The Mission of the Brain Rehabilitation Research Center (BRRC) is: Maximize recovery of cognitive, emotion, and motor function in Veterans affected by neurologic injury or disease by potentiating neural plasticity and neural network reorganization through the discovery of mechanisms and innovation of treatments. The BRRC is a 19-yr consortium with three major institutions: North Florida/South Georgia VA Health Care System, University of Florida (UF)/Shands Healthcare, and Brooks Rehabilitation Hospital. The BRRC supports > 28 investigators (14 PIs with VA-funded studies, 14 associate investigators, and additional collaborating investigators) and their teams. The BRRC supports a collaborative, interdisciplinary research team, providing extensive facilities and resources for sophisticated human performance and brain function measurement. Our planned research programs utilize specific neuroplastic mechanisms to recover cognitive, emotion, and motor function. First, in the Cognition Function Initiative, we are developing innovative treatment for impaired memory, executive function, and goal achievement in TBI survivors. Second, in the Emotion Function Initiative, we are establishing new brain neuromarkers for objective diagnosis of PTSD and prediction of psychotherapy response in the presence and absence of TBI. We are investigating the etiological, pathological and neurophysiological mechanisms of PTSD comorbid with TBI, identifying brain networks involved in the emotional consequences of PTSD/TBI, and testing novel interventions to aid in recovery of emotion regulation. Third, in the Motor Function Initiative, we are investigating brain activation mechanisms during walking and during upper limb movement, to elucidate pathology and identify more useful treatment targets for inducing motor recovery. We are developing and feasibility-testing a new brain neural feedback regimen (real time brain imaging) to improve upper limb function after stroke. We are testing several innovative gait training interventions for stroke survivors: combination of gait coordination and brain stimulation; backward walking training paradigm; enhancing sensory feedback during walking and testing emotional fear factors related to fall self-efficacy; and feasibility-testing a protocol for a comparative effectiveness trial, for long-term mobility and health for chronic stroke. Fourth, in the Rehabilitation Neuroscience Initiative (animal and human models), we are refining our preclinical rodent models of TBI and SCI that reflect clinical symptoms of chronic and persistent disabilities in human TBI/SCI. We are establishing reliable, quantitative, and clinically translatable measures for assessing chronic multiple disabilities and for illuminating the role of TBI in chronic human neurodegenerative disease. We are evaluating efficacy of combined interventions, such as locomotor training and CNS stimulation, to mitigate TBI-induced disabilities. In stroke and TBI separately, we are evaluating the impact of potential modifiers such as age, gender, race/ethnicity, and moderating biomarkers of gene variants, brain structure/function, and inflammatory processes on cognitive impairment. The BRRC has consistently achieved the benchmarks expected by the RR&D Service, as follows: * Thematically cohesive, neural plasticity research portfolio focused on RR&D high priority Veteran needs for those with neurological injury or disease. * Robust science dissemination program, including national leadership by BRRC investigators. * Active and successful capacity-building program, including support and mentoring across career stages. * Excellent funding leverage ratio of Core Center award. * Acquisition and stewardship of extensive facilities, equipment, and shared resources for investigators. * Successful organizational model with a track record of strongly supporting investigators, inclusive budget planning process, visionary strategic planning process.
Veterans with central nervous system injury or diseases such as traumatic brain injury (TBI) or stroke commonly develop chronic disabilities affecting cognitive, motor, and emotion function. Costs for neurologic- related care will likely increase; for example, some estimate that costs to treat stroke alone may double by 2030. Besides the mounting costs, these disabilities worsen quality of life. The purpose of the Brain Rehabilitation Research Center is to identify mechanisms and discover treatments to restore function and enhance quality of life. The BRRC neurorehabilitation portfolio promotes neuroplasticity that drives optimal recovery of emotion, memory, attention, executive control, mobility, gait coordination, and upper limb function, thereby improving the health and well-being of Veterans. Research results will inform and help transform clinical practice, which ultimately enables the VA health system to provide more cost effective and better long- term care for Veterans with neurological injury or disease.