Browsing by Subject "mild traumatic brain injury"

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    Effects of chronic mild traumatic brain injury on white matter integrity in Iraq and Afghanistan war veterans.
    (Human Brain Mapping, 2013-11) Morey, Rajendra A; Haswell, Courtney C; Selgrade, Elizabeth S; Massoglia, Dino; Liu, Chunlei; Weiner, Jonathan; Marx, Christine E; MIRECC Work Group; Cernak, Ibolja; McCarthy, Gregory
    Mild traumatic brain injury (TBI) is a common source of morbidity from the wars in Iraq and Afghanistan. With no overt lesions on structural MRI, diagnosis of chronic mild TBI in military veterans relies on obtaining an accurate history and assessment of behavioral symptoms that are also associated with frequent comorbid disorders, particularly posttraumatic stress disorder (PTSD) and depression. Military veterans from Iraq and Afghanistan with mild TBI (n = 30) with comorbid PTSD and depression and non-TBI participants from primary (n = 42) and confirmatory (n = 28) control groups were assessed with high angular resolution diffusion imaging (HARDI). White matter-specific registration followed by whole-brain voxelwise analysis of crossing fibers provided separate partial volume fractions reflecting the integrity of primary fibers and secondary (crossing) fibers. Loss of white matter integrity in primary fibers (P < 0.05; corrected) was associated with chronic mild TBI in a widely distributed pattern of major fiber bundles and smaller peripheral tracts including the corpus callosum (genu, body, and splenium), forceps minor, forceps major, superior and posterior corona radiata, internal capsule, superior longitudinal fasciculus, and others. Distributed loss of white matter integrity correlated with duration of loss of consciousness and most notably with "feeling dazed or confused," but not diagnosis of PTSD or depressive symptoms. This widespread spatial extent of white matter damage has typically been reported in moderate to severe TBI. The diffuse loss of white matter integrity appears consistent with systemic mechanisms of damage shared by blast- and impact-related mild TBI that involves a cascade of inflammatory and neurochemical events.
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    Family Reintegration Experiences of Soldiers with Combat-Related Mild Traumatic Brain Injury
    (2013) Hyatt, Kyong Suk

    Abstract

    More than 300,000 soldiers have returned from Southwest Asia (i.e., Iraq and Afghanistan) with combat-related mild traumatic brain injuries (mTBIs) associated with exposure to improvised explosive devices (IEDs). Despite less visible physical injuries, these soldiers demonstrate varying levels of physical and cognitive symptoms that impact their post-mTBI family reintegration. The existing literature acknowledges post-mTBI changes in the injured individual affect family functioning; however, post-injury family functioning, such as coping and adaptation, has not been explored. The intent of this dissertation is to explore the problems and challenges of military family reintegration following mTBI.

    Nine soldiers with mTBI and their spouses participated for a total of 27 interviews. Both joint and separate individual interviews were conducted to explore their post-mTBI family reintegration experiences. Participants included active duty soldiers with mTBI who were between 2 and 24 months post-deployment and their civilian spouses. Strauss and Corbin's grounded theory methodology was used to collect and analyze the data. This dissertation study consists of three papers, each of which explored experiences that surround family reintegration following mTBI.

    The first paper is a comprehensive literature review, examining commonly reported mTBI signs/symptoms, and the impact of these symptoms on the injured individuals and their families. The findings also suggest that psychological distress symptoms such as depression and anxiety are common in injured individuals and their

    families after mTBI. The second paper explores the family reintegration processes of post-mTBI soldiers and their spouses. The majority of participants interviewed, both soldiers and their spouses, indicated that symptoms such as irritability, memory loss, and cognitive deficit affected their family reintegration. Some participants reported they had accepted the changes and were working toward a new normal, whereas others indicated these changes were unacceptable and continued their efforts to resume pre-injury functioning.

    The third paper examined the experiences of soldiers and their spouses about seeking treatment for mTBI-related symptoms. The majority of interviewed soldiers and their spouses indicated that a delayed diagnosis, difficulty accessing mental health care, and having to navigate an unfamiliar military healthcare system were their biggest challenges. Post-mTBI soldiers experienced significant disruption due to mismatched expectations among themselves and other family members concerning their post-injury capabilities. More research is needed in order to develop effective post-injury rehabilitation programs for soldiers with mTBI and their families.