Carr Walter, Stone James R, Walilko Tim, Young Lee Ann, Snook Tianlu Li, Paggi Michelle E, Tsao Jack W, Jankosky Christopher J, Parish Robert V, Ahlers Stephen T
Department of Behavioral Biology, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910.
University of Virginia Health System, 480 Ray C. Hunt Drive, Room 281, Box 801339, Charlottesville, VA 22903.
Mil Med. 2016 May;181(5 Suppl):28-39. doi: 10.7205/MILMED-D-15-00137.
The relationship between repeated exposure to blast overpressure and neurological function was examined in the context of breacher training at the U.S. Marine Corps Weapons Training Battalion Dynamic Entry School. During this training, Students are taught to apply explosive charges to achieve rapid ingress into secured buildings. For this study, both Students and Instructors participated in neurobehavioral testing, blood toxin screening, vestibular/auditory testing, and neuroimaging. Volunteers wore instrumentation during training to allow correlation of human response measurements and blast overpressure exposure. The key findings of this study were from high-memory demand tasks and were limited to the Instructors. Specific tests showing blast-related mean differences were California Verbal Learning Test II, Automated Neuropsychological Assessment Metrics subtests (Match-to-Sample, Code Substitution Delayed), and Delayed Matching-to-Sample 10-second delay condition. Importantly, apparent deficits were paralleled with functional magnetic resonance imaging using the n-back task. The findings of this study are suggestive, but not conclusive, owing to small sample size and effect. The observed changes yield descriptive evidence for potential neurological alterations in the subset of individuals with occupational history of repetitive blast exposure. This is the first study to integrate subject instrumentation for measurement of individual blast pressure exposure, neurocognitive testing, and neuroimaging.
在美国海军陆战队武器训练营动态进入学校的爆破手训练背景下，研究了反复暴露于爆炸超压与神经功能之间的关系。在这项训练中，学员们学习如何使用炸药以迅速进入安全建筑。在本研究中，学员和教员都参与了神经行为测试、血液毒素筛查、前庭/听觉测试以及神经成像。志愿者在训练期间佩戴仪器，以便将人体反应测量结果与爆炸超压暴露情况进行关联。本研究的关键发现来自高记忆需求任务，且仅限于教员。显示出与爆炸相关的平均差异的具体测试包括加利福尼亚言语学习测试II、自动神经心理评估指标子测试（样本匹配、延迟代码替换）以及10秒延迟条件下的延迟样本匹配。重要的是，明显的缺陷与使用n-back任务的功能磁共振成像结果相符。由于样本量小和效应问题，本研究的结果具有提示性，但并非结论性的。观察到的变化为有重复性爆炸暴露职业史的个体亚组中潜在的神经改变提供了描述性证据。这是第一项将用于测量个体爆炸压力暴露的受试者仪器、神经认知测试和神经成像结合起来的研究。
