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| Name | Class |
|---|---|
| VISN 19 Mental Illness, Research, Education and Clinical Center | FED |
| Womack Army Medical Center | FED |
| USUHS Preventive Medicine and Biometrics | UNKNOWN |
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The study will provide evidence on the long term outcomes of mTBI in service members returning from Afghanistan and Iraq. In addition, the study will provide evidence on mTBI incidence, and symptom patterns. Self-reported assessments at baseline and follow-ups will be combined with data on health care utilization and military job performance. The work, symptoms, and family interaction outcomes of returning soldiers screening positive for mTBI, combined mTBI and PTSD, and soldier controls will be compared at 3 months, 6 months, and at one year. The assessments over time will permit descriptions of symptom changes for these populations. It is likely the study will find similar findings to those of previous civilian studies - that concussive symptoms often resolve within months of injury. However, some soldier subsets may have chronic problems. Determining the incidence and outcomes of individuals with mTBI will assist medical providers in determining the types of follow-ups needed by returning service members and suggest the development of additional treatment interventions. These results may also inform treatment of civilian populations with mTBI.
The three primary hypotheses are:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TBI while Deployed | Active duty service members returning from Afghanistan or Iraq who were screened positive for Mild TBI | ||
| No TBI while Deployed | Active duty service members returning from Afghanistan or Iraq who screened negative for mild TBI. |
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| Measure | Description | Time Frame |
|---|---|---|
| Over time change in Concussive symptoms | Concussive symptoms are measured with 3 instruments: Neurobehavioral Symptom Inventory; Patient Health Questionnaire; Headache Questionnaire. | Baseline; 3 months; 6 months; 12 months |
| Change in Work Related Issues | Measures of rates of return to duty; rates of return to work; and military job performance (for subjects remaining in military at follow-up). | 3 months; 6 months; 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Automated Neuropsychological Assessment Metrics (ANAM) | The ANAM is a brief computerized cognitive assessment tool used for all individuals deploying to Afghanistan or Iraq; and administered after return from deployment. | Pre-deployment testing; and upon return from deployment |
| Change in Social Interaction |
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Inclusion Criteria:
Exclusion Criteria:
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Cohort of soldiers returning to Fort Bragg and Fort Carson returning from deployment to Iraq and Afghanistan. National Guard and Army Reservists serving on Active Duty will also be included.
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| Name | Affiliation | Role |
|---|---|---|
| Karen Schwab, PhD | The Defense and Veterans Brain Injury Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fort Carson | Fort Carson | Colorado | 80913 | United States | ||
| Fort Bragg |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38059837 | Derived | Ivins B, Risling M, Wisen N, Schwab K, Rostami E. Mild Traumatic Brain Injury in the Maturing Brain: An Investigation of Symptoms and Cognitive Performance in Soldiers Returning From Afghanistan and Iraq. J Head Trauma Rehabil. 2024 Jul-Aug 01;39(4):304-317. doi: 10.1097/HTR.0000000000000919. Epub 2023 Dec 7. | |
| 37796114 | Derived |
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| ID | Term |
|---|---|
| D001924 | Brain Concussion |
| D000070642 | Brain Injuries, Traumatic |
| D013313 | Stress Disorders, Post-Traumatic |
| ID | Term |
|---|---|
| D001930 | Brain Injuries |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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Quality and frequency of interactions with family, friends, and partners. Includes marital status, living arrangements, best friend, people can depend upon for help, comparative quality of relationships before deployment and currently, frequency of communication. |
| Baseline; 3 months; 6 months; 12 months |
| Alcohol and caffeine use | Frequency of alcohol consumption, pre and post deployment consumption, receipt of help. Frequency of caffeine consumption, amount, consume with alcohol. | Baseline; 3 months; 6 months; 12 months |
| Health Utilization | Self-report and military data base information regarding type, and frequency of health care received. Also, self-reports on service needs. | Baseline; 3 months; 6 months; 12 months follow-up |
| Fort Bragg |
| North Carolina |
| United States |
| Scher AI, McGinley JS, VanDam LR, Campbell AM, Chai X, Collins B, Klimp SA, Finkel AG, Schwab K, Lipton RB, Johnson KW. Plasma calcitonin gene-related peptide and nerve growth factor as headache and pain biomarkers in recently deployed soldiers with and without a recent concussion. Headache. 2023 Oct;63(9):1240-1250. doi: 10.1111/head.14635. Epub 2023 Oct 5. |
| 33242991 | Derived | Scher AI, McGinley JS, Wirth RJ, Lipton RB, Terrio H, Brenner LA, Cole WR, Schwab K. Headache complexity (number of symptom features) differentiates post-traumatic from non-traumatic headaches. Cephalalgia. 2021 Apr;41(5):582-592. doi: 10.1177/0333102420974352. Epub 2020 Nov 27. |
| 31924681 | Derived | Metti A, Schwab K, Finkel A, Pazdan R, Brenner L, Cole W, Terrio H, Scher AI. Posttraumatic vs nontraumatic headaches: A phenotypic analysis in a military population. Neurology. 2020 Mar 17;94(11):e1137-e1146. doi: 10.1212/WNL.0000000000008935. Epub 2020 Jan 10. |
| 31368742 | Derived | Betthauser LM, Adams RS, Hostetter TA, Scher AI, Schwab K, Brenner LA. Characterization of lifetime TBIs in a cohort of recently deployed soldiers: The warrior strong study. Rehabil Psychol. 2019 Nov;64(4):398-406. doi: 10.1037/rep0000286. Epub 2019 Aug 1. |
| 28314862 | Derived | 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. |
| D006259 |
| Craniocerebral Trauma |
| D020196 | Trauma, Nervous System |
| D016489 | Head Injuries, Closed |
| D014947 | Wounds and Injuries |
| D014949 | Wounds, Nonpenetrating |
| D040921 | Stress Disorders, Traumatic |
| D000068099 | Trauma and Stressor Related Disorders |
| D001523 | Mental Disorders |