研究信：在LIMBIC-CENC研究中对女性和男性现役军人及退伍军人终身轻度创伤性脑损伤暴露情况进行特征描述。

Research Letter: Characterizing Lifetime Mild TBI Exposure Among Female and Male Military Service Members and Veterans in the LIMBIC-CENC Study.

作者信息

Walton Samuel R, Oldham Jessie R, Remigio-Baker Rosemay A, Brett Benjamin L, Austin Tara A, Cetin Olivia D, Wilde Elisabeth A, Lempke Landon B, Ou Zhining, Kamineni Sreekanth, Martindale Sarah L, O'Neil Maya E, Pugh Mary J, Swanson Randel L, Pappadis Monique R, Cifu David X, Walker William C

机构信息

Author Affiliations: Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine and Richmond Veterans Affairs Medical Center, Central Virginia VA Health Care System, Richmond (Dr Walton); Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond (Dr Oldham); Brain Injury Center of Excellence, Silver Spring; Compass Government Solutions, Annapolis (Dr Remigio-Baker); Department of Neurosurgery, Medical College of Wisconsin, Milwaukee (Dr Brett); San Diego VA Healthcare System, San Diego (Dr Austin); San Diego VA Healthcare System, San Diego (Ms Cetin); Department of Neurology, University of Utah School of Medicine and George E. Wahlen VA Medical Center, Salt Lake City (Dr Wilde); Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond (Dr Lempke); Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City (Ms Ou); Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City (Dr Kamineni); W. G. (Bill) Hefner VA Healthcare System, Salisbury and Department of Translational Neuroscience, Wake Forest School of Medicine, Winston-Salem (Dr Martindale); VA Portland Health Care System Oregon Health and Science University, Portland (Dr O'Neil); Department of Medicine, VA Salt Lake City, Salt Lake City, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City (Dr Pugh); Physical Medicine & Rehabilitation, Perelman School of Medicine, University of Pennsylvania and Rehabilitation Medicine, Corporal Michael J. Crescenz VA Medical Center, Philadelphia (Dr Swanson); Department of Population Health and Health Disparities, School of Public and Population Health, the University of Texas Medical Branch at Galveston, Galveston(Dr Pappadis); Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine and Richmond Veterans Affairs Medical Center, Central Virginia VA Health Care System, Richmond (Dr Cifu); and Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine and Richmond Veterans Affairs Medical Center, Central Virginia VA Health Care System, Richmond (Dr Walker).

出版信息

J Head Trauma Rehabil. 2025;40(2):E121-E128. doi: 10.1097/HTR.0000000000000989. Epub 2024 Jul 5.

DOI:10.1097/HTR.0000000000000989

PMID:39019484

Abstract

OBJECTIVE

To (1) characterize lifetime mild traumatic brain injury (TBI) exposures among male and female US military service members and Veterans (SMVs) and (2) evaluate sex-related differences in mild TBI exposures.

SETTING

Clinical research laboratory.

PARTICIPANTS

Participants were enrolled in the ongoing Long-term Impact of Military-relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) Prospective Longitudinal Study.

DESIGN

Cross-sectional.

MAIN MEASURES

Lifetime history of mild TBI was measured via structured interview. All mild TBI characteristics were collected as part of this interview, including total lifetime number; environment (deployment vs. non-deployment); timing of injury (relative to military service and age); and mechanism of injury (blast-related vs. non-blast).

RESULTS

Most participants ( n = 2323; 87.5% male; 79.6% Veteran) reported ≥1 lifetime mild TBI ( n = 1912; 82%), among whom, many reported ≥2 lifetime mild TBIs. Female SMVs reported fewer total lifetime mild TBIs than male participants ( P < 0.001), including fewer deployment-related ( P < 0.001) and non-deployment ( P < 0.001) mild TBIs. There were significant sex differences for total number of mild TBIs sustained before ( P = 0.005) and during ( P < 0.001) military service but not after separation from military service ( P = 0.99). Among participants with a lifetime history of mild TBI, female SMVs were less likely to report ≥2 mTBIs ( P = 0.003); however, male SMVs were more likely to report a mild TBI during military service ( P = 0.03), including combat-related mild TBI ( P < 0.001) and mild TBI involving blast ( P < 0.001).

CONCLUSIONS

These findings inform clinical and research efforts related to mild TBI in US military SMVs. It may not be sufficient to simply measure the total number of mild TBIs when seeking to compare clinical outcomes related to mild TBI between sexes; rather, it is important to measure and account for the timing, environment, and mechanisms associated with mild TBIs sustained by female and male SMVs.

摘要

目的

（1）描述美国现役军人和退伍军人（SMV）一生中轻度创伤性脑损伤（TBI）的暴露情况；（2）评估轻度TBI暴露中与性别相关的差异。

设置

临床研究实验室。

参与者

参与者入选了正在进行的军事相关脑损伤联盟 - 神经创伤慢性影响联盟（LIMBIC - CENC）前瞻性纵向研究。

设计

横断面研究。

主要测量指标

通过结构化访谈测量轻度TBI的终生病史。本次访谈收集了所有轻度TBI的特征，包括终生总数；环境（部署与非部署）；受伤时间（相对于军事服役和年龄）；以及损伤机制（爆炸相关与非爆炸）。

结果

大多数参与者（n = 2323；87.5%为男性；79.6%为退伍军人）报告有≥1次终生轻度TBI（n = 1912；82%），其中许多人报告有≥2次终生轻度TBI。女性SMV报告的终生轻度TBI总数少于男性参与者（P < 0.001），包括与部署相关的（P < 0.001）和非部署的（P < 0.001）轻度TBI。在服役前（P = 0.005）和服役期间（P < 0.001）遭受的轻度TBI总数存在显著性别差异，但在退役后不存在（P = 0.99）。在有轻度TBI终生病史的参与者中，女性SMV报告≥2次轻度TBI的可能性较小（P = 0.003）；然而，男性SMV在服役期间报告轻度TBI的可能性更大（P = 0.03），包括与战斗相关的轻度TBI（P < 0.001）和涉及爆炸的轻度TBI（P < 0.001）。