Yee Megan K, Janulewicz Patricia A, Seichepine Daniel R, Sullivan Kimberly A, Proctor Susan P, Krengel Maxine H
Boston VA Research Institute, Inc., Boston, MA 02130, USA.
Department of Environmental Health, School of Public Health, Boston University, Boston, MA 02118, USA.
Brain Sci. 2017 Jul 9;7(7):79. doi: 10.3390/brainsci7070079.
Recent research demonstrated a relation between traumatic brain injury (TBI), health symptoms and diagnosis of Gulf War Illness (GWI) in Gulf War Veterans, but no study has examined the impact of multiple mild TBIs (mTBIs). A total of 229 male Gulf War Veterans from the Ft Devens Cohort were categorized by a number of mTBIs reported. One-way ANOVA and chi-square test of independence were used to test for differences in total reported health symptoms and diagnosis of chronic multisymptom illness (CMI) or Kansas GWI criteria, two of the most common case definitions of GWI. A total of 72 veterans reported no mTBIs (31.4%), 26 reported one mTBI (11.4%), 25 reported two mTBIs (10.9%), and 106 veterans reported sustaining three or more mTBIs (46.3%). Veterans reporting two or more mTBIs ( < 0.01) or three or more mTBIs ( < 0.001) endorsed significantly higher rates of health symptoms than Veterans reporting no mTBIs. Significantly higher rates of CMI ( = 0.035) and Kansas GWI criteria ( < 0.001) were seen in the three or more mTBI group. Results suggest two mTBIs increase risk of health symptoms, but three mTBIs may be the threshold needed to sustain chronic symptom reporting needed for a formal diagnosis. These findings highlight the importance of implementing policies and procedures monitoring head injuries in military personnel.
最近的研究表明，海湾战争退伍军人的创伤性脑损伤（TBI）、健康症状与海湾战争综合症（GWI）诊断之间存在关联，但尚无研究考察多次轻度创伤性脑损伤（mTBI）的影响。对来自德文斯堡队列的229名男性海湾战争退伍军人，根据报告的mTBI次数进行了分类。采用单因素方差分析和独立性卡方检验，以检验报告的总体健康症状以及慢性多症状疾病（CMI）诊断或堪萨斯GWI标准（GWI最常见的两种病例定义）之间的差异。共有72名退伍军人报告无mTBI（31.4%），26名报告有1次mTBI（11.4%），25名报告有2次mTBI（10.9%），106名退伍军人报告有3次或更多次mTBI（46.3%）。报告有2次或更多次mTBI（<0.01）或3次或更多次mTBI（<0.001）的退伍军人认可的健康症状发生率显著高于报告无mTBI的退伍军人。在3次或更多次mTBI组中，CMI（=0.035）和堪萨斯GWI标准（<0.001）的发生率显著更高。结果表明，2次mTBI会增加健康症状风险，但3次mTBI可能是维持正式诊断所需的慢性症状报告的阈值。这些发现凸显了实施监测军事人员头部受伤的政策和程序的重要性。
