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Article History

Accepted: 14 November 2024

First Online: 16 January 2025

Declarations

:

: This publication was made possible in part by the National Collegiate Athletic Association (NCAA) and the Department of Defense (DOD). The US Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs, through the Combat Casualty Care Research Program, endorsed by the Department of Defense, through the Joint Program Committee 6/ Combat Casualty Care Research Program—Psychological Health and Traumatic Brain Injury Program under award nos. W81XWH1420151 and W81XWH1820047. Opinions, interpretations, conclusions, and recommendations are those of the author and are not necessarily endorsed by the Department of Defense.

: K.D., T.M., B.M., Y.C.W., S.B., K.G., J.G., J.J., S.R., and K.N. have no relevant disclosures. Dr. Mihalik receives funding from the Department of Defense, National Institutes of Health, Centers for Disease Control and Prevention, National Football League, and Football Research Inc, and is the Co-Founder and Chief Science Officer for Senaptec Inc. Dr. Saykin receives support from multiple NIH grants (P30 AG010133, P30 AG072976, R01 AG019771, R01 AG057739, U19 AG024904, R01 LM013463, R01 AG068193, T32 AG071444, and U01 AG068057 and U01 AG072177). He has also received support from Avid Radiopharmaceuticals, a subsidiary of Eli Lilly (in kind contribution of PET tracer precursor); Bayer Oncology (Scientific Advisory Board); Eisai (Scientific Advisory Board); Siemens Medical Solutions USA, Inc. (Dementia Advisory Board); NIH NHLBI (MESA Observational Study Monitoring Board); Springer-Nature Publishing (Editorial Office Support as Editor-in-Chief, Brain Imaging and Behavior).

: K.M.D. was responsible for data analysis and drafting the manuscript. K.N. contributed to study conceptualization and design, data analysis, and revision of the manuscript. T.W.M., Y.C.W., B.C.M., S.L.R. and A.J.S. contributed to study conception and revision of the manuscript. M.M., S.B., P.P., M.B., J.M., K.G., C.G., J.G., S.D., S.R., S.S., K.C., M.H., D.C., G.M., and J.J. contributed to data collection and revision of the manuscript. All authors read and approved the final version of the manuscript.

: Patient data are accessible as part of CARE 1.0 on the Federal Interagency Traumatic Brain Injury Research Informatics System (FITBIR, ftbir.nih.gov). Criteria for access are determined by each of the entities hosting the data and the governance of their respective regulatory committees.

: Site-level (Indiana University IRB no. IU IRB 1406400404.) Institutional review board (IRB) and DoD Human Research Protections Office (HRPO) approval was obtained (Broglio et al., 2017) for this study. All study operations were in accordance with the standards outlined in the Declaration of Helsinki.

: Written informed consent was obtained from all participants included in the study.

: Not applicable.

: Code is available upon request.