Suicidal thoughts and behaviors are a serious concern after traumatic brain injury (TBI). Research based on the Traumatic Brain Injury Model System National Database – a large database of long-term outcomes after moderate-to-severe TBI including over 1,500 patients recruited from MossRehab – has shown that approximately 3% of individuals report at least one suicide attempt, and over 8% report suicidal thoughts in the first five years after injury. There is an urgent need to identify the risk factors that are associated with these thoughts and behaviors, so clinicians know who needs intervention and how best to intervene.

Amanda Rabinowitz, PhD, is involved in a research project designed to meet this need. Moss Rehabilitation Research Institute (MRRI) is enthusiastic to be one of the sites participating in The Leveraging Nationwide Research Infrastructure to Enrich Brain Health after TBI study, or ENRICH Brain Health for short. This multicenter study, funded by an $8 million Focused Program Award from the Department of Defense to Kristen Dams-O’Connor, PhD, of Mount Sinai, aims to understand and improve long-term cognitive and psychological health after TBI. Moss is participating in one of the five separate projects supported by this award, designed to address a critical gap in understanding risk, resilience, and protective factors associated with cognitive and psychological outcomes among civilians and Veterans with TBI.

This project leverages existing infrastructure of the National Institute of Disability, Independent Living and Rehabilitation Research (NIDILRR)-funded longitudinal civilian and Veteran TBI Model Systems of Care to identify and follow individuals with chronic TBI to investigate factors associated with changes in cognitive function, as well as suicidal thoughts and behaviors over time. Researchers at MRRI will reach out to participants in the TBI Model Systems study who have exhibited changes in their cognitive performance over time to collect new data on potentially-modifiable risk factors and protective factors for cognitive decline. The team will also re-contact Model Systems participants who endorsed high-risk suicidal ideation and/or suicide attempt at a prior study visit to collect data on current suicidality and identify modifiable risk factors and protective factors.

The other projects supported by the award establish a community-based advisory group, broadened recruitment efforts of Veterans with TBI for post-mortem brain donation, histopathological study of post-mortem brain tissue, and brain imaging studies to understand the network-based structural and functional alterations underlying neurobehavioral health deterioration following TBI. Collectively, these projects will contribute to the development of tools for diagnosis and treatment throughout the lives of patients with TBI.