Featured Research

from universities, journals, and other organizations

In military personnel, no difference between blast- and nonblast-related concussions

Date:
June 16, 2014
Source:
Washington University in St. Louis
Summary:
Explosions are the most common cause of traumatic brain injuries in veterans returning from Iraq and Afghanistan. A new study shows that military personnel with mild brain trauma related to such blasts had outcomes similar to those with mild brain injury from other causes, according to researchers.

Explosions are the most common cause of traumatic brain injuries in veterans returning from Iraq and Afghanistan. A new study shows that military personnel with mild brain trauma related to such blasts had outcomes similar to those with mild brain injury from other causes, according to researchers at Washington University School of Medicine in St. Louis.

However, nearly 80 percent of patients in both categories of brain trauma suffered moderate to severe overall disability within a year after injury.

The analysis appears June 16 in JAMA Neurology.

"We are interested in whether there are fundamental differences between the effects of concussions caused by a blast versus other kinds of blunt head trauma," said senior author David L. Brody, MD, PhD, associate professor of neurology. "This study and others make us a bit skeptical of the notion that the long-term effects of blast injury to the brain are somehow unique.

"We still think the physics of how a blast interacts with the brain is quite different from other kinds of brain trauma," he added. "But we have yet to find the consequences of that -- if there are any -- for patients."

About 20 percent of U.S. forces in Iraq and Afghanistan are estimated to have experienced a head injury during deployment. Of those injuries, about 83 percent are considered mild forms of traumatic brain injury or concussion.

The researchers examined 255 U.S. military personnel who were injured while on active duty in Iraq and Afghanistan. All were evacuated to Landstuhl Regional Medical Center in Germany.

To assess long-term outcomes, the investigators were able to evaluate 178 patients six to 12 months later. Of these, 53 had mild traumatic brain injury involving an explosion and 29 had mild traumatic brain injury unrelated to a blast. As a comparison, the study also included 27 military personnel with blast exposure (meaning they felt the force of an explosion) but no brain injuries and 69 with no blast exposure who were evacuated for medical reasons other than brain injury.

"For our patients with blast-related concussions, I want to emphasize that the explosion was always in combination with another event, such as a motor vehicle crash, a fall or an object striking the head," Brody said. "It's important that we're mostly studying the combination of blast plus impact, compared to impact alone. Blast injury alone -- without a secondary impact -- appears to be extraordinarily rare."

Comparing the two groups with traumatic brain injury (blast- versus nonblast-related), the research team saw no difference in overall disability, with 77 percent of the blast group suffering moderate to severe disability compared with 79 percent of the nonblast group. They also saw no differences between these groups in severity of headaches, depression, post-traumatic stress disorder (PTSD) and performance on cognitive tests. That was despite the fact that the blast-related group reported seeing significantly more active combat.

"In patients with brain injury, combat exposure by itself did not seem to correlate with the high rate of PTSD or depression or the other measures we reported," Brody said.

Both brain injury groups showed worse overall disability compared with the two control groups evacuated for medical reasons unrelated to concussions. In contrast to the brain injury groups, 59 percent of the blast-without-head-injury group experienced moderate to severe disability as did 41 percent of the group that had experienced no blasts and no head injuries.

The group exposed to a blast without head injury had elevated rates of PTSD and headaches compared with the group with no blasts and no head injuries. But they were still better off than the two groups with head injuries.

"This may suggest an additive effect, where blast exposure and combat exposure combined have some effect, and brain injury on top of that has additional influence on PTSD and other outcome measures," Brody said.

The investigators, including first author Christine L. MacDonald, PhD, now at the University of Washington in Seattle, also observed that both brain injury groups, even those unexposed to explosions, had much higher rates of disability compared with civilians suffering concussions. To explain these worse outcomes, they note the possibility of active military duty itself playing a role, rather than the physical injury alone.

"Poor outcomes appear to be associated most strongly with having a traumatic brain injury while on active military duty," Brody said. "It's also possible these brain injuries in military personnel that resulted in medical evacuation were more severe than we typically see in a civilian population. After a sports-related concussion, for example, many people make a good recovery over several weeks."

Brody said the researchers' next step in understanding whether blast-related brain injury is unique is to examine military personnel whose brain injuries were mild enough to allow a return to active duty, a situation that is perhaps more similar to typical civilian concussions.


Story Source:

The above story is based on materials provided by Washington University in St. Louis. The original article was written by Julia Evangelou Strait. Note: Materials may be edited for content and length.


Journal Reference:

  1. Christine L. Mac Donald, Ann M. Johnson, Linda Wierzechowski, Elizabeth Kassner, Theresa Stewart, Elliot C. Nelson, Nicole J. Werner, David Zonies, John Oh, Raymond Fang, David L. Brody. Prospectively Assessed Clinical Outcomes in Concussive Blast vs Nonblast Traumatic Brain Injury Among Evacuated US Military Personnel. JAMA Neurology, 2014; DOI: 10.1001/jamaneurol.2014.1114

Cite This Page:

Washington University in St. Louis. "In military personnel, no difference between blast- and nonblast-related concussions." ScienceDaily. ScienceDaily, 16 June 2014. <www.sciencedaily.com/releases/2014/06/140616203937.htm>.
Washington University in St. Louis. (2014, June 16). In military personnel, no difference between blast- and nonblast-related concussions. ScienceDaily. Retrieved September 2, 2014 from www.sciencedaily.com/releases/2014/06/140616203937.htm
Washington University in St. Louis. "In military personnel, no difference between blast- and nonblast-related concussions." ScienceDaily. www.sciencedaily.com/releases/2014/06/140616203937.htm (accessed September 2, 2014).

Share This




More Mind & Brain News

Tuesday, September 2, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Can You Train Your Brain To Eat Healthy?

Can You Train Your Brain To Eat Healthy?

Newsy (Sep. 1, 2014) New research says if you condition yourself to eat healthy foods, eventually you'll crave them instead of junk food. Video provided by Newsy
Powered by NewsLook.com
Coffee Then Napping: The (New) Key To Alertness

Coffee Then Napping: The (New) Key To Alertness

Newsy (Aug. 30, 2014) Researchers say having a cup of coffee then taking a nap is more effective than a nap or coffee alone. Video provided by Newsy
Powered by NewsLook.com
Young Entrepreneurs Get $100,000, If They Quit School

Young Entrepreneurs Get $100,000, If They Quit School

AFP (Aug. 29, 2014) Twenty college-age students are getting 100,000 dollars from a Silicon Valley leader and a chance to live in San Francisco in order to work on the start-up project of their dreams, but they have to quit school first. Duration: 02:20 Video provided by AFP
Powered by NewsLook.com
Baby Babbling Might Lead To Faster Language Development

Baby Babbling Might Lead To Faster Language Development

Newsy (Aug. 29, 2014) A new study suggests babies develop language skills more quickly if their parents imitate the babies' sounds and expressions and talk to them often. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins