Long-term neurobehavioural symptom reporting following mild, moderate, severe, and penetrating traumatic brain injury in U.S. military service members

Lange, Rael T.; Lippa, Sara M.; French, Louis M.; Bailie, Jason M.; Gartner, R; Driscoll, A; Wright, Megan M.; Sullivan, Jamie; Varbedian, Nicole V.; Barnhart, Elizabeth; Holzinger, Jayne B.; Schaper, A; Reese, Maryetta; Brandler, Brian; Camelo-Lopez, V; Brickell, Tracey A.

doi:10.1080/09602011.2019.1604385

Cited by 47 publications

(37 citation statements)

References 41 publications

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“…SMVs underwent auditory and neuropsychological testing at Walter Reed National Military Medical Center (WRNMMC) as part of the Congressionally mandated 15-Year Longitudinal TBI Study (Sec721 NDAA FY2007) by the Defense and Veterans Brain Injury Center (DVBIC). Details on inclusion criteria, group definition, and recruiting procedures are found in Lange et al ( 2 ). In the current analyses, SMV's first session of complete data was included, yielding 278 participants.…”

Section: Methodsmentioning

confidence: 99%

“…Eighteen participants were excluded due to having an equivocal or unknown TBI history. Individuals were also excluded because of invalid cognitive test scores (e.g., performance validity testing) or exaggerated symptom reporting ( 2 , 27 ) ( n = 46) or invalid auditory test scores ( n = 2).…”

Section: Methodsmentioning

confidence: 99%

“…Thus, TBI history (present vs. absent) and TBI severity (no more than uncomplicated mTBI vs. complicated mTBI or more severe) were treated as binary factors. Details of TBI severity categorization are in Lange et al (2). In sum, TBI severity was classified as: uncomplicated mTBI (i) Glasgow Coma Scale (GCS) = 13-15, Post-Traumatic Amnesia (PTA) <24 h, Loss of Consciousness (LOC) <30 min, and/or Alteration of Consciousness (AOC) present, and (ii) no trauma-related intracranial abnormality on CT or MRT; complicated mTBI (i) GCS = 13-15, PTA <24 h, LOC <30 min, and/or AOC present, and (ii) trauma-related intracranial abnormality on CT or MRI; moderate TBI: LOC 1-24 h, PTA 1-7 days, and ICA present or absent; severe TBI: LOC >24 h, PTA >7 days, and ICA present or absent; penetrating TBI: breach of the cranial vault and/or dura mater by external object (e.g., bullet, shrapnel) and/or skull fragment (i.e., skull fracture).…”

Section: Neurological Symptoms Tbi History and Severitymentioning

confidence: 99%

“…This study aims to highlight domains that may be important for comprehensive assessments of the subjective and objective hearing and tinnitus problems of SMVs with or without a history of TBI and/or blast exposure. (2). In the current analyses, SMV's first session of complete data was included, yielding 278 participants.…”

Section: Introductionmentioning

confidence: 99%

“…Traumatic brain injury (TBI) is a common injury among military service members and veterans (SMVs) ( 1 ). There has been increasing awareness that physical, sensory, cognitive, and/or affective symptoms are often reported many months or years following injury [e.g., ( 2 )] or develop following subconcussive blast exposure ( 3 ). Critical for improving patient care is our ability to comprehensively assess the range of problems that individuals with a TBI or blast exposure experience.…”

Section: Introductionmentioning

confidence: 99%

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Objective and Subjective Auditory Effects of Traumatic Brain Injury and Blast Exposure in Service Members and Veterans

et al. 2020

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Service members and veterans (SMVs) with a history of traumatic brain injury (TBI) or blast-related injury often report difficulties understanding speech in complex environments that are not captured by clinical tests of auditory function. Little is currently known about the relative contribution of other auditory, cognitive, and symptomological factors to these communication challenges. This study evaluated the influence of these factors on subjective and objective measures of hearing difficulties in SMVs with and without a history of TBI or blast exposure. Analyses included 212 U.S. SMVs who completed auditory and cognitive batteries and surveys of hearing and other symptoms as part of a larger longitudinal study of TBI. Objective speech recognition performance was predicted by TBI status, while subjective hearing complaints were predicted by blast exposure. Bothersome tinnitus was associated with a history of more severe TBI. Speech recognition performance deficits and tinnitus complaints were also associated with poorer cognitive function. Hearing complaints were predicted by high frequency hearing loss and reports of more severe PTSD symptoms. These results suggest that SMVs with a history of blast exposure and/or TBI experience communication deficits that go beyond what would be expected based on standard audiometric assessments of their injuries.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Neurological Symptoms Tbi History and Severitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Objective and Subjective Auditory Effects of Traumatic Brain Injury and Blast Exposure in Service Members and Veterans

et al. 2020

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Development of a novel bioengineered 3D brain‐like tissue for studying primary blast‐induced traumatic brain injury

Snapper

Reginauld

Liaudanskaya

et al. 2022

J of Neuroscience Research

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Primary blast injury is caused by the direct impact of an overpressurization wave on the body. Due to limitations of current models, we have developed a novel approach to study primary blast‐induced traumatic brain injury. Specifically, we employ a bioengineered 3D brain‐like human tissue culture system composed of collagen‐infused silk protein donut‐like hydrogels embedded with human IPSC‐derived neurons, human astrocytes, and a human microglial cell line. We have utilized this system within an advanced blast simulator (ABS) to expose the 3D brain cultures to a blast wave that can be precisely controlled. These 3D cultures are enclosed in a 3D‐printed surrogate skull‐like material containing media which are then placed in a holder apparatus inside the ABS. This allows for exposure to the blast wave alone without any secondary injury occurring. We show that blast induces an increase in lactate dehydrogenase activity and glutamate release from the cultures, indicating cellular injury. Additionally, we observe a significant increase in axonal varicosities after blast. These varicosities can be stained with antibodies recognizing amyloid precursor protein. The presence of amyloid precursor protein deposits may indicate a blast‐induced axonal transport deficit. After blast injury, we find a transient release of the known TBI biomarkers, UCHL1 and NF‐H at 6 h and a delayed increase in S100B at 24 and 48 h. This in vitro model will enable us to gain a better understanding of clinically relevant pathological changes that occur following primary blast and can also be utilized for discovery and characterization of biomarkers.

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Prevalence and correlates of self‐reported cognitive difficulties in deployment‐injured U.S. military personnel

Jurick

McCabe

Watrous

et al. 2022

Journal of Traumatic Stress

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Cognitive difficulties typically resolve within days to weeks following mild traumatic brain injury (mTBI); however, a sizable proportion of individuals continue to report cognitive symptoms months to years later that are often associated with posttraumatic stress disorder (PTSD) and depression to a greater degree than a history of mTBI. The current study sought to evaluate the prevalence of self-reported cognitive difficulties as well as the relative contributions of demographic, injury-related, and mental health variables in a large study of U.S. military personnel injured during deployment since 2001. Slightly fewer than half (42.0%) of participants reported elevated cognitive difficulties compared with a normative population; however, this was driven primar-

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Long-term neurobehavioural symptom reporting following mild, moderate, severe, and penetrating traumatic brain injury in U.S. military service members

Cited by 47 publications

References 41 publications

Objective and Subjective Auditory Effects of Traumatic Brain Injury and Blast Exposure in Service Members and Veterans

Objective and Subjective Auditory Effects of Traumatic Brain Injury and Blast Exposure in Service Members and Veterans

Development of a novel bioengineered 3D brain‐like tissue for studying primary blast‐induced traumatic brain injury

Prevalence and correlates of self‐reported cognitive difficulties in deployment‐injured U.S. military personnel

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