Mild tbi associated with long-term effects when occurring with psychological trauma | va boston health care | veterans affairs

BOSTON , MA — VA Boston Healthcare System researchers found that mild traumatic brain injury leads to significant long-term consequences only when it occurs at the same time as a

psychologically traumatic event, in a new study published in JAMA Network Open Jan. 22, 2025. “Our findings suggest that mTBI alone may not drive long-term negative outcomes; it’s the

combination of brain injury within a psychologically stressful context that creates lasting challenges among Veterans,” said Dr. Emily Van Etten, co-lead author and a post-doctoral fellow at

the Translational Research Center for Traumatic Brain Injury and Stress Disorders, known as TRACTS, located at VA Boston’s Jamaica Plain campus. The study, “Peritraumatic Context and

Long-Term Outcomes of Concussion,” analyzed data from 567 post-9/11 Veterans who participated in the TRACTS study between 2009 and 2024. Researchers found that Veterans who experienced mild

traumatic brain injury, or mTBI, in the context of a stressful or traumatic event — referred to as “peritraumatic mTBI” — had significantly worse long-term outcomes including higher rates of

posttraumatic stress disorder, or PTSD, postconcussive symptoms, and disability compared to those with mTBI that occurred outside of a potentially traumatic context, or those with no

history of mTBI. Notably, there were no significant differences in long-term outcomes between Veterans with nonperitraumatic mTBI and those with no TBI, suggesting that mTBI’s effects may be

contingent on its psychological context. The study’s findings introduce a “scaffolding” hypothesis about the link between mTBI and PTSD, proposing that acute biological and physiological

effects of mTBI may temporarily support the development of PTSD symptoms. This process could, in turn, contribute to the persistence of postconcussive and PTSD symptoms, and ultimately

long-term disability. “These results emphasize the importance of comprehensive screening and treatment for Veterans who experience a head injury at the same time as a stressful or

psychologically traumatic event,” noted Arielle Knight, co-lead author and senior program manager at TRACTS. “They also highlight the need for interventions aimed at addressing the combined

impact of mTBI and PTSD to improve long-term care for our Veterans.” More information about the study is available at  https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829450

Image caption (image linked below):  Graphs comparing consequences following mild traumatic brain injury in stressful or peritraumatic, right, and non-stressful or non-peritraumatic contexts

over time. The graphs show how brain injury within a psychologically stressful context can create longer-lasting challenges among Veterans.