Publications

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Scoping review of secondary studies using the Federal Interagency of Traumatic Brain Injury Research datasets

February 9, 2026

Amanda N Fitterer, Leila Ledbetter, Peter Duquette, Amy Switzer, Margaret Fletcher, Julia Smith, Karin Reuter-Rice

Background: Traumatic Brain Injury (TBI) affects hundreds of thousands of people in the United States each year and represents a significant public health problem. There is considerable heterogeneity of causes, diagnostic tools, treatments, and outcomes of TBI, and the volume of research on the topic reflects this. Despite the large body of research, significant gaps remain in our knowledge of how to diagnose and treat TBI. To address this, the Federal Interagency Traumatic Brain Injury Research (FITBIR) Informatics System was developed.

Methods: This scoping review aimed to provide a descriptive overview of how FITBIR data has been used in published research since its inception, including the types of studies conducted, datasets used, and methodological approaches. Online databases were used to identify papers that utilized FITBIR data for secondary applications.Results: Forty-nine articles were identified for inclusion through a literature search. We summarize the secondary uses of FITBIR data, focusing on how many and which data sets were used, as well as the varied approaches to data use.

Conclusions: This review demonstrates successful use of existing TBI data to expand the knowledge base regarding diagnosis, treatment, and outcomes, and suggests promising potential for future harmonization and synthesis of available datasets.

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A study protocol for risk stratification in children with concussion (RSiCC): Theoretical framework, design, and methods

July 18, 2024

Karin Reuter-Rice, Amanda N. Fitterer, Peter Duquette, Qing Yang, Anushka K. Palipana, Daniel Laskowitz, Melanie E. Garrett, Margaret Fletcher, Julia Smith, Lynn Makor, Gerald Grant, Kristen Ramsey, O. Josh Bloom, Allison E. Ashley-Koch

Research shows that one in five children will experience a concussion by age 16. Compared to adults, children experience longer and more severe postconcussive symptoms (PCS), with severity and duration varying considerably among children and complicating management of these patients. Persistent PCS can result in increased school absenteeism, social isolation, and psychological distress. Although early PCS diagnosis and access to evidence-based interventions are strongly linked to positive health and academic outcomes, symptom severity and duration are not fully explained by acute post-injury symptoms. Prior research has focused on the role of neuroinflammation in mediating PCS and associated fatigue; however relationship between inflammatory biomarkers and PCS severity, has not examined longitudinally. To identify which children are at high risk for persistent PCS and poor health, academic, and social outcomes, research tracking PCS trajectories and describing school-based impacts across the entire first year postinjury is critically needed. This study will 1) define novel PCS trajectory typologies in a racially/ethnically diverse population of 500 children with concussion (11–17 years, near equal distribution by sex), 2) identify associations between these typologies and patterns of inflammatory biomarkers and genetic variants, 3) develop a risk stratification model to identify children at risk for persistent PCS; and 4) gain unique insights and describe PCS impact, including fatigue, on longer-term academic and social outcomes. We will be the first to use NIH’s symptom science model and patient-reported outcomes to explore the patterns of fatigue and other physical, cognitive, psychological, emotional and academic responses to concussion in children over a full year. Our model will enable clinicians and educators to identify children most at risk for poor long-term health, social, and academic outcomes after concussion. This work is critical to meeting our long-term goal of developing personalized concussion symptom-management strategies to improve outcomes and reduce disparities in the health and quality of life of children.

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