Researchers Study Blast Injuries In Veterans

Researchers at the Boston VA are finding that exposure to blasts even without concussion can cause structural damage to the brain.

SCOTT SIMON, HOST:

The U.S. Veterans Administration is conducting one of the largest studies of blast injuries on post-9/11 veterans. Researchers are discovering that blast exposure can cause damage to the brain in some unexpected ways. Fred Thys from member station WBUR in Boston has the details.

FRED THYS, BYLINE: Chris Riga realized something was not right shortly after he'd been exposed to several improvised explosive devices.

CHRIS RIGA: The first time I noticed, we had been through multiple IED strikes within a week period years ago in Afghanistan. And unfortunately, I was at a memorial ceremony, and I couldn't keep my balance after standing up for about two minutes.

THYS: Riga served several tours in Afghanistan from 2001 to 2014, eventually commanding all U.S. Special Forces there. During his 29 years in the Army's 82nd Airborne, Rangers, and 3rd and 7th Special Forces groups, he also served in Africa and Iraq.

RIGA: We were always either preparing for combat or deployed in combat. Blasts and exposures were a daily incident.

THYS: Improved battlefield medical care in Iraq and Afghanistan means more troops have survived with Traumatic Brain Injury, or TBI. Researchers are trying to understand the long-term effects of TBI. They're looking at vets with a variety of symptoms such as PTSD, alcohol abuse and sleep problems, which tend to co-occur with TBI. Bill Milberg and Regina McGlinchey are the co-directors of the Boston VA study.

REGINA MCGLINCHEY: So we don't only look at the military service period. We look at what happened to these people when they were younger, before they were in the military, so, you know, we capture things like rock wars and sledding incidents when they're growing up. And then also, you know...

BILL MILBERG: Sports injuries and bar fights and the whole gamut.

MCGLINCHEY: Yeah, whole nine yards (laughter).

THYS: And they're trying to understand the possible impact on a person's emotional well-being.

MCGLINCHEY: We're not trying to understand PTSD or just TBI. It's like, what does war do to an entire person?

THYS: Researchers found that exposure to blasts resulted in changes to brain function and brain structure. They also learned that veterans could have suffered a brain injury from blasts even if they never had a concussion. One of the researchers, Laura Grande, found the effects of blast exposure are the same even if a person had no symptoms of concussion.

LAURA GRANDE: It's not the PTSD that's driving this memory deficit. It's not the sleep deprivation. It's not the substance abuse. I think what this study demonstrates is that it's - that's not all that there is, that there is something about blast exposure that is also associated with memory impairment.

THYS: Chris Riga lives in western Massachusetts, where he works as a patient advocate at the local VA. There, a co-worker who works with a lot of recent special operations veterans told him of the Boston study. At 54, he's had many concussions and problems with short-term memory. So Riga volunteered. By participating in the VA research, he's been taught how to cope with his memory loss.

RIGA: I go through a lot of stickies (laughter). My wall is full of them. It's a tool. Rather than not only forgetting something and adding the stress of worrying about forgetting something, you can just simply write it down.

THYS: By working with Riga and 800 other veterans, McGlinchey hopes the VA team can identify combinations of conditions that seem to predict poor outcome.

MCGLINCHEY: So that we can target who it is that are going to need a lot of care, intervene early enough where we can have an effect and have an impact on the rest of their lives rather than letting the horse keep running out of the barn. But first, we have to know who to find, how to target. You can't just bring three million people who've been deployed in for help.

THYS: McGlinchey and her colleagues are trying to identify those at greatest risk for later disability so as to target therapy and other interventions as early as possible.

For NPR News, I'm Fred Thys in Boston.

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