Neuro-psychiatric symptoms in directly and indirectly blast exposed civilian survivors of urban missile attacks

Abstract

Background Blast-explosion may cause traumatic brain injury (TBI), leading to post-concussion syndrome (PCS). In studies on military personnel, PCS symptoms are highly similar to those occurring in post-traumatic stress disorder (PTSD), questioning the overlap between these syndromes. In the current study we assessed PCS and PTSD in civilians following exposure to rocket attacks. We hypothesized that PCS symptomatology and brain connectivity will be associated with the objective physical exposure, while PTSD symptomatology will be associated with the subjective mental experience. Methods Two hundred eighty nine residents of explosion sites have participated in the current study. Participants completed self-report of PCS and PTSD. The association between objective and subjective factors of blast and clinical outcomes was assessed using multivariate analysis. White-matter (WM) alterations and cognitive abilities were assessed in a sub-group of participants (n = 46) and non-exposed controls (n = 16). Non-parametric analysis was used to compare connectivity and cognition between the groups. Results Blast-exposed individuals reported higher PTSD and PCS symptomatology. Among exposed individuals, those who were directly exposed to blast, reported higher levels of subjective feeling of danger and presented WM hypoconnectivity. Cognitive abilities did not differ between groups. Several risk factors for the development of PCS and PTSD were identified. Conclusions Civilians exposed to blast present higher PCS/PTSD symptomatology as well as WM hypoconnectivity. Although symptoms are sub-clinical, they might lead to the future development of a full-blown syndrome and should be considered carefully. The similarities between PCS and PTSD suggest that despite the different etiology, namely, the physical trauma in PCS and the emotional trauma in PTSD, these are not distinct syndromes, but rather represent a combined biopsychological disorder with a wide spectrum of behavioral, emotional, cognitive and neurological symptoms.

The state of antioxidant system and emotional status in rats with mild blast-induced traumatic brain injury

“…Thus, our results indicate persistent impairment of emotional status in rats with mild bTBI, which coincides with the results of modern experimental studies and clinical observations [22,23]. In addition, reliable signs of OS occurring in response to primary damage to the BW were identified.…”

Applying Proteomics and Computational Approaches to Identify Novel Targets in Blast-Associated Post-Traumatic Epilepsy

“…It has been reported that more than 25% of Veterans suffered from closed-head TBI due to blast wave exposure produced by explosive devices or high caliber weapons during combat, and most have been exposed to multiple low-level blasts within their tour of duty [ 4 ]. Assigned a unique medical code in 2023, in the CDC International Classification of Diseases , 10th Revision, Clinical Modification (ICD-10-CM), rbTBI is described to be associated with acute cognitive and behavioral deficits, with a subset of those injured having persistent debilitating effects including headaches, anxiety, depression, and sleep disturbances [ 5 , 6 ]. Blast TBI is of significant concern, particularly to the military population, wherein it has been dubbed the ‘signature wound’ of Operations Enduring Freedom, Iraqi Freedom, and New Dawn (OEF/OIF/OND) [ 7 ].…”