Feasibility and preliminary validation of the LIBRA model among those with mild TBI

Brain Inj. 2026 Sep 29:1-10. doi: 10.1080/02699052.2026.2728032. Online ahead of print.

ABSTRACT

PURPOSE/OBJECTIVE: Methods are needed to evaluate the influence of risk factors on post-injury brain health among those with mild traumatic brain injury (mTBI). We employed an existing model, the LIfestyle for BRAin Health (LIBRA), to demonstrate feasibility and establish initial validation with mTBI cohorts.

RESEARCH METHOD/DESIGN: Analyses of data from 17 civilians with acute mTBI (longitudinal) and 92 male United States Veterans with historical mTBI (cross-sectional). LIBRA scores were constructed; a higher score indicates greater risk to brain health. We also evaluated score distributions, the prevalence of LIBRA factors, and associations with non-LIBRA risk factors (initial validation).

RESULTS: Among those with acute mTBI (longitudinal), the mean ± standard deviation LIBRA score across all time points was 2.34 ± 3.19 (range -1.0 to +11.1). Individual scores were relatively stable across time, with some variability in physical activity and alcohol use. In Veterans with historical mTBI (cross-sectional), the mean LIBRA score was 3.92 ± 2.64 (range -1.0 to +10.3). The most prevalent risk factors were obesity and lifetime history of smoking followed by current depression. Initial validation findings were mixed.

CONCLUSIONS/IMPLICATIONS: Differences in LIBRA scores and other drivers of risk (non-LIBRA) across two mTBI cohorts (acute, historical) support the feasibility of implementation among those with a history of mTBI.

PMID:42808536 | DOI:10.1080/02699052.2026.2728032