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Top 10 Concussion Research Articles of 2016

Military doctors review a CAT scan at a clinic in Iraq. (DoD photo by Sgt. Christopher Giannetti)

There is no shortage of clinical research articles on traumatic brain injury (TBI). In fact, a team of experts from Defense and Veterans Brain Injury Center (DVBIC) recently reviewed more than 250 abstracts from literature published in 2016. The team, with a variety of clinical backgrounds, reviewed the latest in brain injury research and selected 10 articles that advance brain injury research.

In recognition of Brain Injury Awareness Month, here is our top 10 list of TBI research articles, with summaries, categorized by topic. Click on the article title to access the abstract or article on PubMed, a service of the U.S. National Library of Medicine.

Outcomes

  1. Clinical Utility and Psychometric Properties of the Traumatic Brain Injury Quality of Life Scale in U.S. Military Service Members.

    Although concussions can affect quality of life, assessing post-concussion health-related quality of life is not currently standard practice for clinicians. This study evaluated the usefulness of an assessment tool called the TBI quality-of-life scale and found it an effective means for checking on health-related quality of life in military concussion patients as compared to service members without TBI. Further research will also explore usefulness of the tool in civilian settings.

  2. Outcome Trends Following U.S. Military Concussive Traumatic Brain Injury

    Posttraumatic stress disorder (PTSD) and depression often accompany combat-related TBI. In this study, researchers looked at outcomes for service members who sustained a combat-related TBI between 2008 and 2013. After examining possible correlations between PTSD, depression and TBI, they found a trend toward less PTSD in later groups of service members. Overall, however, long-term outcomes for these co-occurring conditions have improved only slightly and are often poor — confirming the importance of early care for PTSD and depression in TBI patients.

Gender Outcomes

  1. Female Service Members and Symptom Reporting following Combat- and Non-combat- Related Mild Traumatic Brain Injury

    More women are serving in combat-related roles and sustaining concussions, although combat-related concussion remains less prevalent among women. This study compared 86 women to 86 men, all of whom sustained a concussion while serving on active duty. Women reported significantly more symptoms than their male counterparts, including nausea, sensitivity to light, changes in taste, smell, and appetite, fatigue, poor sleep, difficulty concentrating, trouble remembering a stressful event, and disturbing memories, thoughts, and images. Analyzing gender-related differences in symptom reporting requires more research to better recognize, understand and treat combat-related concussions.

Post-Concussion Syndrome

  1. Prognostic Indicators of Persistent Post-Concussive Symptoms after Deployment-Related Mild Traumatic Brain Injury: A Prospective Longitudinal Study in U.S. Army Soldiers

    Researchers want to learn more about the outcomes of concussions that happen during deployment. This study identified predictors of persistent post-concussive symptoms among U.S. Army personnel who sustained a concussion while deployed in Afghanistan. These service members experienced an increased risk for more severe persistent symptoms. Severity of symptoms at follow-up was also associated with a history of pre-deployment TBI, pre-deployment psychological distress, more severe deployment stress, and loss of consciousness or lapse of memory (versus being “dazed”) as a result of deployment-related concussion. Knowing more about persistent post-concussive symptoms following deployment-acquired concussion enables health care providers to take preventive measures.

  2. Sensory Sensitivity in Operation Enduring Freedom/Operation Iraqi Freedom Veterans with and without Blast Exposure and Mild TBI

    In this study, researchers looked at Operation Enduring Freedom and Operation Iraqi Freedom veterans exposed to a blast-related event and compared those who experienced a concussion to those who didn’t experience a concussion, to determine whether concussion is independently associated with noise and light sensitivity. Sensory symptoms were reported more frequently in the concussion group. After controlling for PTSD and other conditions, noise and light sensitivity persisted, suggesting that these particular symptoms may occur with concussion alone.

  3. Interpreting Change on the Neurobehavioral Symptom Inventory and the PTSD Checklist in Military Personnel

    Did you know that healthy people sometimes report symptoms resembling persistent post-concussive symptoms? In this study, clinicians administered a test called the Neurobehavioral Symptom Inventory to 215 healthy service members without a history of concussion. Among them, 2-15 percent met criteria for persistent post-concussive symptoms. This highlights the importance of using normative data when evaluating a service member or veteran and when evaluating the likelihood that a change in symptom reporting is reliable and clinically meaningful.

  4. Laboratory Impulsivity and Depression in Blast-Exposed Military Personnel with Post-Concussion Syndrome

    This study found a relationship between impulsivity and symptoms relating to moods, feelings and attitudes in service members and veterans with concussion, but noted that the relationship between impulsivity and blast exposure requires further clarification.

Neurocognitive Baseline Tests

  1. Comparison of Baseline-Referenced Versus Norm-Referenced Analytical Approaches for In-Theatre Assessment of Mild Traumatic Brain Injury Neurocognitive Impairment

    The Defense Department mandates pre-deployment neurocognitive tests to set individual baseline scores for assessment of combat-related concussion. However, the large amount of information collected raises questions about the effectiveness of baseline testing relative to other approaches. To figure out whether baseline scores are necessary, this study compared baseline-referenced neurocognitive testing and other approaches in concussed service members. Results suggest that there is no clear advantage to using baseline-referenced scores.

    Treatment

  2. The Timing of Cognitive and Physical Rest and Recovery in Concussion

    Does it matter how soon you get proper rest for both mind and body after a concussion? For children, it matters a lot. This study looked at how delayed rest affected children’s recovery time. Patients who started mental and physical rest immediately after injury were more likely to recover within 30 days, compared to those who delayed it for one to seven days. Among patients who recovered within 30 days, those with immediate rest recovered 4.6 days sooner than those with delayed rest.

  3. Compensatory Cognitive Training for Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans with Mild Traumatic Brain Injury

    Group-based compensatory cognitive training is a type of cognitive rehabilitation designed to help improve attention, learning, memory and other cognitive functions. This study explored compensatory cognitive training for combat veterans with a history of concussion. Those who participated in the training reported significantly fewer cognitive difficulties and greater use of cognitive strategies. They also demonstrated significant improvements on neurocognitive tests. Overall findings show that this training was successful in enhancing the use of cognitive strategies and facilitated improvement in specific cognitive domains.

Comments (5)

  • Does a mild dose of a nerve agent ( enough to put a person out of commission for three days, with lingering effects for about a week or more) qualify as causing minimal brain injury? I believe it was
    BZ, delivered orally in an alcoholic drink. 1962 Evreux France.

    • Michael, we're sorry that you've experienced this. It is best to be seen by a health care provider to get an assessment. If you need help finding a provider in your area, please call the DCoE Outreach Center at 866-966-1020.

  • The Outcome Trends after US Military Concussive Traumatic Brain Injury findings raise the issue of chronic brain inflammation and pituitary exposure to explosive force trauma. Consequential decrease in hormones evident in blood testing may well explain the persistence and severity of these symptoms.

  • Can tell me the difference of degrees of blast from the flight deck of a carrier vs other mild to moderate blasts, also the correlation between the high number of constant blasting for a long period of time for 10 -12 hours of being on the flight deck? If it's strong enough to permanently damage the hearing what is it doing to the brain?

    • We can ask our subject matter experts and get back to you!

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This page was last updated on: April 18, 2017.