J Neurotrauma. 2023 Sep 7. doi: 10.1089/neu.2022.0192. Online ahead of print.
Sub-concussive injuries have emerged as an important factor in the long-term brain health of athletes and military personnel. The objective of this study was to explore the relationship between service member and veteran’s (SMVs) lifetime blast exposure and recovery from a traumatic brain injury (TBI). 558 SMVs with a history of TBI were examined. Lifetime blast exposure (LBE) was based on self-report (M = 79.4, SD = 392.6; range = 0-7,500) categorized into three groups: Blast Naive (n = 121), Low LBE (n = 223; LBE range 1-9), High LBE (n = 214; LBE > 10). Dependent variables were the Neurobehavioral Symptom Inventory (NSI) and Posttraumatic Stress Disorder Checklist-Civilian (PCL-C) and the Traumatic Brain Injury Quality of Life (TBI-QOL). Analyses controlled for demographic factors (age, gender, and race) as well as TBI factors (months since index TBI, index TBI severity, as well as total number lifetime TBIs). The Blast Naive group had significantly lower NSI and PCL-C scores compared to the Low LBE group and High LBE group, with small to medium effect sizes. On the TBI-QOL the Blast Naïve group had better quality life on 10 of the 14 scales examined. The Low LBE did not differ from the High LBE group on the PCL-C, NSI, or TBI-QOL. Blast exposure over a SMV’s career was associated with increased neurobehavioral and posttraumatic stress symptoms following a TBI. The influence of psychological trauma associated with blasts may be an important factor influencing symptoms as well as the accuracy of self-reported estimates of LBE.