Postconcussive Symptoms After Blast and Nonblast-Related Mild Traumatic Brain Injuries in Afghanistan and Iraq War Veterans

• Published in: Journal of the International Neuropsychological Society Vol. 16; no. 5; pp. 856 - 866
• Main Authors: LIPPA, SARA M., PASTOREK, NICHOLAS J., BENGE, JARED F., THORNTON, G. MATTHEW
• Format: Journal Article
• Language: English
• Published: New York, USA Cambridge University Press 01.09.2010
• Subjects: Adult; Afghan Campaign 2001; Analysis of Variance; Blast Injuries - complications; Blast injury; Brain Concussion - diagnosis; Brain Concussion - etiology; Brain Injuries - complications; Brain research; Concussion; Explosions; Female; Head injury; Humans; Iraq War, 2003-2011; Male; Memory; Neurobehavioral Symptom Inventory; Neuropathology; Neuropsychology; Observational studies; Polytrauma; Post traumatic stress disorder; Posttraumatic stress; Self report; Severity of Illness Index; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - etiology; Traumatic brain injury; Veterans; Young Adult; Iraq; Blast injury; Neurobehavioral Symptom Inventory; Head injury; Concussion; Polytrauma; Posttraumatic stress
• ISSN: 1355-6177; 1469-7661
• DOI: 10.1017/S1355617710000743

Blast injury is common in current warfare, but little is known about the effects of blast-related mild traumatic brain injury (mTBI). Profile analyses were conducted investigating differences in self-reported postconcussive (PC) symptoms in 339 veteran outpatients with mTBI histories reporting current symptoms based on mechanism of injury (blast only, nonblast only, or both blast and nonblast), number of blast injuries, and distance from the blast. Veterans with any blast-related mTBI history were younger and reported higher posttraumatic stress symptoms than veterans with nonblast-related mTBI histories, with a marginally significant difference in posttraumatic stress symptom report between veterans reporting blast-related mTBI only and those reporting nonblast-related mTBI. The groups did not differ in terms of PC symptom severity or PC symptom cluster profiles. Among veterans with blast-related mTBI histories, PC symptom report did not vary by number of blast-related mTBIs or proximity to blast. Overall, posttraumatic stress symptoms accounted for a substantial portion of variance in PC symptom report. In veteran outpatients with remote mTBI histories who have enduring symptom complaints related to the mTBI, mechanism of injury did not clearly contribute to differential PC symptom severity or PC symptom cluster profile. Proximal rather than distal factors may be important intervention targets in returning symptomatic veterans with mTBI histories. (JINS, 2010, 16, 856–866.)