Abstract
Addressing the concerns surrounding blast injury for the military community is a pressing matter. Specifically, sub-concussive blast effects, or those blast effects which do not yield a medical diagnosis but can result in symptom reporting and negative self-reported outcomes, are becoming increasingly important. This work evaluates explosive blast overpressure and impulse effects at the sub-concussive level on neurocognitive performance assessed with the Defense Automated Neurobehavioral Assessment (DANA) across seven breacher training courses conducted by the US Military. The results reported here come from 202 healthy, male military volunteer participants. Findings indicate that the neurocognitive task appearing most sensitive to identifying performance change is the DANA Procedural Reaction Time (PRT) subtask which may involve a sufficient level of challenge to reliably detect a small, transient cognitive impairment among a healthy undiagnosed population. The blast characteristic that was consistently associated with performance change was peak overpressure. Overall, this study provides evidence that increasing blast overpressure, defined as peak overpressure experienced in a training day, can lead to transient degradations in neurocognitive performance as seen on the DANA PRT subtask, which may generalize to other capabilities.
Highlights
Blast injury is an increasing concern of Coalition Forces due to improvised explosives used during conflicts in Iraq and Afghanistan [1]
This study provides evidence that increasing blast overpressure, defined as peak overpressure experienced in a training day, can lead to transient degradations in neurocognitive performance as seen on the Defense Automated Neurobehavioral Assessment (DANA) Procedural Reaction Time (PRT) subtask, which may generalize to other capabilities
The fixed effects estimates suggested greater peak overpressure exposure, less sleep hours, and more military service years were associated with less PRT performance improvement
Summary
Blast injury is an increasing concern of Coalition Forces due to improvised explosives used during conflicts in Iraq and Afghanistan [1] Medical resources from both the Department of Defense and from the Department of Veterans Affairs have been allocated to address these injuries through prevention, recovery, and research. Accumulating evidence suggests that blast exposures can result in negative effects on the brain in absence of a medically diagnosable injury [2,3,4,5]. The effects of these sub-concussive blast exposures are gaining attention in research and military communities concentrating on repeated exposures, deteriorated performance, and long-term health consequences.
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