Combat veterans' brains reveal hidden damage from IED blasts
The brains of some Iraq and Afghanistan
combat veterans who survived blasts from improvised explosive
devices (IEDs) and died later of other causes show a distinctive
honeycomb pattern of broken and swollen nerve fibers throughout
critical brain regions, including those that control executive
function. The pattern is different from brain damage caused by car
crashes, drug overdoses or collision sports, and may be the
never-before-reported signature of blast injuries suffered by
soldiers as far back as World War I.
Vassilis Koliatsos, M.D., professor of pathology, neurology, and
psychiatry and behavioral sciences at the Johns Hopkins University
School of Medicine, recently published a study in Acta
Neuropathologica Communications that found survivable blasts may
cause hidden brain injuries that play a role in the psychological
and social problems some veterans face after coming home.
"This is the first time the tools of modern pathology have been
used to look at a 100-year-old problem: the lingering effect of
blasts on the brain," says Koliatsos, senior author of the study
that used molecular probes to reveal details in the brains of
veterans who died months or years after an IED blast. "We
identified a pattern of tiny wounds, or lesions, that we think may
be the signature of blast injury. The location and extent of these
lesions may help explain why some veterans who survive IED attacks
have problems putting their lives back together."
Soldiers have struggled with bomb-induced brain damage since
1914, when German and Allied forces tried to blast one another out
of entrenched positions with monthslong bombardments. Many World
War I fighters survived the barrage outwardly unscarred, but with
an array of cognitive and psychological difficulties known as shell
shock. After World War I, mass bombardments of troops were rare,
and shell shock became uncommon. Now renamed blast neurotrauma or
blast injury to brain, it has re-emerged due to insurgent forces'
widespread use of IEDs in Iraq and Afghanistan.
To understand this puzzling ailment, a team of eight researchers
examined the brains of five male United States military veterans
who survived IED attacks but later died. The remains were donated
to the Armed Forces Institute of Pathology. Three died of methadone
overdoses that could have been accidental, Koliatsos says, since
the drug is commonly prescribed to treat soldiers' chronic pain.
One died of a gunshot wound to the head, and one died of multiple
organ failure. The researchers compared the veterans' brains to
those of 24 people who died of a range of causes, including motor
vehicle crashes, opiate overdoses and heart attacks.
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