Longitudinal Investigation of Neurotrauma Serum Biomarkers, Behavioral Characterization, and Brain Imaging in Soldiers Following Repeated Low-Level Blast Exposure (New Zealand Breacher Study).
Longitudinal Investigation of Neurotrauma Serum Biomarkers, Behavioral Characterization, and Brain Imaging in Soldiers Following Repeated Low-Level Blast Exposure (New Zealand Breacher Study).
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DOI：
10.1093/milmed/usx186
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发表时间：
2018-03-01
影响因子：
1.2
通讯作者：
Wang, Kevin K W
中科院分区：
文献类型：
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作者：
Kamimori, Gary H;LaValle, Christina R;Wang, Kevin K W
“闯入者”（动态进入人员）在训练和工作期间经常暴露于低水平爆炸超压。数据收集从22个军事breachers（平均29.7年）在5年的时间内，反复低水平爆炸超压暴露的纵向影响的特点。在研究期间，没有参与者报告诊断出脑震荡。基于血液的生物标志物浓度（n = 22）显示无显著变化或随时间显著降低。神经认知能力（n = 20）和症状报告（n = 22）未随时间变化。神经影像学分析显示，受试者内（基线vs随访，n = 8）和受试者间（初治，n = 5 vs有经验，n = 8）比较无显著差异。研究中期对训练原则的改变减少了爆炸暴露（< 4 psi），并可能减轻了与长期、低水平爆炸暴露相关的任何可测量的影响。结果表明，第一个5年的健康，年轻的个人打破职业生涯是不太可能导致可测量的影响时，超压暴露保持在4 psi的安全限制。这些操作员没有任何显著变化表明，没有发生可识别的伤害和/或测量工具可能不够灵敏，无法识别任何负面的亚震荡效应。
"Breachers" (dynamic entry personnel) are routinely exposed to low-level blast overpressure during training and occupational duties. Data were collected from 22 military breachers (mean 29.7 yr) over a 5-yr period to characterize the longitudinal effects of repeated low-level blast overpressure exposure. None of the participants reported a diagnosed concussion during the study period. Blood-based biomarker concentrations (n = 22) showed either no significant change or a significant decrease over time. Neurocognitive performance (n = 20) and symptom reporting (n = 22) did not change over time. Neuroimaging analyses resulted in no significant differences for within-subject (baseline vs follow-up, n = 8) and between-subject (naive, n = 5 vs experienced, n = 8) comparisons. Changes to training doctrine mid-study reduced blast exposure (< 4 psi) and may have mitigated any measurable effects associated with long-term, low-level blast exposure. The results suggest that the first 5 yr of a breaching career in healthy, young individuals is unlikely to result in measurable effects when overpressure exposure is maintained within the 4 psi safe limit. The lack of any significant changes in these operators suggests that either no identifiable injuries occurred and/or measurement tools may not be sensitive enough to identify any negative subconcussive effects.