The NCAA-DoD Concussion Assessment, Research, and Education (CARE) Consortium
Study Description: Established in 2014, the U.S. Department of Defense (DoD) and the National Collegiate Athletic Association (NCAA) funded the Concussion Assessment, Research and Education (CARE) Consortium to inform science, clinical care and public policy related to concussion and repetitive head impact exposure (HIE) in U.S. Military Service Academy (MSA) cadets and collegiate student-athletes. The primary aims of the initial study were to: (1) establish a multisite research consortium to characterize the effects of concussion and repetitive head impact exposure on brain health, (2) characterize the clinical sequelae and natural history of concussion, (3) characterize the effect of concussion and repetitive head impacts on brain structure and brain function. The 30 member institutions of the CARE Consortium (26 civilian universities/colleges and 4 military service academies) agreed to invite all varsity athletes to undergo multimodal clinical assessments at preseason baseline, and at 5 additional timepoints after concussion diagnosis. At the service academies, non-varsity athlete cadets/midshipmen were also studied.
Assessment Categories At Each Time Point
Baseline:
• Demographics
• Personal and Family History
• Neurocognitive Assessment
• Neurological Status
• Postural Stability
• Symptoms
ACUTE POST-INJURY FOLLOW-UP (CARE 1.0)
(24 hrs; 48hrs; Asymptomatic; Unrestricted Return to Play (RTP); 6 mos)
• Neurocognitive Assessment
• Neurological Status
• Postural Stability
• Symptoms
CUMULATIVE & PERSISTENT EFFECTS. (CARE 2.0)
In-Person Exit Visit; Post-grad Online
• Demographics
• Personal and Family History
• Neurocognitive Assessment
• Neurological Status
• Postural Stability
• Symptoms
• PROs
• MROs (at academies only)
LONG-TERM EFFECTS (CARE/SALTOS Integrated (CSI))
Annual Online Assessment (at MSAs only);
In-Person Research Visits
• Demographics
• Symptoms
• Psychological health
• PROs
• MROs (at academies only)
A subset of athletes at 6 of the CARE institutions underwent additional assessments including multimodal MRI, proteomic and genomic biomarker characterization, and head impact quantification (helmet-based sensors).
Assessment time points for the ARC/pARC
Neurocognitive and Behavioral Testing was done at Baseline, <48hrs Post-Injury, Cleared for Return to Play Progression (Asymptomatic), Unrestricted Return to Play, 7 days following Return to Play, and at >60 days after final game of junior year until end of collegiate career.
Blood biomarker collection was done at Baseline, <48hrs Post-Injury, Cleared for Return to Play Progression (Asymptomatic), 7 days following Return to Play, and at >60 days after final game of junior year until end of collegiate career.
Multi-modal MRI studies were done at Baseline, <48hrs Post-Injury, Cleared for Return to Play Progression (Asymptomatic), 7 days following Return to Play, and at >60 days after final game of junior year until end of collegiate career. However, please note that only athletes from one study performance site completed a multi-modal MRI study at baseline.
