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Postconcussive Symptoms After Blast and Nonblast-Related Mild Traumatic Brain Injuries in Afghanistan and Iraq War Veterans

Published online by Cambridge University Press:  04 August 2010

SARA M. LIPPA ,
NICHOLAS J. PASTOREK ,
JARED F. BENGE  and
G. MATTHEW THORNTON
SARA M. LIPPA
Affiliation:
Rehabilitation Care Line, Michael E. DeBakey Veteran’s Affairs Medical Center, Houston, Texas Department of Psychology, University of Houston, Houston, Texas
NICHOLAS J. PASTOREK*
Affiliation:
Rehabilitation Care Line, Michael E. DeBakey Veteran’s Affairs Medical Center, Houston, Texas Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
JARED F. BENGE
Affiliation:
Rehabilitation Care Line, Michael E. DeBakey Veteran’s Affairs Medical Center, Houston, Texas The Menninger Department of Psychiatry, Baylor College of Medicine, Houston, Texas
G. MATTHEW THORNTON
Affiliation:
Rehabilitation Care Line, Michael E. DeBakey Veteran’s Affairs Medical Center, Houston, Texas Department of Psychology, University of Houston, Houston, Texas
*
*Correspondence and reprint requests to: Nicholas J. Pastorek, Ph.D., ABPP-CN, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd. (RCL 117), Houston, Texas 77030. E-mail: nicholas.pastorek@va.gov
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Abstract

Blast injury is common in current warfare, but little is known about the effects of blast-related mild traumatic brain injury (mTBI). Profile analyses were conducted investigating differences in self-reported postconcussive (PC) symptoms in 339 veteran outpatients with mTBI histories reporting current symptoms based on mechanism of injury (blast only, nonblast only, or both blast and nonblast), number of blast injuries, and distance from the blast. Veterans with any blast-related mTBI history were younger and reported higher posttraumatic stress symptoms than veterans with nonblast-related mTBI histories, with a marginally significant difference in posttraumatic stress symptom report between veterans reporting blast-related mTBI only and those reporting nonblast-related mTBI. The groups did not differ in terms of PC symptom severity or PC symptom cluster profiles. Among veterans with blast-related mTBI histories, PC symptom report did not vary by number of blast-related mTBIs or proximity to blast. Overall, posttraumatic stress symptoms accounted for a substantial portion of variance in PC symptom report. In veteran outpatients with remote mTBI histories who have enduring symptom complaints related to the mTBI, mechanism of injury did not clearly contribute to differential PC symptom severity or PC symptom cluster profile. Proximal rather than distal factors may be important intervention targets in returning symptomatic veterans with mTBI histories. (JINS, 2010, 16, 856–866.)

Keywords

Blast injuryHead injuryConcussionPosttraumatic stressPolytraumaNeurobehavioral Symptom Inventory
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 16 , Issue 5 , September 2010 , pp. 856 - 866
Copyright
Copyright © The International Neuropsychological Society 2010

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