Military-related traumatic brain injury and neurodegeneration
Open accessAbstract
Mild traumatic brain injury (mTBI) includes concussion, subconcussion, and most exposures to explosive blast from improvised explosive devices. mTBI is the most common traumatic brain injury affecting military personnel; however, it is the most difficult to diagnose and the least well understood. It is also recognized that some mTBIs have persistent, and sometimes progressive, long-term debilitating effects. Increasing evidence suggests that a single traumatic brain injury can produce long-term gray and white matter atrophy, precipitate or accelerate age-related neurodegeneration, and increase the risk of developing Alzheimer's disease, Parkinson's disease, and motor neuron disease. In addition, repetitive mTBIs can provoke the development of a tauopathy, chronic traumatic encephalopathy. We found early changes of chronic traumatic encephalopathy in four young veterans of the Iraq and Afghanistan conflict who were exposed to explosive blast and in another young veteran who was repetitively concussed. Four of the five veterans with early-stage chronic traumatic encephalopathy were also diagnosed with posttraumatic stress disorder. Advanced chronic traumatic encephalopathy has been found in veterans who experienced repetitive neurotrauma while in service and in others who were accomplished athletes. Clinically, chronic traumatic encephalopathy is associated with behavioral changes, executive dysfunction, memory loss, and cognitive impairments that begin insidiously and progress slowly over decades. Pathologically, chronic traumatic encephalopathy produces atrophy of the frontal and temporal lobes, thalamus, and hypothalamus; septal abnormalities; and abnormal deposits of hyperphosphorylated tau as neurofibrillary tangles and disordered neurites throughout the brain. The incidence and prevalence of chronic traumatic encephalopathy and the genetic risk factors critical to its development are currently unknown. Chronic traumatic encephalopathy has clinical and pathological features that overlap with postconcussion syndrome and posttraumatic stress disorder, suggesting that the three disorders might share some biological underpinnings.
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Epidemiological studies have consistently found higher rates of adverse outcomes in adults who have sustained a TBI compared to the general population.
“Epidemiological studies have consistently found higher rates of adverse outcomes in adults who have sustained a TBI when compared to the general population [7–16].”
From Long-Term Outcomes Associated with Traumatic Brain Injury in Childhood and Adolescence: A Nationwide Swedish Cohort Study of a Wide Range of Medical and Social Outcomes (2016) · cites this paper as [13]
Section 1.2, “Chronic effects of TBI” (page not provided), reports higher risks of Alzheimer’s disease and other neurodegenerative outcomes in several studies comparing people with TBI to controls. But the claim extends this to adverse outcomes generally and to adults with TBI regardless of severity; the section also reports no increased Alzheimer’s risk among veterans with mild TBI. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe third finding, on the effects of recurrent injuries, is broadly consistent with the emerging literature on the adverse consequences of sports and combat-related neurotrauma.
“Our third finding, on the effects of recurrent injuries, is broadly consistent with the emerging literature on the adverse consequences of sports and combat-related neurotrauma [7,9,11–14,46–49].”
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Iverson, G. L., Luoto, T. M., Karhunen, P. J., & Castellani, R. J. (2019) · Journal of Neuropathology & Experimental Neurology · doi:10.1093/jnen/nlz045 · Cited by 63 · see citing works
Kempuraj, D., Ahmed, M. E., Selvakumar, G. P., Thangavel, R., Raikwar, S. P., Zaheer, S. A., Iyer, S. S., Govindarajan, R., Nattanmai Chandrasekaran, P., Burton, C., et al. (2021) · Neurotoxicity Research · doi:10.1007/s12640-020-00288-9 · Cited by 43 · see citing works
- Authors
- McKee, A. C., & Robinson, M. E.
- Affiliations
- Boston University (US)
- VA Boston Healthcare System (US)
- Corresponding author
- McKee, Ann C.
- Venue
- Alzheimer's & Dementia
- Publisher
- Wiley
- Published
- 2014-06
- Volume
- 10
- Issue
- 3S
- Pages
- S242-53
- ISSN
- 1552-5260 (ISSN-L)
- 1552-5279
- PMC
- PMC4255273
- OpenAlex
- W2085684925
- Cited by
- 423
- References
- 76
- Citations by year
- 2026: 13 · 2025: 38 · 2024: 43 · 2023: 29 · 2022: 38 · 2021: 39 · 2020: 62 · 2019: 44 · 2018: 31 · 2017: 28 · 2016: 25 · 2015: 27 · 2014: 6
- FWCI
- 3.83
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Alzheimer s & Dementia (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion, cc-by-nc-nd)
- Funders
- U.S. Department of Veterans Affairs
- National Institute of Neurological Disorders and Stroke
- National Institute of Biomedical Imaging and Bioengineering (UO1NS086659‐01)
- National Operating Committee on Standards for Athletic Equipment
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
- Keywords
- mild traumatic brain injury, chronic traumatic encephalopathy
- MeSH terms
- Animals, Blast Injuries, Brain, Brain Concussion, Humans, Military Personnel, Stress Disorders, Post-Traumatic, Brain Injury, Chronic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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