VCU is a public research university located in Richmond, VA. Special facilities and resources include chartered university research and collaborative research-clinical care centers, a medical education campus with multiple professional schools. The Chronic Effects of Neurotrauma Consortium (CENC) has access to a unique level of resources in neuro-rehabilitation at VCU. VCU is a national leader in rehabilitation and disability research: ranked 11th in the nation in terms of rehabilitation research funded by the National Institutes of Health, and 1st in the nation for research publications in the area of rehabilitation counseling, VCU has a long standing of being a research and service leader in the areas of rehabilitation medicine, disability science, and vocational rehabilitation. For additional information, visit the VCU website by clicking on the following link: https://www.vcu.edu/.

The McGuire VAMC, located in Richmond, Virginia, is a complex tertiary care facility that serves more than 60,000 unique patients and provides over 700,000 outpatient visits per year. The hospital currently operates 403 hospital beds in a state of the art facility. Full radiologic, surgical, laboratory, rehabilitative and pharmacologic services support this mission.

The Richmond VAMC has been a leader in traumatic brain injury (TBI) care and rehabilitation. In 1992, Richmond VAMC began participating in the development of the Defense and Veterans Head Injury Program (DVHIP, later to be renamed DVBIC) and became one of four lead centers specializing in TBI rehabilitation services for active duty service members and veterans. Since January 2005, the Richmond VAMC has been a regional and national leader in the rehabilitation of combat induced injuries as a primary referral site from Department of Defense installations. Multiple programs have been designed, with dedicated staffing and space, to support the recovery of complex combat induced brain injuries and psychological sequelae. For additional information, visit the McGuire VAMC website by clicking on the following link: https://www.richmond.va.gov/.

Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) is one of the largest facilities in the national VA Medical Center system. Located on a 118-acre campus and built in 1991, MEDVAMC is a state-of-the-art facility, with 386 hospital beds, a 40-bed Spinal Cord Injury Center, and a 120-bed transitional care unit for long-term care. Supported with more than $22 million annually, research conducted by MEDVAMC staff ensures veterans’ access to cutting-edge medical and health care technology. In addition to tertiary clinical care services, the MEDVAMC houses many large research units, contributing to a culture of inquiry and scientific engagement among faculty, staff, and patients. Offices and examination rooms for research addressing traumatic brain occupy 4300 square feet of space in the main hospital building of MEDVAMC, adjacent to the polytrauma/TBI clinical area and one floor above the OEF/OIF Post-Deployment Clinic. These resources include video-teleconference facilities, two dedicated interview rooms with neuropsychological assessment materials and equipment, access to the Baylor College of Medicine (BCM) computer network through separate ports and a dedicated network switch, and multiple equipped and furnished offices for research assistants and faculty. For additional information, visit the MEDVAMC website by clicking on the following link: https://www.houston.va.gov/.

The South Texas Veterans Health Care System STVHSC serves one of the largest primary service areas in the nation and is part of the VA Heart of Texas, VISN 17. With an FY12 budget of $593 million and more than 3,340 employees, STVHCS provides health care services for over 100,000 Veterans including almost 1 million outpatient visits. The San Antonio VAMC is a 268-bed facility providing primary, secondary, and tertiary health care in medicine, surgery, psychiatry, and rehabilitation medicine. It also supports a 90 bed Extended Care Therapy Center, a 30-bed Spinal Cord Injury Center, an eight-bed Bone Marrow Transplant Unit, and a Geriatric Research, Education and Clinical Center. The ALMD Hospital Campus is home to a new Level One Polytrauma Rehabilitation Center. The STVHCS serves a population of approximately 300,000 veterans residing in the region stretching from San Antonio in Central Texas southward to the Mexican border. The STVHCS system dedicates 28,000 square feet to medical research, and there are more than 150 research investigators conducting over 500 research activities in areas such as aging, renal disease, diabetes, HIV/AIDs, and cancer treatment and therapy. For additional information, visit the STVHSC website by clicking on the following link: https://www.southtexas.va.gov/.

The Intrepid Spirit Center, Fort Belvoir (ISC) is located at Fort Belvoir Community Hospital in Fort Belvoir, Va. The Intrepid Spirit is a DoD institute dedicated to providing cutting-edge evaluation, treatment planning, research and education for service members and their families dealing with the complex interactions of mild traumatic brain injury and psychological health conditions. Within the facility resides an interdisciplinary team of caring professionals working together to enhance each other’s skills and empower the team to achieve best outcomes and improved quality of life of the service members, their families, and traumatic brain injury (TBI) and psychological health (PH) providers.

The center has been operational since August of 2013 and conducts over 600 unique patient evaluations every year. The population that is targeted by the ISC are active duty service members and other eligible beneficiaries with TBI (mild/moderate/severe) or suspected TBI. All patients are assigned to a treatment team led by a medical provider and treatment is individualized to the patient’s situation and needs via the ISC University Model. Frequency and duration of treatment varies from a few months to up to a year with the goals of treatment based on patient function rather than duration of care. For additional information, visit the ISC, Fort Belvoir website by clicking on the following link: https://www.fbch.capmed.mil/SitePages/Home.aspx.

The VAPORHCS is a teaching hospital within the VA Northwest Health Network 20, with an extensive referral base (>300,000 Veterans in the catchment area), and located on a 28.5 acre-campus with 303 beds. The VAPORHCS provides a full range of patient care services through primary care, tertiary care, and long-term care in areas of medicine, surgery, psychiatry, physical medicine and rehabilitation, neurology, audiology, oncology, post-deployment health, dentistry, geriatrics, and extended care. It provides ongoing care to 80,000 Veterans treated in five primary care clinics, three in metropolitan areas and two Community-based Outpatient Clinics in rural areas. VAPORHCS has received Magnet Designation, recognizing nationally superior patient care, every year since 2006.

Portland CENC collaborators, and the Study 1 research team, are housed at the National Center for Rehabilitative Auditory Research (NCRAR), a VA Rehabilitation Research and Development (RR&D) Center, and the Center to Improve Veteran Involvement in Care (CIVIC), a VA Health Services Research and Development (HSR&D) Center of Innovation. The NCRAR and CIVIC are in adjacent buildings on the VA Portland Healthcare System (VAPORHCS) campus, thereby facilitating easy communication and in-person meetings between investigators and research team members. For additional information, visit the VAPORHCS website by clicking on the following link: https://www.portland.va.gov/.

The Minneapolis VA Health Care System (MVAHCS) is a flagship VA that is highly supportive of research. There are nearly 180 investigators at this institution conducting research. The Minneapolis VAHCS provides comprehensive healthcare to nearly 100,000 veterans from Minnesota and Wisconsin. The VA is centrally located in the Minneapolis-St. Paul metropolitan area and is easily accessible to veterans through light rail and bus service. It has busy outpatient clinics in primary care and all major medical and surgical specialty areas. It supports basic, translational, clinical, and outcomes/health services research, with full-time research support staff, state-of-the-art laboratories, and abundant common service equipment relevant to this project. The medical center uses the VA’s electronic medical record system, CPRS, which allows ready retrieval of relevant clinical and epidemiological data. The MVAHCS has an ample medical library, with interlibrary loan service. If needed, emergency medical and psychiatric services are also available through Urgent Care or consultation with an on-call psychiatrist. In addition, there are institutional resources to support research activities, including statistical consultants, information technology support, media production, and library services. Staff computers and office equipment will be maintained through the Engineering Service at the Minneapolis VA Health Care System. In addition, the VA Health Care System will provide office supplies, telephones, and access to VISN computer resources.

MVAHCS is designated as one of five VA Polytrauma Rehabilitation Center (PRC). As such, the medical center receives active-duty service members and Veterans for rehabilitation of injuries such as traumatic brain injury, blindness and amputation. A 10-bed transitional and community re-entry unit for polytrauma patients provides continued rehabilitation therapies to assist Veterans and active-duty service members to reach their highest level of independence in the community. They will learn to apply their rehabilitation skills in community settings in preparation to transition into their home communities. For additional information, visit the MVAHCS website by clicking on the following link: https://www.minneapolis.va.gov/.

The VA Boston Healthcare System (VABHS), the largest consolidated facility in the Veterans Integrated Service Network (VISN) 1, encompasses three main campuses and five outpatient clinics within a 40-mile radius of the greater Boston area. The consolidated facility consists of the Jamaica Plain Campus, home of the VA Boston CENC Study 1 laboratory, located in the heart of Boston’s Longwood Medical Community; the West Roxbury Campus, located on the West Roxbury/Dedham line; and the Brockton Campus, located 20 miles south of Boston in the City of Brockton. In addition to the 3 main medical centers, the Community Based Outpatient Clinics (CBOCs) that make up the VA Boston Healthcare System (VABHS) are located in Framingham, Lowell, Quincy, Plymouth and Causeway Street (Boston).

Its mission is to provide the best healthcare to Veterans, advance medical knowledge through research, and train tomorrow’s healthcare leaders. VA Boston serves as a national Research and Development center for medical research and is a major tertiary care center for the VA New England Healthcare System VISN 1. VA Boston provides a full range of services, with state-of-the-art technology as well as education and research, offering specialized training to over 1,200 Residents and fellows, 250 medical students, 670 nursing students, and 500 students in psychology, optometry, pharmacy, and other allied health professions. VA Boston is the largest recipient of VA research funds in the nation and has strong affiliations with Harvard Medical School and Boston University School of Medicine as well as with Brigham and Women’s Hospital, Boston Medical Center, Beth Israel Deaconess Medical Center, Massachusetts General Hospital, Massachusetts Eye and Ear Infirmary, and Spaulding Rehabilitation Center. For additional information, visit the VABHS website by clicking on the following link: https://www.boston.va.gov/.

The Salisbury VA Health Care System (SVAHCS) is one of the fastest growing VA medical facilities in the country. As of January 2018, the SVAHCS served more than 104,000 unique Veterans, including 35,313 from OEF/OIF/OND (~33%). The facility consists of a centralized medical center including a newly constructed building for psychology, and two new, state-of-the-art Health Care Centers (HCCs) in nearby Kernersville and Charlotte, North Carolina. The SVAHCS provides office space and equipment for the principal investigator and other research personnel, as well as access to printers, photocopiers, and office supplies. The SVAHCS houses a Level 3 Polytrauma Support Clinical Team (PSCT), a neuropsychiatric TBI teaching service, an outpatient intensive cognitive rehabilitation program for mild TBI (FACT Program), and the Education Core of the Mid-Atlantic Mental Illness Research and Education Clinical Center (MA-MIRECC). The SVAHCS is a member of the MA-MIRECC, a VA research center of excellence whose overall focus is post deployment mental health, and all MA-MIRECC research participants at the SVAHCS site are OEF/OIF/OND Veterans. These clinical and research programs will be a rich source of referrals for this study. Recruiting and retaining an OEF/OIF/OND Veteran population over time has given this team the experience and created the infrastructure necessary to successfully conduct the current project. The current project will be completed by the SVAHCS MIRECC site and its direct academic affiliate, Wake Forest School of Medicine (WFSM). For additional information, visit the SVAHCS website by clicking on the following link: https://www.salisbury.va.gov/.

The VASDHS is a modern 304 bed general medical and surgical medical center situated adjacent to the University of California at San Diego (UC San Diego) and is closely affiliated with the UC San Diego School of Medicine. The VASDHS serves more than 82,000 unique patients annually and provides approximately 930,000 outpatient visits per year. The VA San Diego Healthcare System’s Research & Development Service is one of the largest research programs in the Department of Veterans Affairs with over $41 million in research funding in 2016, over 210 principal investigators, and nearly 700 research projects. Within the Research and Development Service portfolio as well as within the larger clinical Mental Health Care Line at VASDHS, there are large, well established programs in TBI, PTSD, mood disorders, psychosomatics, and empirically supported treatments for mental health conditions. VASDHS is also home to the Center of Excellence for Stress and Mental Health (CESAMH). This CoE focuses on the development, evaluation, and implementation of innovative and effective treatments for Veterans affected by trauma (TBI and PTSD). For additional information, visit the VASDHS website by clicking on the following link: https://www.sandiego.va.gov/.

The San Francisco Veterans Affairs Medical Center founded in 1934 is located in San Francisco’s Outer Richmond district with six community-based outpatient clinics. The San Francisco Veterans Affairs Medical Center (SFVAMC) has been a leader in health care for over 75 years, and is known as one of the most integrated, state-of-the-art acute medical, neurological, surgical, and psychological health care programs. SFVAMC is home to the largest medical research program in the national VHA system, with over $79 million in annual expenditures and more than 200 research scientists and clinicians, all of whom are faculty members at the University of California, San Francisco. For additional information, visit the SFVAMC website by clicking on the following link: https://www.sanfrancisco.va.gov/.

The National Center for PTSD is globally recognized as the leading research and educational center of excellence for PTSD and traumatic stress. The National Center for PTSD aims to raise awareness about PTSD and traumatic stress, as well as provide information regarding stress-related conditions, trauma, and treatment options. For additional information, visit the National Center for PTSD website by clicking on the following link: https://www.ptsd.va.gov/.

The Care Consortium endeavors to provide necessary infrastructure and scientific expertise to investigate concussion, with the ultimate goal of obtaining a better understanding about concussive injury and recovery, in order to enhance the safety and health of student-athletes, service members, and the general public. For additional information, visit the Care Consortium website by clicking on the following link: http://www.careconsortium.net/.

The TED Initiative is a collaboration sponsored by the DoD and FDA, which consists of academic clinician-scientists and innovative industry leaders in biotechnology and imaging technology, patient advocacy organizations, and philanthropies. The aim of the TED Initiative is to identify and validate effective measures or “endpoints” of brain injury and recovery, through examining data from athletes, soldiers, and the civilian population. For additional information, visit the TED website by clicking on the following link: https://tbiendpoints.ucsf.edu/.

TRACK-TBI is an international TBI research initiative that aims to better understand the effects of brain injury, through collection and analysis of clinical, imaging, and biospecimen data, with the ultimate goal of identifying treatment methods for TBI. For additional information, visit the TRACK-TBI website by clicking on the following link: https://tracktbi.ucsf.edu/transforming-research-and-clinical-knowledge-tbi.

The Department of Defense, through its Uniformed Services University, has established the world’s only brain tissue repository that is exclusively dedicated to help researchers characterize and understand the underlying mechanisms responsible for the immediate and long-term persistent effects of traumatic brain injury (TBI) experienced by service members. At this unique facility, repository scientists and physicians use innovative approaches to help better understand how to diagnose, prevent, and care for our military personnel who experience the effects of head injury, especially blast TBI, on the human brain. The DoD/USU Brain Tissue Repository (BTR) provides the opportunity for families of deceased active duty and former service members to donate the brain for use in research on this important topic. For more information about the DoD/USU BTR please contact us at 855-366-8824 or https://www.researchbraininjury.org/

The VA-BU-CLF Brain Bank is the largest tissue repository in the world focused upon TBI and chronic traumatic encephalopathy (CTE). The VA-BU-CLF Brain Bank is dedicated to improving understanding about the long-term consequences of TBI, in order to advance diagnosis, treatment, and care of individuals living with brain injury and related conditions. For additional information, visit the VA-BU-CLF Brain Bank website by clicking on the following link: https://www.bu.edu/cte/brain-donation-registry/.

CONNECT-TBI brings together 30 leading investigators from 13 institutions to generate unparalleled, comprehensive neuropathological and clinical data regarding the connection between traumatic brain injuries (TBI) and neurodegenerative disease. With the collective expertise and harmonized databases that this international collaborative achieves, CONNECT-TBI creates new possibilities to characterize TBI related neurodegeneration (TReND) pathology, and understand the extent and distribution of TReND pathology required to produce neurological dysfunction, the spectrum of symptoms associated with this pathology, and its relationship with wider neurodegenerative disease. For additional information, visit the CONNECT-TBI website by clicking on the following link: http://connect-tbi.med.upenn.edu//.