Health symptoms after war zone deployment-related mild traumatic brain injury: contributions of mental disorders and lifetime brain injuries

Brain Inj. 2021 Sep 19;35(11):1338-1348. doi: 10.1080/02699052.2021.1959058. Epub 2021 Sep 20.


Primary objective: To gain a better understanding of the complex relationship between combat deployment-related mild traumatic brain injury (mTBI) and persistent post-concussive symptoms (PPCSs), taking into consideration a wide range of potentially mediating and confounding factors.

Research design: Cross-sectional.

Methods and procedures: Subjects were 613 U. S. military Veterans and Service Members who served during operations Enduring Freedom, Iraqi Freedom, or New Dawn (OEF/OIF/OND) and completed a structured interview of mental disorders and a battery of questionnaires. Hierarchical binary logistic regression analyses were used to test the hypotheses.

Main outcomes and results: After accounting for mental disorders, lifetime mTBIs outside of OEF/OIF/OND deployment, medical conditions, and injury/demographic characteristics, deployment-related mTBI continued to be associated with several PPCSs (headaches, sleep disturbance, and difficulty making decisions). Deployment-related mTBI was also associated with two symptoms not normally associated with mTBI (nausea/upset stomach and numbness/tingling).

Conclusions: After adjusting for a wide range of factors, OEF/OIF/OND deployment-related mTBI was still associated with PPCSs on average 10 years after the injury. These findings suggest that mTBI sustained during OEF/OIF/OND deployment may have enduring negative health effects. More studies are needed that prospectively and longitudinally track health and mental health outcomes after TBI.

Keywords: Brain concussion; Veterans; blast injuries; brain injuries; mental health; stress disorders; traumatic.

Publication types

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

MeSH terms

  • Afghan Campaign 2001-
  • Brain Concussion* / epidemiology
  • Brain Concussion* / etiology
  • Brain Injuries*
  • Cross-Sectional Studies
  • Humans
  • Mental Disorders* / epidemiology
  • Mental Disorders* / etiology
  • Stress Disorders, Post-Traumatic* / epidemiology
  • Stress Disorders, Post-Traumatic* / etiology
  • Veterans*