According to a new study in JAMA Neurology, U.S. military service members who endured a mild concussion after blast injury while deployed may continue to experience mental health symptoms as well as decreases in quality of life for at least five years after their injury. This prospective, longitudinal study enrolled active-duty US military after concussive blast injury (n = 50) and combat-deployed control individuals (n = 44) in Afghanistan or after medical evacuation to Germany. One- and 5-year clinical evaluations were completed in the United States. In-person clinical evaluations included standardized evaluations for neurobehavior, neuropsychological performance, and mental health burden that were essentially identical to the evaluations completed at 1-year follow-up.
Among the 94 participants (87 men and 7 women; mean age, 34 years), global disability, satisfaction with life, neurobehavioral symptom severity, psychiatric symptom severity, and sleep impairment were significantly worse in patients with concussive blast TBI compared with combat-deployed controls, whereas performance on cognitive measures was no different between groups at the 5-year evaluation. 36 of 50 patients with concussive blast TBI (72%) had a decline in the GOS-E from the 1- to 5-year evaluations, in contrast with only 5 of 44 combat-deployed controls (11%). Worsening of symptoms in concussive blast TBI was also observed on measures of posttraumatic stress disorder and depression. Service members with concussive blast TBI experienced evolution, not resolution, of symptoms from the 1- to 5-year outcomes.