Mild TBI associated with long-term effects when occurring with psychological trauma
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“Our findings suggest that mTBI alone may not drive long-term negative outcomes; it’s the combination of brain injury within a psychologically stressful context that creates lasting
challenges among Veterans,” said Dr. Emily Van Etten, co-lead author and a post-doctoral fellow at the Translational Research Center for Traumatic Brain Injury and Stress Disorders, known as
TRACTS, located at VA Boston’s Jamaica Plain campus.
The study, “Peritraumatic Context and Long-Term Outcomes of Concussion,” analyzed data from 567 post-9/11 Veterans who participated in the TRACTS study between 2009 and 2024. Researchers
found that Veterans who experienced mild traumatic brain injury, or mTBI, in the context of a stressful or traumatic event — referred to as “peritraumatic mTBI” — had significantly worse
long-term outcomes including higher rates of posttraumatic stress disorder, or PTSD, postconcussive symptoms, and disability compared to those with mTBI that occurred outside of a
potentially traumatic context, or those with no history of mTBI. Notably, there were no significant differences in long-term outcomes between Veterans with nonperitraumatic mTBI and those
with no TBI, suggesting that mTBI’s effects may be contingent on its psychological context.
The study’s findings introduce a “scaffolding” hypothesis about the link between mTBI and PTSD, proposing that acute biological and physiological effects of mTBI may temporarily support the
development of PTSD symptoms. This process could, in turn, contribute to the persistence of postconcussive and PTSD symptoms, and ultimately long-term disability.
“These results emphasize the importance of comprehensive screening and treatment for Veterans who experience a head injury at the same time as a stressful or psychologically traumatic
event,” noted Arielle Knight, co-lead author and senior program manager at TRACTS. “They also highlight the need for interventions aimed at addressing the combined impact of mTBI and PTSD to
improve long-term care for our Veterans.”
More information about the study is available at https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829450