Sub-concussive injuries have emerged as an important factor in the long-term brain health of athletes and military personnel. The objective of this study was to explore the relationship between service member and veteran's (SMVs) lifetime blast exposure and recovery from a traumatic brain injury (TBI). 558 SMVs with a history of TBI were examined. Lifetime blast exposure (LBE) was based on self-report (M = 79.4, SD = 392.6; range = 0-7,500) categorized into three groups: Blast Naive (n = 121), Low LBE (n = 223; LBE range 1-9), High LBE (n = 214; LBE > 10). Dependent variables were the Neurobehavioral Symptom Inventory (NSI) and Posttraumatic Stress Disorder Checklist-Civilian (PCL-C) and the Traumatic Brain Injury Quality of Life (TBI-QOL). Analyses controlled for demographic factors (age, gender, and race) as well as TBI factors (months since index TBI, index TBI severity, as well as total number lifetime TBIs). The Blast Naive group had significantly lower NSI and PCL-C scores compared to the Low LBE group and High LBE group, with small to medium effect sizes. On the TBI-QOL the Blast Naïve group had better quality life on 10 of the 14 scales examined. The Low LBE did not differ from the High LBE group on the PCL-C, NSI, or TBI-QOL. Blast exposure over a SMV's career was associated with increased neurobehavioral and posttraumatic stress symptoms following a TBI. The influence of psychological trauma associated with blasts may be an important factor influencing symptoms as well as the accuracy of self-reported estimates of LBE.

中文翻译：

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军事生涯中累积的爆炸暴露会对脑外伤的恢复产生负面影响。

亚脑震荡损伤已成为运动员和军事人员长期大脑健康的重要因素。本研究的目的是探讨现役军人和退伍军人 (SMV) 终生爆炸暴露与创伤性脑损伤 (TBI) 恢复之间的关系。对 558 名有 TBI 病史的 SMV 进行了检查。终生爆炸暴露 (LBE) 基于自我报告（M = 79.4，SD = 392.6；范围 = 0-7,500），分为三组：爆炸天真（n = 121）、低 LBE（n = 223；LBE 范围 1） -9)，高 LBE (n = 214；LBE > 10)。因变量是神经行为症状量表 (NSI) 和创伤后应激障碍检查表 - 平民 (PCL-C) 以及创伤性脑损伤生活质量 (TBI-QOL)。分析控制了人口因素（年龄、性别和种族）以及 TBI 因素（指数 TBI 以来的月数、指数 TBI 严重程度以及终生 TBI 总数）。与低 LBE 组和高 LBE 组相比，Blast Naive 组的 NSI 和 PCL-C 评分显着较低，且效应大小为小到中等。在 TBI-QOL 中，Blast Naïve 组在检查的 14 个量表中的 10 个上有更好的生活质量。低 LBE 组在 PCL-C、NSI 或 TBI-QOL 上与高 LBE 组没有差异。SMV 职业生涯中的爆炸暴露与 TBI 后神经行为和创伤后应激症状的增加有关。与爆炸相关的心理创伤的影响可能是影响症状以及自我报告的 LBE 估计准确性的重要因素。