The Effects of Explosive Blast as Compared to Post-Traumatic Stress Disorder on Brain Function and Structure

Status unconfirmed

Conditions studied: Blast Injuries, Traumatic Brain Injury, Post-Traumatic Stress Disorders

In brief

Brain injury from explosive blast is a prominent feature of contemporary combat. Although protective armor and effective acute medical intervention allows soldiers to survive blast events, a growing number of veterans will have disability stemming from blast-related neural damage. Soldiers also return from combat with psychological disabilities caused by traumatic war events. The clinical presentation of individuals with blast-related neural damage and post-traumatic psychopathology are markedly similar and thus a clear description of the direct consequences of explosive blast is complicated by the emotional and cognitive sequelae of psychological trauma. We will use sophisticated measures of neural function and structure to characterize brain injury from explosive blasts in a sample of Operation Iraqi Freedom (OIF) National Guard soldiers who returned from deployment in the fall of 2007. Survey data gathered near the end of deployment indicated that over 50% of the brigade had been exposed to direct physical effects of explosive blasts. To fully characterize the effects of blast on the brain and differentiate them from post-traumatic stress disorder, we will contrast groups of soldiers exposed to blast and with groups experiencing post-traumatic stress disorder. This investigation will improve the characterization of blast-related traumatic brain injury, describe the essential features of the condition in terms of neural function and structure to inform diagnosis, and characterize mechanisms of recovery after blast-related neural injury to allow the creation of interventions that return soldiers to maximum levels of functioning.

Key facts

Study ID

NCT00631436

Run by

Center for Veterans Research and Education

People needed

180

Starts

2008-04-01

Expected to finish

2012-03-01

Last updated by the study team

2011-07-21

Who can join

Age: 20 and older, up to 50. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• A high level of posttraumatic stress will be operationally defined "moderate" levels (a rating of 3 or more on a 1 to 5 scale) of the following symptoms according to Hoge et al 4: one re-experiencing symptom, three avoidance symptoms, and two hyperarousal symptoms. Staff will complete a screening interview via telephone in which the potential participant answers questions from the Blast Exposure Screen. The Blast Exposure Screen provides a comprehensive assessment of exposure to blast for the duration of deployment. Blast events will be rated for physical effects (e.g., knocked off balance, physically thrown by blast) and after effects (i.e., memory problems, headache) on the individual.
• Individuals who report memory lapses,
• Sensitivity to light or noise, headaches
• Difficulty with concentration shortly after the explosive blast and have any of the same symptoms in the past month will be invited to participate in the study.

You may not qualify if…

• Participants will be excluded from the study if they manifest
• Current substance induced psychotic disorder or psychotic disorder due to a general medical condition than TBI
• Current or past DSM IV defined substance dependence other than alcohol, caffeine, or nicotine
• Current DSM IV substance abuse other than alcohol, caffeine, or nicotine
• A neurologic condition or DSM Axis I mental disorder prior to deployment (predeployment data from a sample of soldiers from the 1/34 BCT yielded an estimated rate of 5% of either PTSD or depression)
• Current or predeployment unstable medical condition that would likely affect brain function (e.g., clear anoxic episode, cardiac arrest, current uncontrolled diabetes)
• Significant risk of suicidal or homicidal behavior
• Head injury from a source other than blast that resulted in loss of consciousness for more the 15 minutes, post-traumatic amnesia, skull fracture, or hospitalization. The screening interview will include questions to assess subjects with respect to the above exclusion criteria. During the telephone contact subjects will complete a screening for MRI protocols in order to exclude individuals who may have metal fragments in their bodies.

Where it is running

• Minneapolis VA Medical Center — Minneapolis, Minnesota, United States (enrolling)

Full record on ClinicalTrials.gov

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