Difficulties in Diagnosing Mild Traumatic Brain Injury in Military Personnel

Difficulties in diagnosing mild Traumatic Brain Injury in military personnel

The diagnosis of mild Traumatic Brain Injury (mTBI) in military service members remains challenging. About 60—75% of the general population report mTBI symptoms to medical professionals shortly after suffering head injury. Military personnel, on the other hand, rely significantly on retroactive self-reporting of mTBI, in which altering consciousness and/or amnesia can interfere with correct diagnosis during the acute phase. When seeking help from the Veterans Health Administration for neurological diseases like depression or anxiety, or neurodegenerative disorders like brain atrophy or chronic traumatic encephalopathy, some soldiers discover that they have suffered a brain injury months or even years earlier. In consequence, medical personnel are left with few therapeutic options to treat the neurological consequences that mTBI can induce – the later the detection, the worse the prognosis.

In acute situations where no medical professionals are present, eyewitness testimonies and casualty self-reports are the only techniques available to diagnose military action caused mTBI. Unfortunately, clinicians frequently lose access to these two types of data, especially in a combat setting. In these cases, knowing the Glasgow Coma Scale score obtained within 24 hours of a TBI event is critical for better predicting patient prognosis.

The degree of cognitive dysfunction in soldiers with mTBI has been assessed using computerized neurocognitive assessment instruments, however, the instrument's reliability and validity have yet to be determined.

Furthermore, imaging techniques such as MRI and CT are insufficient for diagnosing small lesions in brain structure, a problem that must be addressed immediately. Diffusion tensor imaging and functional MRI are now used to diagnose military TBI. However, there are still unavoidable limitations of neuroimaging techniques, such as undetectable subtle changes in neural pathways, accessibility to these techniques, and time and cost burden for patients and society.

Biomarker detection is a feasible option for diagnosis of military mTBI and severity grading, and provides information on potential therapeutic targets.

Medicortex is working on a diagnostic test that uses glycan biomarkers to predict the existence of mTBI. Visit www.medicortex.fi for additional details.