This article is more than 5 years old. Information may no longer be current.

Psychological disability more severe 6 to 12 months after blast-related traumatic brain injuries

United States military personnel with consecutive blast-related mild traumatic brain injuries resulted in significantly worse global outcomes and symptoms of posttraumatic stress disorder, according to data published in Brain.

“Symptoms of post-traumatic stress and depression have always been thought to develop months to years later,” David L. Brody, MD, PhD, associate professor of neurology at Washington University, said in a press release. “We don’t know what causes these symptoms, whether they result from the brain injury itself, from the stress of war or some combination of factors. But regardless of their origin, the severity of these psychological symptoms soon after injury was the strongest predictor of later disability.”

David L. Brody

The researchers evaluated 38 military personnel with blast-related concussive traumatic brain injury and 34 controls between March and September 2012. Evaluations occurred up to 7 days after injury at two sites in Afghanistan, with follow-up at 6 to 12 months at Washington University in Saint Louis.

Patients with traumatic brain injuries had significantly higher scores on the Rivermead Post Concussion Symptoms Questionnaire compared with controls (P = .0000002), according to data.

Those with the injuries also had significantly worse symptoms of PTSD (P = .000002), and depression (P = .0006), during the acute phase following injury.

They also performed worse on Automated Neurocognitive Assessment Metrics-Traumatic Brain Injury Military Version 4 test, compared with pre-deployment baseline measures, researchers wrote.

Six to 12-month data also indicate 63% of those with 15 traumatic brain injuries and 20% of controls demonstrated moderate overall disability, according to researchers.

More frequent cognitive performance deficits and significant headache impairments were also observed among those with injuries compared with controls.

“I was surprised by how severe the level of disability was 6 to 12 months after these seemingly mild injuries, especially given that virtually all of these patients returned to duty soon after their concussions,” Brody said in the release.

Further research is needed to determine the long-term implications of concussive blast-related military traumatic brain injuries, they wrote. – by Samantha Costa

Disclosure: Brody reports no relevant financial disclosures. The study was funded by the Congressionally Directed Medical Research Program. Please see the full study for a list of all other authors’ relevant financial disclosures.