Health symptoms after war zone deployment-related mild traumatic brain injury: contributions of mental disorders and lifetime brain injuries

ABSTRACT

Primary Objective

To gain a better understanding of the complex relationship between combat deployment-related mild traumatic brain injury (mTBI) and persistent post-concussive symptoms (PPCSs), taking into consideration a wide range of potentially mediating and confounding factors.

Research Design

Cross-sectional.

Methods and Procedures

Subjects were 613 U. S. military Veterans and Service Members who served during operations Enduring Freedom, Iraqi Freedom, or New Dawn (OEF/OIF/OND) and completed a structured interview of mental disorders and a battery of questionnaires. Hierarchical binary logistic regression analyses were used to test the hypotheses.

Main Outcomes and Results

After accounting for mental disorders, lifetime mTBIs outside of OEF/OIF/OND deployment, medical conditions, and injury/demographic characteristics, deployment-related mTBI continued to be associated with several PPCSs (headaches, sleep disturbance, and difficulty making decisions). Deployment-related mTBI was also associated with two symptoms not normally associated with mTBI (nausea/upset stomach and numbness/tingling).

Conclusions

After adjusting for a wide range of factors, OEF/OIF/OND deployment-related mTBI was still associated with PPCSs on average 10 years after the injury. These findings suggest that mTBI sustained during OEF/OIF/OND deployment may have enduring negative health effects. More studies are needed that prospectively and longitudinally track health and mental health outcomes after TBI.

KEYWORDS:

• Brain concussion
• Veterans
• stress disorders
• mental health
• blast injuries
• brain injuries
• traumatic

Acknowledgments

The views expressed are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or any of the institutions with which the authors are affiliated. Preliminary work on this study was presented as a poster at the Annual Meeting of the International Society for Traumatic Stress Studies (ISTSS), November 2013. The Mid-Atlantic MIRECC Workgroup contributors for this paper include: Mira Brancu, PhD, Jean C. Beckham, PhD, Patrick S. Calhoun, PhD, Eric Dedert, PhD, Eric B. Elbogen, PhD, John A. Fairbank, PhD, Robin A. Hurley, Md, Jason D. Kilts, PhD, Nathan A. Kimbrel, PhD, Angela Kirby, MS, Christine E. Marx, MD, MS, Scott D. Moore, MD, PhD, Rajendra A. Morey, MD, MS, Jennifer C. Naylor, PhD, Jared Rowland, PhD, Cindy Swinkels, PhD, Steven T. Szabo, MD, PhD, Katherine H. Taber, PhD., and Elizabeth E. Van Voorhees, PhD. Szabo are funded by a Department of Veterans Affairs Clinical Science Research and Development Career Development Award (1IK2CX001397). Correspondences should be addressed to Scott McDonald, Richmond VA Medical Center (128), 1201 Broad Rock Boulevard, Richmond, VA 23249 USA. Telephone: [phone] ext. 3633. Fax [phone]. E-mail: [email protected]

Data availability statement

The dataset associated with this manuscript can be requested through the VA Mid-Atlantic MIRECC, Durham VA Medical Center, NC, USA VISN 6 MIRECC > Home - MIRECC / CoE (va.gov).

Disclosure statement

The authors report no financial interest or benefit that has arisen from the direct applications of this research.

Additional information

Funding

This work was supported by the VA Mid-Atlantic Mental Illness, Education, and Clinical Center [0000].