Why was the CARE Consortium Created?
Concussion (mild traumatic brain injury or mTBI) is a fundamental concern facing the U.S. military, the sports medicine community, and society at large. Sport-related concussion (SRC) has become recognized as a major public health issue in the United States and worldwide, with increasing focus and concern among clinicians, researchers, sporting organizations, and athletes themselves. The National Collegiate Athletic Association (NCAA) and the Department of Defense (DoD) have led the way in advancing the science of SRC over the past 20 years, supporting discoveries that have had a major influence on domestic and international guidelines for best practice in the evaluation and management of concussion.
Due to many factors however, the clinical management of SRC remains among the greatest challenges in sports medicine because:
- The clinical effects of concussion are often subtle and difficult to detect with common assessment tools;
- Athletes commonly under-report their symptoms and falsely inflate their level of recovery in hopes of a rapid return to competition;
- “Signal detection” on clinical measures (e.g., cognitive testing) often quickly diminishes in the acute phase; and
- There is now recognition that our clinical assessment of concussion merely represents a surrogate index of recovery, but not a direct measure of brain structure and function after concussion.
To date, the natural history of concussion remains poorly defined and no objective biomarker of physiological recovery exists for clinical use.
Science lags far behind public opinion about the potential chronic risks associated with SRC and repetitive head impact exposure in athletes. Societal concerns have escalated to a point that they fuel public fear, particularly in the competitive sporting environment. Sport governing bodies (e.g., NFL, NCAA) are facing intense pressure to change the inherent nature of sport. National debates are being held about the possibility of eliminating contact sports such as football, in the absence of scientific data to support such extreme measures.
The NCAA-DoD Grand Alliance: Concussion Assessment, Research and Education (CARE) Consortium offers the promise of a large-scale, multi-site study of the natural history of concussion in both sexes and multiple sports, that will address the current gaps in our knowledge, and shed light on the neurobiological mechanisms of concussion symptoms and trajectory of recovery. It will provide a cohort of richly phenotyped individuals with SRC to contribute to other datasets for public use, and result in a more informed public debate about concussion care and policy.
Thomas W. McAllister, M.D., is the Albert Eugene Sterne Professor and Chairman, Indiana University School of Medicine Department of Psychiatry. He was previously Millennium Professor of Psychiatry and Neurology, Director of the Section of Neuropsychiatry at Dartmouth Medical School, and Vice Chair for Neuroscience Research for the Department of Psychiatry. He is a past president of the American Neuropsychiatric Association. Dr. McAllister received his undergraduate degree from Dartmouth College, and his medical degree from Dartmouth Medical School. He served on the faculties of the University of Kentucky, and the University of Pennsylvania before returning to Dartmouth Medical School in 1990.
Dr. McAllister has been working in the field of brain injury recovery for over 25 years. He has written widely on the neuropsychiatric sequelae of TBI, and is the principal investigator of several grants from NIH, the CDC, NOCSAE, and the Department of Defense (DoD), exploring the nature of cognitive and behavioral difficulties following mild and moderate TBI. With Drs. Jon Silver and Stuart Yudofsky he is a co-editor of the Textbook of Traumatic Brain Injury published by American Psychiatric Publishing, Inc. Recent research has focused on characterizing the biomechanical basis of concussion, and the effects of repetitive head impacts on brain structure and function in contact sport athletes.
Michael McCrea, PhD, ABPP is Professor of Neurosurgery and Neurology and Director of Brain Injury Research at the Medical College of Wisconsin, and a research neuropsychologist at the Clement Zablocki VA Medical Center in Milwaukee, Wisconsin. He is ABCN board-certified in clinical neuropsychology and is the past President of the American Academy of Clinical Neuropsychology (AACN). Dr. McCrea has been an active researcher in the neurosciences, with numerous scientific publications, book chapters, and national and international lectures on the topic of traumatic brain injury. Dr. McCrea has led several large, multi-center studies on the effects of traumatic brain injury and sport-related concussion. Dr. McCrea has authored numerous peer-reviewed publications and book chapters on the acute and chronic effects of concussion, and he authored the text Mild Traumatic Brain Injury and Postconcussion Syndrome: The New Evidence Base for Diagnosis and Treatment published by Oxford University Press. He currently serves on the National Football League (NFL) Head, Neck and Spine Committee and as a neuropsychology consultant for the Green Bay Packers, and served as a panelist on the 2008 and 2012 Zurich International Consensus Conference on Sports Concussion.
Steven Broglio PhD, ATC is an Associate Professor at the University of Michigan in the School of Kinesiology and Departments of Neurology and Physical Medicine and Rehabilitation. He is also Director of the NeuroSport Research Laboratory and member of the University of Michigan Injury Center. Dr. Broglio is a Certified Athletic Trainer who received his undergraduate degree from the University of North Carolina at Chapel Hill in 2000, his Master’s Degree from the University of Pittsburgh in 2002, and his Doctorate from the University of Georgia in 2006. His first faculty position was in the Department of Kinesiology and Community Health at the University of Illinois at Urban-Champaign from 2006 to 2011.
Dr. Broglio has been conducting sport concussion research since 1999, in which he has continually focused on improving athlete health and safety through injury prevention, early recognition, and management. These efforts have been supported by the National Athletic Trainers’ Research and Education Foundation, the National Institutes of Health, the National Collegiate Athletic Association, and the Department of Defense and are chronicled in medical journals and book chapters. Dr. Broglio was awarded the new investigator award by the National Athletic Trainers’ Association in 2011 and Fellowship in the American College of Sports Medicine in 2014.
CARE Consortium Standing Committees
Consortium work is supported by several committees, which are comprised of Consortium members, as well as content-specific experts external to the Consortium. The Administrative Operations Core (AOC) will provide support for committee functions. The standing committees are described below:
Executive Committee (EC)
Representatives from the DOD, NCAA and NIH
Oversees the Operating Committee and Consortium activities
View Roster >
Publication Committee (PC)
Representatives from Consortium investigators with demonstrated expertise in science
Operating Committee (OC)
Representatives from Consortium investigators with demonstrated expertise in science and clinical management of SRC
Scientific Advisory Board (SAB)
Representatives from the field of SRC research with demonstrated scientific expertise
Provides consultation regarding, and independent review of, the