Symptoms Persist in Veterans with Mild Traumatic Brain Injury

SILVER SPRING, MD—What is the longer-term prognosis for veterans who suffered mild traumatic brain injury (mTBI) during deployment?

The Defense and Veterans Brain Injury Center focused on nearly 25,000 nonmedically evacuated soldiers returning from Afghanistan or Iraq to two military bases between 2009 and 2014 who were screened for mTBI. A random sample was invited to participate in the present study, oversampling those screening positive, resulting in 557 mTBI cases and 1,010 controls, of whom 366 cases and 599 controls completed three-month follow-up evaluations.

For the study published in the journal Neurology, the criterion measure of screened mTBI was the Ohio State University Traumatic Brain Injury Identification Method. Postconcussive symptoms (PCS) were measured at follow-up with the Neurobehavioral Symptom Inventory. Symptoms reported at a severe or very severe level were considered clinically relevant.

Results indicated that about half (47%) of soldiers who had sustained an mTBI during this latest deployment reported PCS at three-month follow-up vs. 25% of controls, for an adjusted odds ratio of 2.4.

The most commonly reported symptoms (cases vs. controls) were sleep problems (30% vs 14%), forgetfulness (21% vs 9%), irritability (17% vs 8%) and headaches (15% vs 5%).

In fact, mTBI cases were about twice as likely as controls to report receiving rehabilitative services and fair or poor health. Other predictors of PCS included post-traumatic stress, combat exposure and noncephalic pain.

The study noted that a majority of both cases and controls reported traumatic brain injuries predating their latest deployment.

“In this nonclinical population of recently deployed soldiers, a substantial proportion of those who had sustained an mTBI were symptomatic 3 months postdeployment,” study authors concluded. “Future studies need to include longer follow-up to measure symptom resolution.”

  1. Schwab K, Terrio HP, Brenner LA, Pazdan RM, McMillan HP, MacDonald M, Hinds SR 2nd, Scher AI. Epidemiology and prognosis of mild traumatic brain injury in returning soldiers: A cohort study. Neurology. 2017 Apr 18;88(16):1571-1579. doi: 10.1212/WNL.0000000000003839. Epub 2017 Mar 17. PubMed PMID: 28314862.

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