Skip to main content

Military Health System

Military researchers gain new insights into brain injuries

Image of Military personnel sitting at a table collecting data. Study team members from Naval Medical Center Camp Lejeune and the Hearing Center of Excellence conduct pre-exposure auditory testing on Marines during an Integrated Training Exercise at Marine Corps Air Ground Combat Center Twentynine Palms, California in January 2020. The CHASMPAS study is working to better understand noise-induced hearing loss by collecting audiometric data before and after noise exposure (Photo by: Quintin Hecht).

Recommended Content:

Brain Injury Awareness | Brain Injury Awareness | Brain Injury Awareness | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Brain Injury Awareness | Brain Injury Awareness

Military researchers have recently found that headache, dizziness and cognitive dysfunction occur far more frequently among military personnel with mild traumatic brain injury than in those without injury. Sleep disorders and emotional issues are also significantly more common in members with this injury.

These findings are from a study supported by the Defense Health Agency’s Hearing Center of Excellence (HCE) that evaluated a battery of neurologic assessment tests to help diagnose mild head injury. The Madigan Army Medical Center at Joint Base Lewis-McChord in Washington, and the Naval Medical Center San Diego in California served as enrollment sites from 2014 through 2017 for the study called, "Assessment of Oculomotor, Vestibular and Reaction Time Response Following a Concussive Event."

The Center for Disease Control and Prevention defines a traumatic brain injury (TBI) as a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury. The severity of a TBI may range from mild, commonly called concussions, to severe. According to the Armed Forces Health Surveillance Branch, mild traumatic brain injury, or mTBI, is the most common traumatic brain injury affecting military personnel, and includes concussion, subconcussion that does not cause symptoms, and exposures to blasts like improvised explosive devices.

"The objective of the research was to collect data to advance our understanding of oculomotor, vestibular and reaction time responses in relation to mTBI," said HCE division chief, Dr. Carlos Esquivel. "Three of the tests yielded an 89% sensitivity and 95% specificity for confirming a current diagnosis of mTBI."

The hearing center is facilitating several other research projects to better understand hearing injury and its connection to traumatic brain injury.

A multi-site field study, called CHASMPAS (Characterization of Acute or Short-term Acquired Military Population Auditory Shifts) has been underway since 2019 to characterize short-term changes in hearing among military personnel exposed to blast. Researchers are using advanced boothless hearing test technology to conduct in-field hearing evaluations immediately before and after a service member's blast exposure, and state-of-art blast measurement technology from the federally funded Massachusetts Institute of Technology - Lincoln Laboratory.

"This comprehensive study approach may identify risk factors, mitigating factors and dose-response relationships, which could result in refinement of acoustic standards, new hearing protection strategies, and direction of future research to explore pharmaceutical intervention for hearing loss," said Dr. Douglas Brungart, chief scientist of the HCE and the National Military Audiology and Speech Center at Walter Reed National Military Medical Center in Bethesda, Maryland.

According to Brungart, so far, roughly 95 service members have taken part in the study with future data collection and analysis planned at Fort Benning, Georgia; Camp Lejeune, North Carolina; and Quantico, Virginia.

Esquivel said the HCE will continue to support the CHASMPAS project and other related ongoing projects, to advance work in this area of study.

According to Esquivel, research efforts to date have shown that people can suffer from a form of hidden injury, signaling the importance of continuing these studies. "When people report having difficulties hearing, we cannot dismiss their complaints when their hearing test results are normal. Research in this area will be critical in understanding these impacts as risk factors, and short-term and long-term auditory effects may be identified from the retrospective and prospective, longitudinal analysis," Esquivel explained.

Additional plans in brain injury research are underway for MAMC and NMCSD to participate in a study called, "Clinical Trial of Etanercept (TNF-a Blocker) for Treatment of Blast-Induced Tinnitus." Led by Wayne State University, the project will test an FDA-approved medication for the treatment of blast-induced tinnitus.

The NMCSD has also started enrolling participants for a study called, "The Use of a Standardized Instrument to Provide Diagnostic and Prognostic Information in Traumatic Brain Injury." This Uniformed Services University of the Health Sciences-funded study is a collaboration with the University of Miami and University of Pittsburgh to evaluate the utility of a multi-modality suite of tests for diagnosing TBI, as well as the ability to provide prognostic information about recovery.

Esquivel explained the symptoms of TBI, such as headaches, hearing loss, and dizziness, generally resolve within six weeks, but for some, these symptoms persist and can worsen over time."For that reason, examining tests to determine the presence of TBI is a pressing need in this field. Equally as important is a test or set of tests that can be prognostic in nature, and predict a person’s return to duty and other activities," said Esquivel.

The center's regional research administrators at MAMC and NMCSD have supported multiple local and multi-site studies sponsored through the Congressionally Directed Medical Research Programs and industry grants. In addition, the HCE research coordination branch supports multi-site hearing injury research in collaboration with WRNMMC to collect data at Marine Corps Base Camp Lejeune, North Carolina; Marine Corps Combat Development Command, Quantico, Virginia; and Ft. Benning, Georgia.

"These research projects are providing invaluable data to address previously identified knowledge gaps in this area, but our work is not done. We must continue to support this area of research as the state of science advances," Esquivel summed up.

You also may be interested in...

Blast Overpressure Research Brings NATO Group to DHHQ

Article
12/13/2022
Military personnel fire mortar rounds

DOD and NATO experts recently met to continue their work on warfighter brain health to protect soldiers from the overblast pressure of their weaponry.

Recommended Content:

Research & Innovation | Brain Injury Awareness | Traumatic Brain Injury Center of Excellence

More Inclusive Research Key to Understanding Prevalence of Dementia

Article
12/7/2022
Animated image of brain

Dementia and its most common form, Alzheimer’s disease, are cognitive disorders that affect more women than men. Although there are various theories on why, more equitable research is needed.

Recommended Content:

Women's Health | Psychological Fitness | Traumatic Brain Injury Center of Excellence

DHA's E Caregiver Directory Puts Resources at Your Fingertips

Article
11/30/2022
Woman on left stretching her husband's left arm and right leg

Caregivers now have needed resources at their fingertips on their mobile phones, tablets, and computers.

Recommended Content:

Brain Injury Awareness | Mental Health: Seeking Care with TRICARE | Suicide Prevention | Warrior Care | Mental Health is Health Care

DOD Brain Health Initiative is at Work Across the Military

Article
11/17/2022
Two hands holding damaged wearable blast mesurement gauges from a study on blast pressure exposure.

From enlistment to retirement, the brain health of service members is being checked. See why the results are creating new action plans for the DOD.

Recommended Content:

Brain Injury Awareness

Groundbreaking Study on Trauma-related Sleep Disorder

Article
10/17/2022
Airman with elecronic trackers on his head seen in profile for a sleep disorder study on TSD.

Army researchers publish an important new study on Trauma-associated Sleep Disorder, or TSD.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Sleep

Top U.S. Military Enlisted Leader Shares Experience of Stigma Surrounding TBI

Article
9/30/2022
A man wearing headphones in front of his computer

Recovery after brain injury keeps warfighters mission-ready.

Recommended Content:

Traumatic Brain Injury Center of Excellence

On National Concussion Awareness Day, Learn the Truth about TBI

Article
9/16/2022
A mountain biker wearing a helmet bikes through hard terrain.

Separate the myths and truths around TBI

Recommended Content:

Traumatic Brain Injury Center of Excellence

A History of the Combat Helmet and the Quest to Prevent Injuries

Article
4/25/2022
Lt. Gen. George S. Patton and Brig. Gen. Theodore Roosevelt Jr. are pictured here in 1943 wearing the standard M1 helmet, sometimes called the "steel pot." (Photo: 1st Infantry Division Courtesy Photo)

The combat helmet has evolved over time to improve protection against projectiles and shock waves to reduce the risk of fatal blows and traumatic brain injuries.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Our History | Injury Prevention

Concussion Care Pathway Streamlined for Better Results

Article
4/1/2022
Dr. Gregory Johnson, Tripler Concussion Clinic medical director, conducts a neurological exam on Army Spc. Andrew Karamatic, a combat medic, having him follow his finger with his eyes, at Tripler Army Medical Center, in Honolulu, Hawaii. Neurologic exams are part of the MACE 2 diagnostic tool to assess service members’ Acute Concussion Care Pathway. (Photo: Army Staff Sgt. Christopher Hubenthal, DMA Pacific – Hawaii Media Bureau)

The Defense Health Agency has developed a comprehensive clinical care program (Acute Concussion Care Pathway) to manage concussions based on the military medical community’s many years of experience with injured service members.

Recommended Content:

Traumatic Brain Injury Center of Excellence

Brain-Boosting Meal Plans Help Service Members with TBI

Article
3/30/2022
During the NICoE intensive outpatient program (IOP), staff nutritionist Ruth Clark teaches hands-on classes in the on-site patient kitchen. (Photo: Tahira Hayes (Ctr), NICoE/WRNMMC, NSA Bethesda)

Research has shown that dietary changes may help relieve symptoms that might complicate recovery from a traumatic brain injury (TBI), such as chronic pain, anxiety, depression, and sleep problems.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Nutritional Fitness | Total Force Fitness

Immediate Testing: How the Military Evaluates Risk For Brain Injuries

Article
3/28/2022
Pfc. Thomas Icenogle, a student in the Army’s Combat Medic Specialist Training Program at the Medical Education and Training Campus on Joint Base San Antonio-Fort Sam Houston, Texas, conducts a Military Acute Concussion Evaluation 2 (MACE 2) on Pvt. Alejandro Leija, while Pvt. Dominic Dubois refers to the MACE 2 card. (Photo: Lisa Braun, Medical Education and Training Campus Public Affairs)

MACE 2 allows for a quick assessment of traumatic brain injuries in the field and is similar to sports concussion checks.

Recommended Content:

Traumatic Brain Injury Center of Excellence

Five Clinical Tools To Help Assess and Treat TBI

Article
3/17/2022
An Army 'gun team' brace for the concussion of a 105mm howitzer during operations in Iraq in 2008. (Photo: Master Sgt. Kevin Doheny)

Here are five new ways that doctors can diagnose and treat mild concussions.

Recommended Content:

Traumatic Brain Injury Center of Excellence

Ask the Doc: Can a Concussion Affect Hearing and Vision?

Article
3/16/2022
Elizabeth Kirkpatrick, a physical therapist for the Fort Drum Traumatic Brain Injury (TBI) Clinic, New York, uses a model of the inner ear on Feb. 27, 2019, to demonstrate how a concussion can cause inner ear, or vestibular, damage which may result in dizziness, anxiety, depression, moodiness, balance problems and irritability to name a few. (Photo: Warren W. Wright Jr., Fort Drum MEDDAC)

Even a mild concussion can lead to hearing and vision problems.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Vision and Hearing Loss Prevention | Hearing Center of Excellence | Vision Center of Excellence | Vision and Hearing Loss Prevention | Ask The Doc

Tackling Concussions: NCAA-DOD CARE Consortium Battles Brain Injuries

Article
1/6/2022
Naval Academy football team runs onto the field

Dr. Paul Pasquina and Dr. Terry Rauch recently discussed the NCAA-DOD Concussion Assessment, Research and Education (CARE) Consortium, the largest concussion and repetitive head impact study in history, on the NCAA’s “Social Series.”

Recommended Content:

Uniformed Services University of the Health Sciences | Traumatic Brain Injury Center of Excellence | Medical Research and Development | Injury Prevention

USU Co-leads Largest NCAA-DOD Concussion Study in History

Article
10/8/2021
A doctor looks at a patient's prosthetic arm.

The Uniformed Service University will co-lead the next phase of the largest concussion and repetitive head impact study.

Recommended Content:

Traumatic Brain Injury Center of Excellence
<< < 1 2 3 4 > >> 
Showing results 1 - 15 Page 1 of 4
Refine your search
Last Updated: December 28, 2022
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery