Longitudinal Investigation of Neurotrauma Serum Biomarkers, Behavioral Characterization, and Brain Imaging in Soldiers Following Repeated Low-Level Blast Exposure (New Zealand Breacher Study)

Mil Med. 2018 Mar 1;183(suppl_1):28-33. doi: 10.1093/milmed/usx186.

Abstract

"Breachers" (dynamic entry personnel) are routinely exposed to low-level blast overpressure during training and occupational duties. Data were collected from 22 military breachers (mean 29.7 yr) over a 5-yr period to characterize the longitudinal effects of repeated low-level blast overpressure exposure. None of the participants reported a diagnosed concussion during the study period. Blood-based biomarker concentrations (n = 22) showed either no significant change or a significant decrease over time. Neurocognitive performance (n = 20) and symptom reporting (n = 22) did not change over time. Neuroimaging analyses resulted in no significant differences for within-subject (baseline vs follow-up, n = 8) and between-subject (naïve, n = 5 vs experienced, n = 8) comparisons. Changes to training doctrine mid-study reduced blast exposure (< 4 psi) and may have mitigated any measurable effects associated with long-term, low-level blast exposure. The results suggest that the first 5 yr of a breaching career in healthy, young individuals is unlikely to result in measurable effects when overpressure exposure is maintained within the 4 psi safe limit. The lack of any significant changes in these operators suggests that either no identifiable injuries occurred and/or measurement tools may not be sensitive enough to identify any negative subconcussive effects.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Biomarkers / analysis*
  • Biomarkers / blood
  • Blast Injuries / complications
  • Blast Injuries / physiopathology
  • Brain Injuries / diagnosis*
  • Glial Fibrillary Acidic Protein / analysis
  • Glial Fibrillary Acidic Protein / blood
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging / methods
  • Mental Status and Dementia Tests / statistics & numerical data
  • Military Personnel / statistics & numerical data*
  • Neuroimaging / methods
  • New Zealand
  • Ubiquitin Thiolesterase / analysis
  • Ubiquitin Thiolesterase / blood

Substances

  • Biomarkers
  • GFAP protein, human
  • Glial Fibrillary Acidic Protein
  • UCHL1 protein, human
  • Ubiquitin Thiolesterase