Trajectory of Postconcussive Symptoms 12-Months Post-Deployment in Soldiers with and without Mild Traumatic Brain Injury - Warrior STRONG Study

Abstract

Postconcussive symptoms are believed to resolve in days or months in most instances for civilian injuries, though recent evidence suggests that recovery may be slower for injuries sustained during military deployment. The present study is based on a cohort of recently deployed soldiers from two US Army military bases (Fort Carson and Fort Bragg, followed from 2009-2015). Soldiers with and without a recent history of a deployment mild traumatic brain injury (mTBI) were evaluated within days of return and at 3, 6, and 12-months. Those with mTBI were more likely than non-mTBI to endorse one or more postconcussive symptoms at a severe and or very severe level (47% vs. 21% baseline; aRR=1.7 95% CI: 1.51,1.93 all-time points) and remained significant after adjusting for PTSD (aRR=1.34 95%CI: 1.41,1.82). Prevalence and relative risks (for three of most common baseline symptoms remained constant over time: sleep problems (RR=2.19), forgetfulness (RR=2.56), irritability (RR=2.73). The pattern was slightly different for headache, decreasing from RR=3.44 at baseline to RR=3.26 at 12 months, due to increased prevalence of headache in those without mTBI. . The prevalence of clinically relevant postconcussive symptoms remained relatively constant over one year of follow-up, whether or not symptoms were associated with concussion. Service members with recent mTBI reported more symptoms than non-mTBI at all time-points.