Sarah Knapton / The Telegraph – 2016-06-13 23:03:01

http://www.telegraph.co.uk/science/2016/06/09/post-traumatic-stress-disorder-linked-to-shockwaves-from-bomb-bl/

Post-traumatic Stress Disorder
Linked to Shockwaves from Bomb Blasts
Sarah Knapton, Science Editor / The Telegraph

LONDON (June 9, 2016) — Shockwaves from explosions may scar the brains of soldiers in areas linked to post-traumatic stress disorder (PTSD), suggesting a possible physical cause for the condition.

Scientists found distinctive injuries in the brains of eight military personnel who survived bomb blasts but died between four days and nine years after the trauma.

The damage, which can only be seen following a post mortem examination, was in areas of the brain associated with cognitive function, memory and sleep.

All of the soldiers had been caught up in explosions with grenades, mortars or improvised explosive devices (IEDs) and five had been diagnosed with PTSD.

One 45-year-old veteran included in the study, who had been subjected to numerous shockwaves in his 25-year military career, took his own life after being diagnosed with PTSD, anxiety and depression. However MRI scans taken when he was alive showed no brain abnormalities.

“Blast-related brain injuries are the signature injury of modern military conflicts”, said senior author Dr Daniel Perl from the Uniformed Services University of the Health Sciences, Maryland, USA.

“Although routine imaging for blast-related traumatic brain injury often shows no brain abnormalities, soldiers frequently report debilitating neuropsychiatric symptoms such as headaches, sleep disturbance, memory problems, erratic behaviour and depression suggesting structural damage to the brain.

“Because the underlying pathophysiology is unknown, we have difficulty diagnosing and treating these ‘invisible wounds’.”

The authors conclude: “This presents the possibility that the scarring, particularly that in the neuroanatomical areas associated with PTSD…may increase the probability of PTSD symptom expression in people exposed to blasts.”

In five male soldiers who survived more than six months after blast exposure, the scientists found a ‘distinctive, consistent, and unique pattern’ of prominent scarring in parts of the brain that are crucial for thinking, memory, sleep and other important functions.

Scarring was seen in several brain structures associated with post-traumatic stress disorder.

The brains of three male soldiers who died shortly after an explosive blast (4 — 60 days) showed a similar distinctive pattern of early scar formation in the same locations, further suggesting that the pattern is caused by the blast itself.

The scarring was different to injuries seen in soldiers who had suffered other types of brain injury such as through car accidents or contact sports.

“In these controls we did not see similar scarring to the blast cases, which increases the likelihood that the pattern is linked with high-explosive exposure,” added Dr Perl.

“Although little is known about the effect of blast shockwave on the human brain, the unique pattern of damage that we found is consistent with known shockwave effects on the human body.”

Dr William Stewart at the University of Glasgow, UK said: “Unquestionably, this study is commendable in drawing attention to the need for careful study of human tissue to further understanding of traumatic brain injury.

“However, far from an answer to the question of what is blast traumatic brain injury, the work instead exposes the remarkable absence of robust human neuropathology studies in this field.”

The findings were published in the journal The Lancet Neurology.

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