Epidemiological Study of Mild Traumatic Brain Injury Sequelae Caused by Blast Exposure During Operations Iraqi Freedom and Enduring Freedom.

摘要

Accomplishments include initial and continued IRB approvals, completion of enrollment, study assessments, data collection, data management and all preliminary analyses. Two hundred and thirty eight (238) participants passed eligibility pre-screen and consented for study procedures. Of these, twenty-two (22) participants either did not meet final eligibility or failed to complete Phase 1 (baseline) evaluations resulting in the final enrollment sample size of two hundred and sixteen (216) participants. The overwhelming majority (77%) of the final sample met criteria for post-concussion syndrome (PCS). From the analyses, we have so far achieved 6 fulllength publications in peer-reviewed scientific journals, another submitted manuscript is under review, and multiple pending manuscripts are in varying stages of completion. Summary of Findings: The more significant findings include: 1) screening questionnaires for PTSD and mTBI after military blast-exposure have important diagnostic limitations, 2) a novel fully structured interview algorithm was developed and validated for determining the retrospective diagnosis of blast mTBI, 3) Post- concussive like symptoms, PTSD, depression and pain are common after blast exposure during deployment, do not diminish over time, and none are clearly related to having sustained blast mTBI, 4) Persisting neuropsychological and balance impairments and physiologic changes on quantitative EEG are common after military blast exposure and each have profiles related to and hence potentially attributable to blast mTBI especially when accompanied by post- traumatic amnesia (PTA). Conclusions: PCS like symptoms are ubiquitous after military blast exposure, do not dissipate over one year follow-up, and have poor specificity for blast mTBI. Cognitive and balance deficits are common after military blast exposure and are influenced in part by blast mTBI.