CTE: Are Veterans Sustaining Repeat Concussive Injury from Weapons Training?

CTE, or Chronic Traumatic Encephalopathy, is a progressive, neurodegenerative disease that starts with concussive injury to the head and ends in cognitive impairment, sleep and mood disorders, and in many cases, suicide. The condition is associated with professional football players and in earlier times, with boxers. It is being studied by scientists at the Uniformed Services Health University as the etiology behind the behavioral and physical symptoms exhibited by veterans who experienced blast injuries.

Current thinking in military medicine is that PTSD and TBI, with their similar symptoms, have overlapping etiology, and that etiology is related to concussive injury from blast trauma. Since CTE is a progressive, fatal condition that can only be confirmed by biopsy of the brain after death, the VA and other military medicine specialists have been hesitant to clarify the role of repeated blast injuries to CTE in veterans. Liability issues, of course, are also of a concern.

In December 2016, the Pentagon shelved a project that was using mobile sensors attached to helmets and body armor that was designed to measure blast force trauma, in an effort to quantify the amount of blast and concussive injury military members received. Part of several studies looking at blast trauma, the sensors were also used in studies by the USMC to measure signs of concussive trauma in weapons training instructors. At this time, they have no plans to begin using the blast sensors again. It is a rule of thumb in health care that if you do not intend to treat a condition, don’t test for it. You don’t want documentation of untreated symptoms in someone’s medical record. But not testing servicemembers for blast injuries from weapons training and combat is not going to prevent the resulting brain damage.

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