Pathway of Care across 

DoD and provides a collaborative and transparent forum supporting enterprise-wide coordination. DVBIC serves as the 

manager of the Pathway of Care and chair of the TAC.

In 2016, the TAC formalized and codified the review process for TBI products (e.g., DVBIC CRs). The TAC also welcomed 

four new service representatives in 2016: Air Force and Navy (January), Army (March), and Marine Corps (May). The 

DVBIC national director, and new TAC chair, arrived in April. In addition, the TAC:

■ Drafted the TBI program description, a formal deliverable to the Tri-Service Specialty Care Board that inventoried 

and outlined the services’ TBI programs as well as the history, successes and challenges of the MHS TBI community.

■ Reviewed and mapped the services’ TBI education policies facilitating an end state of a unified education policy across 

the services (led by DVBIC Education Division).

■ Identified gaps in referral and transition patterns (led by DVBIC Clinical Affairs Division).
20 | DVBIC 2016 ANNUAL REPORT

Working Groups and Committees

In addition to its role as manager of the TBI Pathway of Care, 

DVBIC performs important functions as a key member of 

numerous executive committees, working groups and other 

TBI-related professional entities. In 2016, DVBIC participated 

in a leadership capacity in the following: TBI End Points 

Development Initiative, Chronic Effects of Neurotrauma 

Consortium, Committee on Surgical Combat Casualty Care, 

Neurotrauma Steering Committee, Brain Trauma EvidenceBased Consortium, Non-Invasive Neuro-assessment Devices 

Integrated Project Team, and capability-based assessment 

integrated project teams for Joint Program Committee-5 and 

Joint Program Committee-8.

2016 also marked the sunset of the Neurocognitive Assessment 

Implementation Work Group (NAIWWG), a chartered working 

group led by DVBIC and dedicated to tracking progress on 

Automated Neuropsychological Assessment Metrics (ANAM) 

testing before deployment. Launched in 2013, NAIWG finally 

reached all of its goals in 2016. Although ongoing needs 

persist for tracking deployment-related cognitive testing, 

NAIWG transferred responsibility to the TAC since both 

groups include the same members.

15-Year Studies

Researchers at the DVBIC network site at Walter Reed 

National Military Medical Center (WRNMMC) are leading 

a set of longitudinal studies on TBI in service members 

and veterans who served in Operation Enduring Freedom 

and Operation Iraqi Freedom, as well as the impact of TBI 

on their families. Under the umbrella name of “the 15-year 

studies,” several studies launched in 2010 and are conducted 

in collaboration with the Center for Neuroscience and 

Regenerative Medicine, VA and other DVBIC sites.

The goals of these projects include developing a data 

repository of clinical and health data and bio specimens 

collected from injured and non-injured service members, 

documenting long-term outcomes over the course of 15 

years to improve understanding of TBI in a military cohort, 

investigating the effects of caring for a service member with 

TBI on the caregiver’s health and well-being, and examining 

the effects of the TBI on the health and behavior of service 

members’ children. 

Since 2010, researchers working on the 15-year studies 

have published 62 peer-reviewed manuscripts and 112 

abstracts and presented 134 conference talks and posters. 

The findings from these publications and presentations 

contributed to the Year 7 Report to Congress submitted to 

DVBIC senior leadership for review in November 2016 prior 

to delivery to Congress in 2017. During 2016, the longitudinal 

family caregiver study underwent an expansion in scope 

and integrated four of the new TBI-care quality-of-life short 

forms. The natural history study started analyses with blood 

from intensive clinical evaluations looking at tau and amyloidbeta 42. As of December 2016, the natural history study had 

1147 participants actively enrolled and the family caregiver 

study had 300. While some study procedures were paused 

due to staffing challenges this year, the break provided an 

opportunity to refine procedures, tackle a backlog of referrals 

and analyze existing data for conference presentations.

A Head for the Future

A Head for the Future is DVBIC’s TBI awareness initiative. 

A Head for the Future provides resources to help the military 

community prevent, recognize and recover from TBI. In 2016, 

A Head for the Future expanded its social media reach, 

collaborated with other TBI stakeholders and developed 

a variety of educational products, including public service 

announcements. Among its 2016 accomplishments, A Head 

for the Future:

■ Exceeded 2.8 million Facebook page interactions with over 

230,000 TBI Champion video views and 65,000 “likes” 

■ Reached over 3.5 million Twitter users, including 3,900 

followers and over 163,000 videos views

■ Collaborated with Centers for Disease Control and 

Prevention’s HEADS UP campaign to publish a joint blog 

on Huffington Post on Veterans Day 2016

■ Participated in the Hidden Heroes campaign launch 

sponsored by the Elizabeth Dole Foundation

■ Participated in Office of Warrior Care Policy Facebook 

Townhall to address questions regarding resources 

available for wounded warriors. The event reached more 

than 8,300 users and was engaged over 490 times. 

■ Published 11 TBI champion videos, shot six additional 

videos, and launched three public service announcements. 

The public service announcements ran on Armed Forces 

Network channels and DHHQ, with the A Head for the 

Future logo and brand, 14 to 42 times a week, reaching 

over 300,000 service members. 
DVBIC 2016 ANNUAL REPORT | 21

■ Secured news coverage including: 

■ “A Head for the Future initiative Raises Awareness 

of Traumatic Brain Injury Among Service Members” 

— Quantico Sentry, Quantico VA http://www.

quanticosentryonline.com/news/article_91d66458-

ce66-11e5-849d-6b1607dd7cc2.html 

■ “Veteran and Service Dog Sharing Message about 

Brain Injury, PTSD” — Las Vegas-Review Journal, 

Las Vegas NV http://www.reviewjournal.com/life/

health/henderson-veteran-service-dog-sharingmessage-about-brain-injury-ptsd 

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 2016 was THINK AHEAD: Be Safe, Know the Signs, 

and Get Help. During BIAM 2016, the DVBIC network:

■ Conducted 481 education, outreach and training events 

related to TBI, reaching a total audience of over 99,303 

stakeholders (a 58 percent increase over BIAM 2015)

■ Conducted a satellite media tour consisting of 14 

television interviews and 10 radio interviews resulting 

in over 338,000 television interview impressions and 

over 5.3 million radio interview impressions

■ Participated in Brain Injury Awareness Day on Capitol 

Hill on March 16, which included the Brain Injury Health 

Fair and the “Concussion: It’s Not Just a Concussion” 

panel presentation

A Head for the Future is the 

traumatic brain injury (TBI) 

awareness and prevention 

initiative for the military 

community.

RECOGNIZE 

Know the signs and symptoms

PREVENT 

Protect your head

RECOVER 

Rest and get checked out

dvbic.dcoe.mil/aheadforthefuture

 twitter.com/aheadforthefuture

 facebook.com/DVBICpage

DVBIC led a social media campaign during Brain Injury 

Awareness Month encouraging people to share supportive 

messages using the hashtag #ThinkAhead. (Photo by 

DVBIC social media follower)
22 | DVBIC 2016 ANNUAL REPORT

In-Person Education Events

Regional education coordinators (RECs) across the DVBIC 

network completed 4,419 events, thereby providing TBI 

education and outreach to over 359,000 providers, service 

members, family members and veterans. RECs provided 

297 in-person training briefings to 14,120 service members 

and military and civilian health care providers. They also 

disseminated approximately 350,000 hard copy TBI educational 

resources, including approximately 5,000 products in-theater. 

Online Training and Information

The Education Division produced 10 monthly TBI webinars 

and four VA/DVBIC Clinical Grand Rounds presentations, 

training a total of approximately 3,775 military, VA and 

civilian health care providers. Presentations for the TBI 

webinar series included:

■ Do Head Injuries Cause Chronic Traumatic 

Encephalopathy (CTE)?

■ Concussion and Winter Sports

■ Management of Sleep Disturbances Following 

Concussion

■ Management of Headache Following Concussion/

Mild TBI: Guidance for Primary Care Management 

in Deployed and Non-Deployed Settings

■ Cognitive Rehabilitation in Mild Traumatic Brain Injury: 

Applications in Military Service Members and Veterans

■ Using the Performance Triad for Optimal Brain 

Injury Recovery

■ Animal-Assisted Therapy: An Alternative Treatment 

for Traumatic Brain Injury Rehabilitation

■ Unique Perspective for Women with Traumatic Brain 

Injury: Gender Differences and Coping Strategies

■ Advancement of Traumatic Brain Injury Research and 

Clinical Care in the Department of Defense

■ Return to Duty Following Mild TBI: Lessons Learned 

from Sports Concussion Management

Presentations in the VA/DVBIC Clinical Grand Rounds 

quarterly series included:

■ Using Technology to Help Students with TBI Transition 

from College to Employment

■ The VA/DoD Clinical Practice Guideline for the 

Management of Concussion/Mild Traumatic Brain Injury

■ Creative Arts Therapy and Mind-Body Medicine for 

Service Members with Traumatic Brain Injury

■ The Interface of Sleep and Traumatic Brain Injury

DVBIC staff at San Antonio Military Medical Center shared 

educational materials at veterans “Welcome Home” event. 

(Photo by SAMMC staff)

DVBIC hosted a quarterly series of “Grand Rounds” 

presentations for clinicians.
DVBIC 2016 ANNUAL REPORT | 23

The Deborah L. Warden Lectureship Award 

Dr. Louis French received the 2016 Deborah L. Warden 

Lectureship Award. French is a clinical psychologist and 

deputy director of operations at the National Intrepid Center 

of Excellence at Walter Reed National Military Medical 

Center. 

The award is dedicated to Dr. Deborah Warden, a neurology 

professor and former national director of DVBIC. It is 

presented annually to professionals who have exhibited 

outstanding devotion, guidance and commitment to medical 

science, clinical care and the well-being of TBI patients.

DVBIC was active on social media throughout 2016 

Dr. Deborah L. Warden, former DVBIC national director, 

attended the award ceremony named in her honor. (DVBIC 

photo by Carlson Gray)

Colonel Geoffrey Grammer, DVBIC national director, 

presented the Deborah L. Warden Lectureship Award to 

Dr. Louis French. (DVBIC photo by Carlson Gray)
24 | DVBIC 2016 ANNUAL REPORT

National Meeting

Held in September 2016 at DVBIC headquarters in Silver Spring, Maryland, the DVBIC National 

Meeting brought together staff members from across DVBIC network sites for the first time in five 

years. Site directors, senior clinical research directors and leadership from DVBIC headquarters 

discussed strategy, research priorities and new processes for the network. 

DVBIC photos by Carlson Gray

DVBIC leadership and division 

directors led a panel at the national 

meeting to address questions from 

network staff.

DVBIC staff participated in numerous working group sessions during the national meeting.
DVBIC staff members participated in a working group during the national meeting.

DVBIC 2016 ANNUAL REPORT | 25

Interaction among staff across divisions created many opportunities to help inform work over the next year. 

Session topics included, but were not limited to: leadership priorities, division overviews, site director brainstorming, the Human Research Protection Program, policy and procedure gaps, role of the public affairs office, 

network site needs, and education initiatives. Most sessions concluded with due outs for leadership and staff 

to conduct following the meeting. Due outs included, but were not limited to: 

■ Develop site director orientation book with information on role, policies and procedures

■ Devote more time on monthly national and research calls to resolve obstacles to multisite studies

■ Identify a platform for sharing information and a discussion forum

■ Provide information or policies about when and what type of support agreement is needed

Karen A, Schwab, Ph.D., has 

contributed significantly to 

DVBIC research since in 1992.

Samantha L. Finstad, Ph.D. was DVBIC’s strategy, plans, 

and programs chief and acting communications and technology 

chief. She played a key role in organizing the national meeting.
26 | DVBIC 2016 ANNUAL REPORT

Network Site Updates

A DVBIC network site is a collaborative relationship between DVBIC and a military treatment 

facility or VA medical center. Each DVBIC network site conducts clinical research; educates 

service members, medical personnel and caregivers; and consolidates and reports DoD and 

VA TBI-related incidence and prevalence data. Network sites sign a support agreement with 

DVBIC. The network site and DVBIC both provide resources, including facilities, equipment and 

personnel. In 2016, DVBIC added three new network sites: Fort Drum, Fort Gordon and the San 

Antonio VAMC (see page 8).

Partnerships with military training facilities and VA medical centers are integral to DVBIC.
DVBIC 2016 ANNUAL REPORT | 27

Camp Lejeune

The Intrepid Spirit Concussion Recovery Center at Naval Hospital 

Camp Lejeune concluded the year with new research studies 

on the effects of repetitive low-level blast exposure, relaxation 

training, acupuncture for treatment of TBI-related headaches, and 

neuroendocrine, genetic and epigenetic correlates in cognitive 

assessment. Research agreements supported this active 

research agenda with East Carolina University, University of 

California, Irvine, Wayne State University, Princeton University, 

Chatham University, as well as the Syracuse VA Medical Center.

The number of poster presentations by DVBIC staff at professional 

conferences grew by 60 in 2016. These presentations reached 

a wide audience at prestigious gatherings in the U.S. such as 

the Military Health System Research Symposium. DVBIC staff 

members from Camp Lejeune also presented at conferences in 

Chile and Puerto Rico, conducted a webinar on Camp Lejeune 

Intrepid Spirit’s “Return to School” program at the DCoE Summit 

in September, and created a “battlebook” to inform special 

operations patients about the Intrepid Spirit Center at Camp 

Lejeune. The outreach to special operations proved successful 

in increasing clinic referrals.

Camp Pendleton

DVBIC Camp Pendleton 

conducts TBI research with 

a particular emphasis on 

investigating the short and 

long-term effects of blast 

exposure. In 2016, DVBIC 

researchers completed the 

study entitled “Neurocognitive 

Assessment of Blast 

Exposure Sequelae in 

Training (NC-BEST Study).” 

This study examined the 

effects of repetitive low-level 

blast exposure on service members, provided new information 

pertaining to blast exposure from shoulder-mounted rocket 

launchers (a common anti-tank weapon for our military), and 

assessed concerns of potential neurological consequences. 

DVBIC staff at Camp Pendleton initiated a study entitled 

“Investigating the Neurologic Effects of Training Associated 

Blast (I-TAB Study).” This study offered a unique approach to 

investigating neurotrauma from combat training operations. 

The study examined advanced assessment techniques to 

include processing of blood biomarkers, audiology, neurootologic and neurophysiologic diagnostics, and transcranial 

Doppler imaging all in remote settings. Two custom designed 

trailers allowed for private assessment rooms, freezers for 

biologics, centrifuges, and high powered generators capable 

of traversing remote terrains and maintaining full functionality. 

The trailers debuted in October of 2016.

Fort Belvoir

DVBIC researchers made significant progress initiating 

multiple research studies by receiving institutional review 

board approval and starting patient recruitment. “The Chronic 

Effects of Neurotrauma Consortium” is the largest of the 

studies that started recruiting in 2016. DVBIC staff members 

were also invited to three international conferences to present 

on models of stress and TBI, Fort Belvoir’s university model 

clinical program, and other topics. 

This year marked the first full year of the university model 

program. This new program helped patients “graduate” from 

active treatment to significant functional gains in their duties 

as service members, family members and citizens. The 

recovery support specialist integrated new standardized 

protocols, procedures and policies for data entry into the 

Wounded, Ill and Injured Registry to strengthen outcomes 

for TBI health care delivery across the continuum of care. 

In 2016, the regional education coordinator at Fort Belvoir 

provided TBI outreach and DVBIC materials to over 7,600 

individuals (providers, service members, veterans, caregivers, 

military families and stakeholders). Additionally, the regional 

education coordinator focused on caregiver peer education; 

concussion education, prevention and helmet use to military 

children; and the dissemination of DVBIC resources and 

education to Fort Belvoir Community Hospital Behavioral 

and Mental Health medical residents. Outreach efforts 

included regional site visits to military treatment facilities 

and VA polytrauma centers, the National Capitol Regions 

Chaplain Association, and the National Museum of Health 

and Medicine. The regional education coordinator was also 

invited to co-teach a new TBI course with providers at the 

TBI clinic.

Keith Steussi, M.D., served 

as DVBIC medical director 

at Camp Pendleton. (DVBIC 

photo by Carlson Gray)

Navy Captain Thomas Johnson, pictured here, served as the 

DVBIC site director at Camp Lejeune. (Photo by Camp 

Lejeune staff)
28 | DVBIC 2016 ANNUAL REPORT

Fort Bragg

The Intrepid Spirit Center at Womack 

Army Medical Center opened in January 

2016 with a ribbon cutting ceremony in 

March attended by Col. Grammer and 

many other dignitaries. As part of the 

event, DVBIC subject matter experts gave 

talks on chronic traumatic encephalopathy 

and posttraumatic headache. 

The research team authored or co-authored 

six peer-reviewed publications, submitted 

five other manuscripts, and presented 

11 posters at professional conferences. 

Throughout the year, DVBIC researchers 

were involved in multiple active research 

studies, developed protocols to begin at 

least three new studies in the next year 

and collaborated on two grant proposals.

The recovery support specialist facilitated 

adding TBI services to the NCServes–

RDU/Fayetteville network, a component 

of AmericaServes. The regional education 

coordinator began giving regular TBI 

education sessions to the Fort Bragg 

Reception Company newcomers brief, 

the new provider orientation at Womack 

Army Medical Center, and the Drop Zone 

Medical Officers Brief. The REC also 

joined the Installation Prevention Team 

and Me Too Program at Fort Bragg.

Fort Carson

Researchers at DVBIC Fort Carson 

continued to enroll service members 

and veterans in a neurofeedback study 

funded by the Telemedicine and Advanced

Technology Research Center (TATRC), 

an office of the U.S. Army Medical 

Research and Materiel Command. 

TATRC supports studies that address 

gaps in military medical research through 

technology. The neurofeedback study 

tests a non-invasive novel treatment 

option for TBI. DVBIC took possession 

of the Outcomes Assessment Center, 

an off-post facility with equipment 

for vestibular, auditory and ocularmotor research. The regional education 

coordinator continued to brief soldiers 

deploying from, and returning to, Fort 

Carson and partnered with Evans Army 

Community Hospital to secure additional 

TBI training for all medical providers.

Fort Drum

The TBI Clinic at Fort Drum, which 

launched in December 2016, is the 

newest DVBIC network site. Major (Dr.) 

Thaddeus Pajak serves as the DVBIC 

site director. Rebecca S. Newton serves 

as TBI program director. “The DVBIC 

regional education coordinator joining 

our team will help the soldiers and family 

members of the 10th Mountain Division 

have a better understanding of prevention 

and treatment of traumatic brain injury,” 

Newton said. “We are excited for her to 

join our team!”

Fort Drum provides comprehensive TBI 

care and recovery support to soldiers 

and family members of the 10th Mountain 

Division. Clinic staff includes a primary 

care physician, neurologist, psychologist, 

speech pathologist, social worker, 

occupational therapist, physical therapist. 

Some of the unique services offered are 

Botox injections for migraines, alpha 

stimulation for reduction of headaches, 

and visual perception training. 

Fort Gordon

Launched in 2016, the DVBIC site at Fort 

Gordon is co-located with the Neuroscience 

and Rehabilitation Center at the Dwight 

D. Eisenhower Army Medical Center 

(DDEAMC). The Neuroscience and 

Rehabilitation Center integrates the TBI 

clinic and neurology services. DDEAMC’s 

TBI clinic was the first program to be 

awarded full validation as a Category 1 

TBI Center in accordance with the Office 

of the Surgeon General’s Proponency for 

Rehabilitation and Reintegration. 

Treatment at this site encompasses a 

myriad of patient-centered approaches 

including medical management of 

symptoms, psychotherapy, education, 

cognitive rehabilitation, occupational 

and physical therapies, interdisciplinary 

pain management, biofeedback, 

acupuncture, yoga, mind-body medicine 

approaches, substance abuse services 

and recreational outings. Treatment 

also includes options to address the 

most common comorbidities (e.g., 

PTSD, pain, sleep disorders, substance 

abuse). DVBIC Fort Gordon offers a 

three-week multidisciplinary intensive 

outpatient program which includes 

post-concussive symptom management, 

neuropsychological screening and 

comprehensive testing, Automated 

Neuropsychological Assessment Metrics 

(ANAM-IV), pre-deployment baseline 

cognitive testing, driving simulator training 

and evaluation, and encephalogram 

studies.

Close collaborations with other programs at 

DDEAMC bolster the Fort Gordon DVBIC 

site and Neuroscience and Rehabilitation 

Center capabilities. Collaborators include 

the Residential Treatment Facility (a 28-day 

inpatient substance abuse program), 

Interdisciplinary Pain Management Center 

and Outpatient Behavioral Health Service 

(including interventional psychiatry via 

transcranial magnetic stimulation). Fort 

Gordon also serves as the host for the 

Regional Health Command-Atlantic 

Virtual Behavioral Health Hub.

Robin Cornwell, Ph.D., a DVBIC 

research scientist at Fort Carson, 

explained her research interests during 

the national meeting. (DVBIC photo by 

Carlson Gray)
DVBIC 2016 ANNUAL REPORT | 29

Edison Wong, M.D., 

DVBIC senior clinical 

research director at Fort 

Hood, posed for a photo 

at the national meeting. 

(DVBIC photo by Carlson 

Gray)

Fort Hood

Working extensively on the 

posttraumatic headache CR 

study, the DVBIC Fort Hood 

team developed protocols, 

managed institutional review board 

submissions, recruited providers, 

and cultivated relationships with 

Fort Hood clinics, Fort Bliss, the 

Uniformed Services University of 

the Health Sciences, and other 

DVBIC sites. In collaboration with 

researchers at the new Carl R. 

Darnall Medical Center (CRDAMC), 

the DVBIC team also developed 

a research consortium to bring 

together researchers on post for a 

forum to discuss research efforts 

across the post and Army wide.

The DVBIC recovery support specialist and regional education 

coordinator participated in the 42nd Annual Retiree Fair at the 

CRDAMC and collaborated with the Army Wounded Warrior 

Program to introduce veterans to Defense Department TBI 

and support services at CRDAMC. The clinical team provided 

clinical support at the TBI clinic at the Intrepid Spirit Center to 

include the following programs: intensive outpatient sessions, 

physiatric specialty care in pain management, coverage for 

primary care management of TBI, and development of the 

pain management section at the Intrepid Spirit Center.

Joint Base Elmendorf-Richardson

The Joint Base Elmendorf-Richardson (JBER) Mild Traumatic 

Brain Injury Clinic is DVBIC’s sole Air Force-based TBI 

facility. JBER’s population includes more than 50,000 

Alaska-based service members and dependents and 

approximately 73,000 veterans. The clinic led the base-wide 

Automatic Neuropsychological Assessment Metric, known 

as ANAM, screening 673 service members and civilians 

prior to deployment. 

The Recovery Support Program network assisted more than 

60 service members and veterans and worked with their 

family members during their care transition throughout the 

year from JBER. The regional education coordinator reached 

more than 25,000 Alaska and Hawaii-based service members, 

veterans, family members, medical and mental health providers, 

education professionals and community organizations, sharing 

information about TBI prevention, screening and care.

To provide optimum service to its stakeholders, DVBIC JBER 

continued to increase collaboration with other medical and 

complementary care professionals. JBER is one of five DoD 

sites chosen by the National Endowment for the Arts to assist 

in adding art and music therapy services beginning in 2017.

Landstuhl

The Regional Health Command Europe, DVBIC Landstuhl 

site became fully operational in 2016 with the addition of the 

senior clinical research director, regional program manager, 

regional education coordinator and recovery support specialist 

in place. DVBIC staff members aggressively met stakeholder 

expectations for recovery support service coordination and 

research development across the region. Notably, the senior 

clinical research director implemented full TBI data portal utilization 

across Europe for tracking TBI health outcome metrics. With 

the recent advent of the new regional education coordinator, 

DVBIC Landstuhl anticipates achieving the same success with 

educational activities.

Minneapolis VA

DVBIC staff collaborated with VA research staff on two separate 

studies reviewing the use of deep transcranial magnetic 

stimulation for treatment of mild depression and alcohol use 

disorder. Studies on longitudinal neurodegeneration and 

cognitive control continued to recruit, screen and conduct 

follow-up at the Minneapolis VA location. A study on visual 

sensory impairment and progression following mild TBI started 

collecting data in 2016, and a study on retinal imaging with 

adaptive optics for early diagnosis in TBI was proposed and 

will begin in early 2017. The regional education coordinator 

remained actively involved with the polytrauma center staff 

and helped with the development of a future study investigating 

acupuncture in the polytrauma population.

Naval Medical Center San Diego

DVBIC at Naval Medical Center San Diego (NMCSD) works 

collaboratively with the Office of Neurotrauma at NAVMED 

West and TBI Clinical Services at NMCSD to provide improved 

access to care for service members. DVBIC at NMCSD also 

conducts state-of-the-science research aimed at improving 

care for service members with TBI. The 2016 clinical research 

portfolio included studies examining short-term and long-term 

outcomes after TBI for patients and caregivers, evaluating

Lars Hungerford, Ph.D., DVBIC senior clinical research 

director at Naval Medical Center San Diego, participated in 

a working group session at the national meeting. (DVBIC 

photo by Carlson Gray)
30 | DVBIC 2016 ANNUAL REPORT

advanced technologies for assessment and rehabilitation 

of TBI — such as mobile eye tracking, EEG, and virtual 

reality — and investigating the real-world implementation 

and impact of clinical practice guidelines for progressive 

return to activity after TBI.

DVBIC coordinated care for TBI patients and provided 

extensive educational services. For example, DVBIC initiated 

a far-reaching “TBI Roadshow” to provide a face-to-face 

introduction to the NMCSD TBI Evaluation Clinic and DVBIC 

as well as introduce and disseminate available resources 

for TBI referrals, education and treatment. The regional 

education coordinator facilitated 135 education and training 

events reaching over 17,397 stakeholders. The Third Annual 

TBI Symposium at NMCSD, a high-level event targeting 

providers, was well attended and highly praised.

Palo Alto VA

The unique collaboration developed by DVBIC Palo Alto’s 

clinical investigative research program working in tandem 

with the VA Palo Alto Health Care System (VAPAHCS) and 

Stanford University made possible the implementation of 

local and multi-center TBI studies in active duty and veteran 

groups. The DVBIC Palo Alto research program helped 

initiate a new VA Office of Academic Affairs Polytrauma 

System of Care (PSC) Research Fellowship program due to 

begin in 2017. Further, DVBIC Palo Alto researchers formed 

a multidisciplinary Rehabilitation Research Committee within 

the VA. Going forward, this committee will leverage the 

combined expertise, interests and resources from DVBIC, 

the polytrauma system of care, spinal cord injury, assistive 

technology, and vision rehabilitation to develop new lines 

of research, expand ongoing interests, and forge new 

collaborations and relationships.

This year, the regional education coordinator focused on 

supporting PSC clinical providers in their education and 

supporting community stakeholders in a variety of settings. 

Looking ahead to 2017, the regional education coordinator 

plans to expand education outreach to PSC and DVBIC 

researchers and study participants in an effort to improve 

on-site research awareness and recruitment.

Richmond VA

The DVBIC research team at McGuire Veterans Affairs 

Medical Center published four manuscripts and delivered 

five presentations using DVBIC study data in 2016. The 

team also contributed to several grant applications to the 

Commonwealth Neurotrauma Fund and Congressionally 

Directed Medical Research Programs. Additionally, over 

the past year, enrollment across Richmond longitudinal 

studies surpassed 1,000. Satellite media tours coordinated 

by DVBIC HQ were conducted on January 11 and February 

26, 2016, with DVBIC’s deputy director and the Richmond 

regional education coordinator.

San Antonio Military Medical Center

In 2016, the recovery support specialist completed over 300 

encounters with service members and veterans recovering

The DVBIC REC at the San Antonio Military Medical 

Center shared information about TBI at a veterans “Welcome 

Home” event. (DVBIC photo)

DVBIC regional education coordinator Randy Gross talks 

with a service member about TBI. (Photo by Richmond VA 

staff)
DVBIC 2016 ANNUAL REPORT | 31

from TBI and developed new contacts with 26 supportive 

service organizations in the region. The regional education 

coordinator provided clinical education support to nearly 

1,800 providers and conducted education outreach to over 

5,300 service members, veterans, and families through 

presentations and community outreach. 

Researchers published three peer-reviewed journal articles, two 

book chapters, and five abstracts and gave 11 presentations 

at national meetings based on the SCORE study of cognitive 

rehabilitation. Researchers also submitted a grant proposal 

on complex TBI for funding to Joint Program Committee-8/

Clinical and Rehabilitative Medicine Research Program, 

developed a return-to-driving study in collaboration with the 

BAMC Brain Injury Rehabilitation Service, administered an 

online survey of TBI education to a sample of Army primary 

care providers, and received administrative and financial 

support from the BAMC Division of Clinical Investigation 

for a DVBIC-led epigenetic study of TBI.

San Antonio VA

The Audie L. Murphy Memorial Veterans Hospital (ALMMVH) 

is a quaternary care facility affiliated with the University of 

Texas Health Science Center at San Antonio. Comprehensive 

health care is provided through acute medical, surgical, 

mental health, physical medicine, rehabilitation, geriatric 

and primary care services. Attached to ALMMVH, the San 

Antonio Polytrauma Rehabilitation Center (PRC) is the newest 

of five facilities in the country designed to provide intensive 

rehabilitative care to veterans and service members with 

severe injuries (including brain injuries) to more than one 

organ system. In late 2016, DVBIC partnered with the San 

Antonio PRC to enhance research efforts.

Tampa VA

DVBIC staff members formed a partnership with MacDill AFB, 

allowing DVBIC research psychologists to see active-duty 

patients outside of the VA setting, providing convenience for 

patients and increasing patient involvement in local research 

opportunities. The regional education coordinator facilitated 

a series of “Lunch & Learn” events at MacDill AFB, educating 

the public on various aspects of TBI and offering continuing 

medical education credits for medical providers. DVBIC is 

also part of the curriculum presented at the Senior Enlisted 

Academy portion of the Joint Special Operations University 

with Special Operations Command.

Several longitudinal studies on TBI continued to enroll 

subjects and gather data at the Tampa VA. DVBIC staff, in 

partnership with the VA, presented the Smart Home project 

at the VA Brain Trust InnoVAtion meeting in Washington, 

D.C. The team placed third out of over 100 submissions and 

received recognition directly from the Secretary of the VA.

Walter Reed National Military Medical Center

2016 continued to see the evolution of the National Intrepid 

Center of Excellence (NICoE) as a directorate of Walter 

Reed National Military Medical Center (WRNMMC) and as 

a key component within the MHS’s TBI Pathway of Care. 

NICoE’s clinical operations department focused efforts on 

maturing the integration of the DVBIC outpatient clinic with 

the NICoE legacy four-week Intensive Outpatient Program. 

Through these efforts, the portfolio of care options spans 

the full scope of TBI treatment and has enhanced each 

patient’s ability to access a wide variety of holistic services 

under one roof. The Brain Fitness Center also continued its 

successful growth this year. 

In addition to the 15-year studies WRNMMC research that 

supports clinical care passed a milestone in August 2016 

with the submission of an analysis plan for its longitudinal 

database to the intuitional review board. This protocol was 

submitted with several internal collaborators (departments of 

gynecologic-oncology and neuro-oncology and the National 

Military Audiology and Speech Pathology Center) as well 

outside collaborators (Fort Belvoir Community Hospital, 

University of British Columbia’s Division of Physical Medicine 

and Rehabilitation, and Wisconsin VA). This wide ranging 

collaboration is expected to yield important answers about 

the treatment of cognitive dysfunction in military and veteran 

populations.

In November 2016, Dr. Lou French, DVBIC site director at 

WRNMMC, received the 8th annual Dr. Deborah L. Warden 

Lectureship Award. Warden succeeded Dr. Andres M. Salazar 

as the second DVBIC national director. The award honors 

outstanding contributions in the field of TBI research. The 

lectureship event was held at NICoE.

The Fort Bragg TBI community celebrates the opening of the 

new Intrepid Spirit Center. (DVBIC photo)
Photo by DVBIC Fort Bragg Intrepid Spirit Center Staff

32 | DVBIC 2016 ANNUAL REPORT

External Partnerships

DVBIC relies on different types of partnerships to carry out its mission. Partnership types include relationships integral 

to DVBIC’s structure, such as the network sites, as well as military, government and civilian stakeholder entities. Across 

the spectrum, partnerships encourage effective collaboration, drive proactive stakeholder engagement, enhance 

efficiency, and improve the impact of DVBIC research, educational and clinical initiatives.

In addition to the network sites, DVBIC partners with other federal agencies, academic institutions and non-profits 

to support its mission. These organizations serve similar stakeholders or provide similar services to DVBIC. Many of 

these organizations collaborate on research protocols, conduct outreach to those impacted by TBI, or serve those 

impacted by TBI. 

In 2016, DVBIC conducted an assessment of its partnerships. The assessment determined that DVBIC’s partnership 

goal should be to establish a standardized, measurable, and sustainable partnership program to identify and facilitate 

collaborative, mutually beneficial partnerships that support DVBIC’s ability to accomplish its mission. To achieve this, 

DVBIC outlined objectives and activities for each of its divisions. As DVBIC’s partnership program matures, additional 

objectives and metrics will be defined and assessed through ongoing reviews of the program.
DVBIC 2016 ANNUAL REPORT | 33

Government, Military and Nonprofit Organizations

Armed Forces Health 

Surveillance Center

Center for Neuroscience 

and Regenerative Medicine 

(CNRM)

Centers of Excellence 

Research Directorates, Office 

of the Assistant Secretary 

of Defense for Research & 

Engineering

Centers for Disease 

Control and Prevention

Chronic Effects 

of Neurotrauma 

Consortium

Elizabeth Dole Foundation Federal Recovery 

Coordination Program

Fort Bliss Intrepid Spirit, 

Fort Bliss TX

Fort Campbell, KY Joint Base Lewis-McChord 

Tacoma, WA

Joint Program Committee 

5 (Military Operational 

Medicine Research Program)

Joint Program 

Committee 6 (Combat 

Casualty Care Research 

Program)

Joint Program 

Committee 8 (Clinical 

and Rehabilitative 

Medicine Research 

Program)

MacDill Air Force Base, 

Tampa, FL

National Collegiate Athletic 

Association National Football League

National Institute of 

Neurological Disorders 

and Stroke

National Institute on 

Disability, Independent 

Living, and Rehabilitation 

Research

National Intrepid Center of 

Excellence One Mind

Rosalynn Carter 

Institute for Caregiving

TBI End Points 

Development (TED) 

Government Steering 

Committee

TBI Model Systems Program

Transforming Research 

and Clinical Knowledge 

in TBI

U.S. Army Aeromedical 

Research Laboratory U.S. Coast Guard

University Partners

Dartmouth College Georgetown University Harvard Medical School Institute of Soldier 

Nanotechnologies at MIT

University of California, 

San Diego University of Pennsylvania University of Pittsburgh

Uniformed Services 

University of the Health 

Sciences

Virginia 

Commonwealth 

University

The table lists key partner organizations in 2016. It reflects the scope of DVBIC’s partnerships but does 

not include all partners
34 | DVBIC 2016 ANNUAL REPORT

Publications

Since 1992, DVBIC subject matter experts have published more than 400 peer-reviewed manuscripts. 

In 2016, they served on the editorial boards of the Journal of Neurotrauma and Journal of Head 

Trauma Rehabilitation and published the peer-reviewed papers listed below. As indicated, some 

papers were published online in 2016 ahead of subsequent print publication:

Allan, A. C., Edmed, S. L., Sullivan, K. A., Karlsson, L. J., Lange, R. T., & Smith, S. S. (2017). Actigraphically measured sleep-wake behavior after mild 

traumatic brain injury. Journal of Head Trauma Rehabilitation, 32(2). Advance online publication March 2016. doi:10.1097/htr.0000000000000222

Armistead-Jehle, P., Cooper, D., & Vanderploeg, R. (2016). The role of performance validity tests in the assessment of cognitive functioning after 

military concussion: A replication and extension. Applied Neuropsychology: Adult, 23(4), 264-273. http://dx.doi.org/10.1080/23279095.2015.1055564

Bailie, J. M., Kennedy, J. E., French, L. M., Marshall, K., Prokhorenko, O., Asmussen, S., . . . Lange, R. T. (2016). Profile analysis of the neurobehavioral 

and psychiatric symptoms following combat-related mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 31(1), 2-12. doi:10.1097/

htr.0000000000000142

Belanger, H.G., Lange, R.T., . . . Bailie, J. (2016) Interpreting change on the neurobehavioral symptom inventory and the PTSD checklist in military 

personnel. Journal of Clinical Neuropsychology, 30(7), 1063-73.

Belanger, H. G., Vanderploeg, R. D., & Mcallister, T. (2016). Subconcussive blows to the head. Journal of Head Trauma Rehabilitation, 31(3), 

159-166. doi:10.1097/htr.0000000000000138

Belanger, H.G., Vanderploeg, R.D. & Sayer, N. (2016). Screening for remote history of mild traumatic brain injury in VHA: A critical literature review. 

Journal of Head Trauma Rehabilitation, 31(3), 204-214.

Bell, K., Fann, J., Brockway, J., Cole, W., Bush, N., . . . and Temkin, N. (2016). Telephone problem solving for service members with mild traumatic 

brain injury: A randomized, clinical trial. Journal of Neurotrauma, 34(2), 313-321. http://dx.doi.org/10.1089/neu.2016.4444

Bjork, J. M., Burroughs, T. K., Franke, L. M., Pickett, T. C., Johns, S. E., Moeller, F. G., & Walker, W. C. (2016). Laboratory impulsivity and depression 

in blast-exposed military personnel with post-concussion syndrome. Psychiatry Research, 246, 321-325. doi:10.1016/j.psychres.2016.10.008

Brickell, T. A., Lippa, S. M., French, L. M., Kennedy, J. E., Bailie, J. M., & Lange, R. T. (2016). Female service members and symptom reporting 

after combat and non-combat-related mild traumatic brain injury. Journal of Neurotrauma, 34(2), 300-312. Advance online publication July 2016. 

doi:10.1089/neu.2016.4403

Carlozzi, N., Brickell, T., French, L., Sander, A., Kratz, A., & Tulsky, D. et al. (2016). Caring for our wounded warriors: A qualitative examination 

of health-related quality of life in caregivers of individuals with military-related traumatic brain injury. Journal of Rehabilitation Research and 

Development, 53(6), 669-680. http://dx.doi.org/10.1682/jrrd.2015.07.0136

Cole, W.R., Arrieux, J.P., Dennison, E.M. & Ivins, B.J. (2017). The impact of administration order in studies of computerized neurocognitive assessment 

tools (NCATs). Advance online publication October 2016. Journal of Clinical Experimental Neuropsychology. doi:10.1080/13803395.2016.1198470

Cooper, D. B., Bowles, A. O., Kennedy, J. E., Curtiss, G., French, L. M., Tate, D. F., & Vanderploeg, R. D. (2017). Cognitive rehabilitation for military 

service members with mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 32(3). Advance online publication September 2016. 

doi:10.1097/htr.0000000000000254

Cripps, A.E. & Livingston, S. C. (2017). Differentiating concussion from intracranial pathology in athletes. Journal of Sport Rehabilitation, 26(1), 

101-108. Advance online publication November 2016. doi:10.1123/jsr.2015 0043

Cripps, A.E., Livingston, S.C. & DeSantis B. (2016). The test-retest reliability and minimal detectable change of the sensory organization test and 

head-shake sensory organization test. Journal of Sports Medicine and Allied Health Sciences, 2(2), 1-10.
DVBIC 2016 ANNUAL REPORT | 35

Dretsch, M. N., Silverberg, N., Gardner, A. J., Panenka, W. J., Emmerich, T., Crynen, G., . . . Iverson, G. L. (2017). Genetics and other risk factors 

for past concussions in active-duty soldiers. Journal of Neurotrauma, 34(4), 869-875. Published online August 2016. doi:10.1089/neu.2016.4480

Dretsch, M. N., Williams, K., Staver, T., Grammer, G., Bleiberg, J., Degraba, T., & Lange, R. T. (2016). Evaluating the clinical utility of the Validity-10 

for detecting amplified symptom reporting for patients with mild traumatic brain injury and comorbid psychological health conditions. Applied 

Neuropsychology: Adult, 24(4), 376-380. doi:10.1080/23279095.2016.1220947

Finkel, A. G., Yerry, J. A., Klaric, J. S., Ivins, B. J., Scher, A., & Choi, Y. S. (2016). Headache in military service members with a history of mild 

traumatic brain injury: A cohort study of diagnosis and classification. Cephalalgia, 37(6), 548-559. doi:10.1177/0333102416651285

Franke, L. M., Walker, W. C., Hoke, K. W., & Wares, J. R. (2016). Distinction in EEG slow oscillations between chronic mild traumatic brain injury 

and PTSD. International Journal of Psychophysiology, 106, 21-29. doi:10.1016/j.ijpsycho.2016.05.010

Gilmore, C. S., Camchong, J., Davenport, N. D., Nelson, N. W., Kardon, R. H., Lim, K. O., & Sponheim, S. R. (2016). Deficits in visual system functional 

connectivity after blast-related mild tbi are associated with injury severity and executive dysfunction. Brain and Behavior, 6(5). doi:10.1002/brb3.454

Gilmore, C. S., Marquardt, C. A., Kang, S. S., & Sponheim, S. R. (2016). Reduced P3b brain response during sustained visual attention is associated 

with remote blast mTBI and current PTSD in U.S. military veterans. Behavioural Brain Research. doi:10.1016/j.bbr.2016.12.002

Gregory, E., West, T.A. & Cole, W.R. (2016) 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. Published online ahead of print. Contemporary Clinical 

Trials. doi:10.1016/j.cct.2016.11.005

Hinds, S. & Livingston, S.C. (2016). Traumatic brain injury clinical recommendations: Impact on care and lessons learned. US Army Medical 

Department Journal, Apr-Sep (2-16), 97-101.

Holcomb, E. M., Schwartz, D. J., Mccarthy, M., Thomas, B., Barnett, S. D., & Nakase-Richardson, R. (2016). Incidence, characterization, and predictors of 

sleep apnea in consecutive brain injury rehabilitation admissions. Journal of Head Trauma Rehabilitation, 31(2), 82-100. doi:10.1097/htr.0000000000000230

Holcomb, E. M., Towns, S., Kamper, J. E., Barnett, S. D., Sherer, M., Evans, C., & Nakase-Richardson, R. (2016). The relationship between sleepwake cycle disturbance and trajectory of cognitive recovery during acute traumatic brain injury. Journal of Head Trauma Rehabilitation, 31(2), 

108-116. doi:10.1097/htr.0000000000000206

Jonas, W., Bellanti, D., Paat, C., Boyd, C., Duncan, A., & Price, A. et al. (2016). A randomized exploratory study to evaluate two acupuncture methods 

for the treatment of headaches associated with traumatic brain injury. Medical Acupuncture, 28(3), 113-130. http://dx.doi.org/10.1089/acu.2016.1183

Kamper, J., Garofano, J., Schwartz, D., Silva, M., Zeitzer, J., & Modarres, M. et al. (2016). Concordance of actigraphy with polysomnography in traumatic 

brain injury neurorehabilitation admissions. Journal of Head Trauma Rehabilitation, 31(2), 117-125. http://dx.doi.org/10.1097/htr.0000000000000215

Lange, R., Brickell, T., Bailie, J., Tulsky, D., & French, L. (2016). Clinical utility and psychometric properties of the traumatic brain injury quality of life 

scale (TBI-QOL) in us military service members. Journal of Head Trauma Rehabilitation, 31(1), 62-78. http://dx.doi.org/10.1097/htr.0000000000000149

Licona, N.E., Chung, J.S., Poole, J., Salerno, R.M., Laurenson, N. & Harris, O.A. (2016). Prospective tracking and analysis of traumatic brain injury 

in veterans and military personnel. Archives of Physical Medicine Rehabilitation. Published online ahead of print. doi:10.1016/j.apmr.2016.09.131

Lippa, S. M., Axelrod, B. N., & Lange, R. T. (2016). The mild brain injury atypical symptoms (mBIAS) scale in a mixed clinical sample. Journal of 

Clinical and Experimental Neuropsychology, 38(7), 721-729. doi:10.1080/13803395.2016.1161732

Lippa, S. M., Lange, R. T., Bailie, J. M., Kennedy, J. E., Brickell, T. A., & French, L. M. (2016). Utility of the Validity-10 scale across the recovery 

trajectory following traumatic brain injury. Journal of Rehabilitation Research and Development, 53(3), 379-390. doi:10.1682/jrrd.2015.01.0009

Lippa, S., Lange, R., Bhagwat, A., & French, L. (2016). 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.

http://dx.doi.org/10.1080/23279095.2015.1100617

Liu, Z., Dong, J., Zhao, X., Chen, X., Lippa, S. M., Caroselli, J. S., & Fang, X. (2016). Assessment of feigned cognitive impairment in severe traumatic 

brain injury patients with the forced-choice graphics memory test. Brain and Behavior, 6(12). doi:10.1002/brb3.593
36 | DVBIC 2016 ANNUAL REPORT

Marion, D., Lattimore, T., & Helmick, K. (2016). Military acute concussion evaluation screen in a civilian population. Journal of Trauma and Acute 

Care Surgery, 80(2), 351-352. http://dx.doi.org/10.1097/ta.0000000000000906

O’Neil, M., Callahan, M., Carlson, K., Roost, M., Laman-Maharg, B., & Twamley, E. et al. (2016). Postconcussion symptoms reported by Operation 

Enduring Freedom/Operation Iraqi Freedom veterans with and without blast exposure, mild traumatic brain injury, and posttraumatic stress disorder. 

Journal of Clinical and Experimental Neuropsychology, 39(5), 449-458. http://dx.doi.org/10.1080/13803395.2016.1232699

Pogoda, T. K., Stolzmann, K. L., Iverson, K. M., Baker, E., Krengel, M., Lew, H. L., . . . Meterko, M. (2016). Associations between traumatic brain 

injury, suspected psychiatric conditions, and unemployment in Operation Enduring Freedom/Operation Iraqi Freedom veterans. Journal of Head 

Trauma Rehabilitation, 31(3), 191-203. doi:10.1097/htr.0000000000000092

Regasa, L. E., Thomas, D. M., Gill, R. S., Marion, D. W., & Ivins, B. J. (2016). Military deployment may increase the risk for traumatic brain injury 

following deployment. Journal of Head Trauma Rehabilitation, 31(1). doi:10.1097/htr.0000000000000155

Schulz-Heik, R. J., Poole, J. H., Dahdah, M. N., Sullivan, C., Date, E. S., Salerno, R. M., . . . Harris, O. (2016). Long term outcomes after moderate-tosevere traumatic brain injury among military veterans: Successes and challenges. Brain Injury, 30(3), 271-279. doi:10.3109/02699052.2015.1113567

Silverberg, N., Crane, P., Dams-O’Connor, K., Holdnack, J., Ivins, B., & Lange, R. et al. (2017). Developing a cognition endpoint for traumatic brain 

injury clinical trials. Journal of Neurotrauma, 34(2), 363-371. Advance online publication June 2016. http://dx.doi.org/10.1089/neu.2016.4443

Tate, D. F., Wade, B. S., Velez, C. S., Drennon, A. M., Bolzenius, J., Gutman, B. A., . . . York, G. E. (2016). Volumetric and shape analyses of 

subcortical structures in United States service members with mild traumatic brain injury. Journal of Neurology, 263(10), 2065-2079. doi:10.1007/

s00415-016-8236-7

Towns, S., Zeitzer, J., Kamper, J., Holcomb, E., Silva, M., Schwartz, D., & Nakase-Richardson, R. (2016). Implementation of actigraphy in acute 

traumatic brain injury (TBI) neurorehabilitation admissions: A Veterans Administration TBI Model Systems feasibility study. PM&R, 8(11), 1046-1054. 

http://dx.doi.org/10.1016/j.pmrj.2016.04.005

Toyinbo, P. A., Vanderploeg, R. D., Belanger, H. G., Spehar, A. M., Lapcevic, W. A., & Scott, S. G. (2016). 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

Toyinbo, P. A., Vanderploeg, R. D., Donnell, A. J., Mutolo, S. A., Cook, K. F., Kisala, P. A., & Tulsky, D. S. (2016). Development and initial validation of 

military deployment-related TBI quality-of-life item banks. Journal of Head Trauma Rehabilitation, 31(1), 52-61. doi:10.1097/htr.0000000000000089

Walker, W. C., Carne, W., Franke, L. M., Nolen, T., Dikmen, S. D., Cifu, D. X., . . . Williams, R. (2016). The Chronic Effects of Neurotrauma Consortium 

(CENC) multi-centre observational study: Description of study and characteristics of early participants. Brain Injury, 30(12), 1469-1480. doi:10.1

080/02699052.2016.1219061

Walsh, D. V., Capó-Aponte, J. E., Beltran, T., Cole, W. R., Ballard, A., & Dumayas, J. Y. (2016). Assessment of the King-Devick® (KD) test for 

screening acute mTBI/concussion in warfighters. Journal of the Neurological Sciences, 370, 305-309. doi:10.1016/j.jns.2016.09.014

Wickwire, E., Williams, S., Roth, T., Capaldi, V., Jaffe, M., & Moline, M. et al. (2016). Sleep, Sleep disorders, and mild traumatic 

brain injury. what we know and what we need to know: findings from a national working group. Neurotherapeutics, 13(2), 403-417. 

http://dx.doi.org/10.1007/s13311-016-0429-3
DVBIC 2016 ANNUAL REPORT | 37

U.S. Air Force photo by Staff Sgt. Evelyn Chavez
38 | DVBIC 2016 ANNUAL REPORT

Presentations

Throughout 2016, DVBIC subject matter experts presented at conferences hosted by both military 

and civilian professional organizations.

■ Armistead-Jehle P., Cooper, D.B., Grills, C.E., Cole, W., & Lippa, S.. Validation of the mild brain injury atypical symptoms 

scale (mBIAS) and NSI validity-10 in military service members.

■ Brickell, T.A., French, L.M., Lange, R.T., Bailie, J., Sullivan, J., Thompson, D., Snelling, A., Kacmarek, C. & Lippa, 

S.M.A. The natural history of individual postconcussion symptoms from the acute/sub-acute recovery phase to one 

year following mild-moderate TBI: Part 2 of 2.

■ Brickell, T.A., Lange, R.T,, Lippa, S.M,, Bailie, J., Gartner, R., Dilay, A., Driscoll, A., Wright, M. & French, L.M. 

Self-reported outcome 5-years following mild-moderate traumatic brain injury.

■ French, L.M. & Lange, R.T. Does the validity-10 scale incorrectly identify symptom exaggeration when genuine 

distressing symptoms are endorsed?

■ Lange, R.T., French, L.M., Brickell, T.A., Bailie, J. & Lippa, S.M. Cross-Sectional perspective of self-reported 

postconcussion symptoms across the first 10 years of the recovery trajectory following mild-moderate TBI.

■ Lange, R.T., French, L.M., Lippa, S.M., Bailie, J., Pizzano, B., Johnson, L., Nora, D., Mahatan, H. & Brickell, T.A. Impact of 

mild-moderate tbi on health-related quality of life from one year to two years post-injury in u.s. military service members.

■ Lippa, S.M., Brickell, T.A., French, L.M., Bailie, J., Sullivan, J., Thompson, D., Snelling, A., Kacmarek, C. & Lange, 

R.T. Longitudinal Comparison of postconcussion symptom status from the acute/sub-acute recovery phase to 1-year 

following mild-moderate TBI: Part 1 of 2.

■ Lippa, S.M., Lange, R.T., Brickell, T.A., Bailie, J., Pizzano, B., Johnson, L., Nora, D., Mahatan, H., & French, L. The 

Relationship between symptom reporting in the acute care phase and neurobehavioral outcome 1-year following mild 

moderate traumatic brain injury.

American Academy of Clinical Neuropsychology

Annual Meeting

June 2016 | Chicago, Illinois

■ Cotner, B.A., Carlozzi, N., Lange, R.T., French, L.M., O’Connor, D.R., Nakase-Richardson, R., & Brickell, T.A. Influence 

of comorbidities of TBI on caregivers’ quality of life: Case examples.

American Congress of Rehabilitation Medicine

Annual Conference

November 2016 | Chicago, Illinois

This DVBIC session was one of the mostly highly rated and well attended sessions at this meeting.

■ Eshel, I. Keeping up with concussion: Best practices and resources for SLPs.

American Speech-Language-Hearing Association

Annual Convention

November 2016 | Philadelphia, Pennsylvania
DVBIC 2016 ANNUAL REPORT | 39

2016 marked DVBIC’s debut as an organization presenting at this meeting and the first military-specific provider conference 

for DVBIC in this research field. DVBIC was invited to return and present at future conventions.

■ Stout, K., Ray, J. & Wong, K. Military TBI: DVBIC overview, MHS Pathway of Care and TBI 101.

■ Stout, K., Ray, J. & Wong, K. Military TBI: Progressive return to activity, headache clinical recommendation and sleep 

clinical recommendation.

Association of Military and Osteopathic Physicians

Annual Meeting

April 2016 | Philadelphia, Pennsylvania

The Deborah L. Warden Lectureship is an award that honors Dr. Deborah L. Warden, DVBICs’ national director from July 

2001 to July 2007. Dr. Louis M. French received the 2016 award in recognition of his efforts to advance TBI clinical care 

and research within the MHS. French is the deputy director for operations at the National Intrepid Center of Excellence 

and director of the DVBIC network site at Walter Reed National Military Medical Center. The title of his presentation was 

“Advancement of Traumatic Brain Injury Research and Clinical Care in the Department of Defense.”

Deborah Warden Lectureship

November 2016 | National Intrepid Center of Excellence | Bethesda, MD

■ Besterman-Dahan, K. Community reintegration in veterans with TBI.

■ Bunner, A. & Bailie, J. Irritability, aggression, and anger after traumatic brain injury.

■ Carlson, K., Pogoda, T. & Resnick, S. The provision of supported employment to veterans with TBI in the VHA.

■ Chanpimol, S., Lisle, L. & Seamon, B. The TBI interdisciplinary fitness and social engagement (InFUSE) program: 

Development and initial outcomes.

■ Davis, D. Development of a technology-based pilot program to prepare active duty service members to return to school.

■ Dieter, J. & Engel, S. An interdisciplinary intensive outpatient program for treating TBI and associated disorders.

■ Elias, E., Rumrill, P., & Hendricks, D. Project career: Using technology to help veteran college students with traumatic 

brain injury achieve academic and employment success.

■ Jackson, J. Evaluation and management of auditory processing disorder in patients with PTSD and/or TBI.

■ Jorgenson-Wagers, K., Tiede, J., Frankart, J., & McNary, S. Interdisciplinary outpatient program for special operators.

■ Nelson-Schmitt, S., Brandler, B., & Guise, B. Neurocognitive driving rehabilitation in virtual environments (NeuroDRIVE): 

An adjunctive intervention for traumatic brain injury.

■ Picon, L.P., Grammer, G.G., & DeGraba, T. 2016 Updates to the VA/DoD clinical practice guideline for the management 

of concussion/mTBI.

■ Rhea, C., Kuznetsov, N., & Jakiela, J. Development of Composite measures using neuromotor and neurocognitive 

assessments to predict return-to-duty in post-concussive military personnel.

Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury

Annual Summit

September 2016 | Silver Spring, Maryland
40 | DVBIC 2016 ANNUAL REPORT

■ Tate, D.F., Velez, C.S., Drennon, A.M., Reid, M., Kennedy, J., Bowles, A., & Cooper, D. Subjective reports of cognitive 

dysfunction and objective neuropsychological test results among active duty service members.

■ Velez, C.S, Reid, M., Drennon, A.M., Kennedy, J., Cooper, D., Bowles, A., & Tate, D.F. Base rates neuropsychological 

performance in service members with mild TBI, PTSD and orthopedic controls.

International Neuropsychological Society

Annual Meeting

February 2016 | Boston, Massachusetts

In addition to the sessions listed below, DVBIC staff members presented a poster on computerized neurological assessment 

tools and gave oral presentations on DVBIC clinical recommendations (sleep and neuroimaging) and on the Pathway of 

Care and TBI Advisory Committee.

■ Hinds, S. (moderator); Helmick, K., Brickell, T., French, L., Lange, R., Malik, S., & Richardson, R. (speakers). Symposium 

session: Longitudinal Research on traumatic brain injury in military service members and veterans.

This invited session featured DVBIC research and described longitudinal studies aimed at understanding the long-term 

effects of TBI in U.S. military service members and veterans. Speakers focused on the role of resilience on outcomes 

after TBI, examined the trajectory of postconcussion symptom reporting and its association to diffusion tensor imaging 

findings, and discussed long-term rehabilitation needs in the chronic stage of TBI across severity levels.

■ Lange, R.T., Brickell, T.A., Tulsky, D.S., Holdnack, J., & French, L.M. Postconcussion symptom reporting and diffusion 

tensor imaging findings following mild-moderate traumatic brain injury.

International Brain Injury Association

Eleventh World Congress on Brain Injury

March 2016 | The Hague, Netherlands

■ Riechers, R. & Marion, D. Management of headache following TBI: Guidance for primary care management in deployed 

and non-deployed settings.

■ Vaudreuil, R.& Bronson, H. Considerations of applied neurologic music therapy: Treatment of traumatic brain injury 

and psychological health in military populations.

Military Health System

Research Symposium

August 2016 | Kissimmee, Florida 

In addition to supporting the conference planning committee, moderating a plenary session, and presenting several

poster sessions, DVBIC research staff gave the following oral presentations:

■ Bailie, J.M., Powell, B.E., Suthee, W., Sargent, P.D., & Duckworth, J.D. Impact of height on service member blast 

exposure levels from shoulder mounted rocket launchers. 

■ Bailie, J.M., Suthee, W.O, Powell, B.E., Sargent, P.D., & Duckworth, J.D. Post-concussive disorder associated with 

cognitive changes following sub-concussive blast exposure.

■ Ettenhofer, M.L. Neurocognitive correlates of impaired driving after traumatic brain injury: A preliminary analysis.

■ Finkel, A.G., Klaric, J.S., Yerry, J.A., & Choi, Y.S.. Headaches in soldiers with mild traumatic brain injury/concussion: 

Relationships to occupational outcomes.
DVBIC 2016 ANNUAL REPORT | 41

■ French, L.M., Brickell, T.A., Lippa, S.M., Bailie, J., Gartner, R., Dilay, A., Driscoll, A., Wright, M., & Lange, R.T. 

Neuropsychological outcome 1 year post-injury following mild to moderate traumatic brain injury in a civilian and military 

sample: Preliminary findings from an NIH/DoD multi-site collaboration.

■ Gilmore, C.S., Nelson, N.W., Finn, J.A., Lamberty, G.J., & Lim, K.O. Differential effects of mild tbi severity and ptsd 

symptomatology on cognitive performance in veterans.

■ Gregory, E., Arrieux, J.P., Haran, F.J., & Cole, W.R. Intraindividual cognitive variability: An examination of anam4 tbi-mil 

simple reaction time data from service members with and without mild traumatic brain injury.

■ Kuznetsov, N.A., Robins, R.K., Ross, S.E., Wright, W.G., Haran, F.J, Jakiela, J.T., Bailie, J.M., Yanagi, M.A., Long, B., 

Duckworth, J.L., & Rhea CK. Neuromotor testing post-mTBI: Reliability of movement metrics from a smartphone application.

■ Jolly, M.J., Bailie, J.M., Hussain, M.A., Sargent, P.D., & Duckworth, J.D. The impact of lifetime traumatic brain injury 

and lifetime blast exposure history on reported neurobehavioral symptoms of service members.

■ Schwab, K., Scher, A., Pazdan, R., & Brenner, L. Prognosis of military mild traumatic brain injury (mTBI) for non-hospitalized 

soldiers returning from Afghanistan (OEF) and Iraq (OIF).

■ Van der Merwe, A.J., McNally, S., Brickell, T.A., Lippa, S.M., Lange, R.T., French, L.M., & Chan, L. The influence of PTSD on 

Outcome from civilian and military-related mild traumatic brain injury: Preliminary findings from an NIH/DoD multi-site collaboration.

Minnesota Multiphasic Personality Inventory-2 (MMPI-2) 2-RF 

Research Symposium

May 2016 | Fort Lauderdale, Florida

■ Finn, J.A., Lamberty, G.J., & Lim, K.O. Personality and participation: Associations between the MMPI-2-RF and the 

MPAI-4 in veterans with a reported history of mild TBI.

Minneapolis VA 

Research Day

May 2016 | Minneapolis, Minnesota

■ Gentz, C.L., Carson, M.R., Gilmore, C.S., Albott, C.S., Lim, K.O., & Nelson, B.G. deep transcranial magnetic stimulation 

for medication refractory depression in mild traumatic brain injury.

■ Gilmore, C.S., Nelson, N.W., Finn, J.A., Lamberty, G.J., & Lim, K.O. Differential effects of mild TBI severity and PTSD 

symptomatology on cognitive performance in veterans.

National Academy of Neuropsychology 

Annual Conference

October 2016 | Seattle, Washington

■ Brickell, T.A., French, L.M., Lange, R.T., Bailie, J., Gartner, R.L., Dilay, A.N., Driscoll, A.E., Wright, M.M., Pizzano, B.N., 

Johnson, L.B., Nora, D.E., Mahatan, H.S,, Sullivan, J.K., Thompson, D.M., Snelling, A.C., Kacmarek, C.N., & Lippa, 

S.M. Predictors of neurobehavioral outcome at 1-year following military-related mild-moderate traumatic brain injury.

■ Brickell, T.A., French, L.M., Lange, R.T., Bailie, J., & Lippa, S.M. Neurobehavioral outcome 10-years following 

mild-moderate traumatic brain injury in U.S. military service members.

■ French, L.M., Brickell, T.A., Lippa, S.M., Bailie, J., & Lange, R.T. A longitudinal comparison of the traumatic brain injury 

quality of life (TBI-QOL) scale from the sub-acute recovery period to 1-year following mild-moderate traumatic brain injury.
42 | DVBIC 2016 ANNUAL REPORT

■ French, L.M., Lange, R.T., Lippa, S.M., Bailie, J., & Brickell, T.A. Base rates and longitudinal trajectories of icd-10 postconcussion 

symptom status from 1- to 2-years following military-related mild-moderate traumatic brain injury: part 1 of 2.

■ Hussain, M.A., Bailie, J.M., Jolly, M.J., Powell, B.E., Sargent, P.D., & Duckworth, J.D. The impact of traumatic brain 

injury and heavy weapons blast exposure on neuropsychological functioning in the military.

■ Lange, R.T., Brickell, T.A., Lippa, S.M., Chan, L., McNally, S., van der Merwe, A.J., & French, L.M. base rates and 

longitudinal trajectories of individual self-reported postconcussion symptoms from 1- to 2-years following military-related 

mild-moderate traumatic brain injury: Part 2 of 2.

■ Lange, R.T., Lippa, S.M., Brickell, T.A., Gartner, R.L., Dilay, A.N., Driscoll, A.E., Wright, M.M., Pizzano, B.N., Johnson, 

L.B., Nora, D.E., Mahatan, H.S., Sullivan, J.K., Thompson, D.M., Snelling, A.C., Kacmarek, C.N., & French, L.M. 

Neuropsychological outcome from concurrent PTSD and mild traumatic brain injury in U.S. military service members: 

A cross-sectional perspective of recovery in the first 12-months of injury.

■ Lippa, S.M., Brickell, T.A., French, L.M., Bailie, J., & Lange, R.T. Self-reported post-traumatic stress symptoms in the 

subacute recovery period are strong predictors of poor neurobehavioral outcome 2-years following military-related 

mild-moderate traumatic brain injury.

■ Lippa, S.M., Lange, R.T., Brickell, T.A., Bailie, J., & French, L.M. The natural history of neurocognitive outcome from 

the sub-acute recovery phase to 1-year post-injury in military-related mild-moderate traumatic brain injury. 

National Institute of Mental Health

Transcranial Electrical Stimulation: Mechanisms, Technology, and Therapeutic Applications (workshop)

September 2016 | Bethesda, Maryland

■ Lim, K.O. (invited speaker). In-progress studies of tDCS augmentation of cognitive remediation in schizophrenia and impulsivity.

North American Brain Injury Association

Annual conference

April 2016 | Tampa, Florida

■ Brickell, T.A., Carlozzi, N., Sander, A., Kratz, A., French, L.M., Tulsky, D., Hahn, E., Kallen, M., Chiaravalloti, N., & 

Lange, RT. Barriers and supports to health care among caregivers of service members or veterans with traumatic 

brain injury: A qualitative analysis using focus group methodology. 

■ Brickell, T.A., French, L.M., Bailie, J., Lippa, S., Gartner, R., Driscoll, A., Li, Z., Schmidt, E., Wright, M., Smith, J., Dilay, 

A., Pizzano, B., Johnson, L., Nora, D., Kilgore, J., Mahatan, H., Miles-Mooney, M., & Sullivan, J., Thompson D, Lange 

RT. Post-9/11 family caregivers: Examining the characteristics and perceived burden of family members who care for 

u.s military service members following traumatic brain injury. 

■ Lange, R.T., French, L.M., Bailie, J., Lippa, S., Gartner, R., Driscoll, A., Li, Z., Schmidt, E., Wright, M., Smith, J., Dilay,A., 

Pizzano, B., Johnson, L., Nora, D., Kilgore, J., Mahatan, H., Miles-Mooney, M., Sullivan, J., Thompson, D., & Brickell, 

T.A. Caring for U.S. military service members following mild-moderate traumatic brain injury: examination of access 

to services, service needs, and barriers to care. 

■ Lange, R.T., Lippa, S., French, L.M., Bailie, J., Gartner, R., Driscoll, A., Li, Z., Schmidt, E., Wright, M., Smith, J., Dilay, 

A., Pizzano, B., Johnson, L., Nora, D., Kilgore, J., Mahatan, H., Miles-Mooney, M., Sullivan, J., Thompson, D., & Brickell, 

T.A. Transitioning home following traumatic brain injury: Examination of the long-term service needs and barriers for 

caregivers of military personnel following injury.

■ McKinney, G., Marion, D., Eshel, I., Panakkal, D., Wong, K., & Stout, K. Management of headache following concussion/

mild traumatic brain injury.
DVBIC 2016 ANNUAL REPORT | 43

Uniformed Services University of the Health Sciences and the University of Pittsburgh

State of the Science Symposia Series: Caring for Wounded Warriors with Traumatic Brain Injury

September 2016 | Bethesda, Maryland

■ Eshel, I. & Livingston S. Clinical recommendations for the management of concussion/mild traumatic brain injury in 

the Military Health System.

■ Stout, K. & Livingston S, Smith J. Recovery support for service members, veterans and their families affected by 

traumatic brain injury.

State of the Science Symposium Series: Fitness and Health Outcomes — Exercise, Health, and 

Nutrition for Wounded, Injured, and Ill Veterans

March 2016 | Bethesda, Maryland

■ Stout, K. Progressive return to activity following acute concussion/mild TBI.

University of Minnesota Institute for Engineering in Medicine (IEM) 

Neuromodulation Symposium

April 2016 | Minneapolis, Minnesota

■ Gilmore, C.S., Carson, M.R., Gentz, C.L., Dickmann, P.J., Lamberty, G.J., Armstrong, M.T., & Lim, K.O. Reducing 

impulsivity and risk-taking behavior using transcranial direct current stimulation (tDCS).

Womack Army Medical Center 

Research Day

May 2016 | Fort Bragg, North Carolina

■ Arrieux, J.P. & Cole, W.R. An examination of the differences between healthy controls and acute mTBI on ANAM4 TBI 

MIL simple reaction time subtests.

■ Capo-Aponte, J.E., Cole, W.R., Beltran, T.A., Walsh, D.V. & Dumayas, J.Y. Validation of visual objectives biomarkers 

for acute concussion.

■ Finkel, A.G., Klaric, J.S., Yerry, J.A. & Choi, Y.S. Headaches in soldiers with mild traumatic brain injury/concussion: 

relationships to occupational outcomes.

Colonel Sidney R. Hinds II served as DVBIC’s national director from July 1, 2013 to March 16, 2016. (DVBIC photo by 

Carlson Gray)
Defense and Veterans 

Brain Injury Center

1335 East-West Highway, Ste. 6-100 

Silver Spring, Maryland 20910 | 800-870-9244

dvbic.dcoe.mil