Chronic Traumatic Encephalopathy in the Military
Dr. Jack Tsao talks about research on military-related CTE and what questions are being asked — from who is most susceptible to can it develop from blast injuries rather than direct hits to the head.
The effect of cumulative concussions in the military is an extremely hot research topic. I think that much is still unknown about CTE. For example, we don't know if just exposure to blasts alone is sufficient to cause CTE, or whether one has to actually physically hit their head or have enough force applied to the brain itself to actually cause the symptoms. We also don't know who's actually susceptible to getting CTE because many people get concussions, but as far as we can tell, CTE has only been seen in people who've had either boxing- or NFL- or NHL-type of— like repetitive type of head injury type of sports. So, again, there's much to be learned about it, and obviously we have a lot of service members who come in to the military having been very active people, they have a history of concussion before they even joined the military, then they're on combat deployment, they get another concussion, so the question is sort of on the short-term, we know that people cognitively recover; it's the question of longer-term what—who is likely to have problems and if there's a—if we can—if there's a way to identify who these people are, there might be a way to figure out what the treatment would be and to be able to give it to them years before they might show up clinical symptoms of the disease. Similar with our hope to improve the way we track our service members who are exposed to an event and who actually get a diagnosis of concussion, the goal is that longer-term that we would be able to match up sort of people's total numbers, as it were, of concussions in their lifetime and then hopefully, as the research evolves, we'd have a better sense of is there a certain number of concussions at which point you really need to see the doctor right away? Right now, our policy is planned to mirror what we do in theater, which is, if you had three concussions in a 12-month period, you need to go see the neurologist to be cleared to return to full duty.
Posted on BrainLine February 4, 2014.
Jack Tsao, MD, DPhil, CAPT, MC, USN is a United States Navy neurologist and the director of Traumatic Brain Injury Programs for the US Navy Bureau of Medicine and Surgery, professor of Neurology at the Uniformed Services University of the Health Sciences, and fellow of the American Academy of Neurology.