Lifetime Traumatic Brain Injury and Risk of Post-Concussive Symptoms in the Millennium Cohort Study

Details

• Personal Author:
  Gimeno Ruiz de Porras D ; Jannace KC ; Perkison WB ; Pompeii L ; Rull RP ; Trone DW ; Yamal J-M
• Description:
  Traumatic brain injury (TBI) is prevalent among active duty military service members, with studies reporting up to 23% experiencing at least one TBI, with 10-60% of service members reporting at least one subsequent repeat TBI. A TBI has been associated with an increased risk of cumulative effects and long-term neurobehavioral symptoms, impacting operational readiness in the short-term and overall health in the long term. The association between multiple TBI and post-concussive symptoms (PCS), however, defined as symptoms that follow a concussion or TBI, in the military has not been adequately examined. Previous studies in military populations are limited by methodological issues including small sample sizes, the use of non-probability sampling, or failure to include the total number of TBI. To overcome these limitations, we examined the association between the total lifetime number of TBI and total number of PCS among U.S. active duty military service members who participated in the Millennium Cohort Study. A secondary data analysis was conducted using the Millennium Cohort Study's 2014 survey (n = 28,263) responses on self-reported TBI and PCS (e.g., fatigue, restlessness, sleep disturbances, poor concentration, or memory loss). Zero-inflated negative binomial models calculated prevalence ratios (PRs) and 95% confidence intervals (CIs) for the unadjusted and adjusted associations between lifetime TBIs and PCS. A third of military participants reported experiencing one or more TBIs during their lifetime with 72% reporting at least one PCS. As the mean number of PCS increased, mean lifetime TBIs increased. The mean number of PCS by those with four or more TBI (4.63) was more than twice that of those with no lifetime TBI (2.28). One, two, three, and four or more TBI had 1.10 (95% CI: 1.06-1.15), 1.19 (95% CI: 1.14-1.25), 1.23 (95% CI: 1.17-1.30), and 1.30 times (95% CI: 1.24-1.37) higher prevalence of PCS, respectively. The prevalence of PCS was 2.4 (95% CI: 2.32-2.48) times higher in those with post-traumatic stress disorder than their counterparts. Active duty military service members with a history of TBI are more likely to have PCS than those with no history of TBI. These results suggest an elevated prevalence of PCS as the number of TBI increased. This highlights the need for robust, longitudinal studies that can establish a temporal relationship between repetitive TBI and incidence of PCS. These findings have practical relevance for designing both workplace safety prevention measures and treatment options regarding the effect on and from TBI among military personnel. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Occupational Health Safety
• Keywords:
  Author Keywords: Acute Brain Injuries Brain Concussion Closed Head Injuries Cohort Studies Head Injuries Military Military Personnel Neurophysiological Effects Post-traumatic Stress Disorder PTSD Repeat Traumatic Brain Injury TBI Traumatic Brain Injury

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• ISSN:
  0897-7151
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; Maryland ; OSHA Region 3 ; OSHA Region 6 ; OSHA Region 9 ; Texas
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  41
• Issue:
  5
• NIOSHTIC Number:
  nn:20068540
• Citation:
  J Neurotrauma 2024 Mar; 41(5-6):613-622
• Contact Point Address:
  Kalyn C. Jannace, PhD, Henry M. Jackson Foundation for the Advancement of Military Medicine, Uniformed Health Sciences University, Solace Hall, Building 61-215E, Palmer Road North, Bethesda, MD 20814, USA
• Email:
  Kalyn.Jannace.Ctr@usuhs.edu
• Federal Fiscal Year:
  2024
• Performing Organization:
  University of Texas Health Science Center, Houston
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Journal of Neurotrauma
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:e4448c510006fc1b7d3580bebe3863220c07124eae5e18f53d9704ceea17710a154bf5ac033dabe3b157f8c5dfc4e849bd4adc5c4079155ad798f503151e0bb3
• Download URL:
  https://stacks.cdc.gov/view/cdc/207151/cdc_207151_DS1.pdf
• File Type:
  [PDF - 242.11 KB ]