The Invisible Wounds of War

In a video of her presentation at UW Medicine/Gonzaga University, researcher Christine MacDonald Ph.D. shares several important discoveries about the impact of combat concussions on mental health. The EVOLVE study, for which she is the lead researcher, found that those who suffer combat concussions worsen over the course of their 1-year and 5-year follow-ups; 80% seek mental health assistance by the 5-year follow-up, and only 19% achieve a “sustained resolution of their symptoms.” The service members had blast or non-blast related concussions, but none had more complex or severe brain injuries.

Study participants with both blast and the non-blast combat concussions had a significant mental health load at 1-year and 5-year follow-up, with moderate to severe symptoms of neurobehavioral impairment (including irritability and disinhibition) as well as headache frequency intensity.

Dr. MacDonald describes how an MRI-based technique called Diffusion Tensor Imaging (DTI) is identifying traumatic (or diffuse) axonal injuries which are “abnormalities consistent with brain injury not apparent on conventional MRI.” Follow-up scan at 1-year and 5-years “show evolution, not resolution of DTI abnormalities.”

Diffusion Tension Imaging measures the direction of water in the brain, changes in which can indicate injuries to axons, changes to the myelin sheath around the axons, or changes to both.

One of her studies, published in JAMA Neurology, identifies factors that were predictive of poor outcomes at 5 years: age at injury, depression symptoms, reaction time, and verbal fluency. In conjunction with her presentation, Dr. MacDonald gave an interview with the Spokesman.

About Christine MacDonald, PhD

MacDonald is the lead researcher for the EVOLVE study, which stand for Evaluation Of mild Long-term outcome in Active-Duty US Military and Veterans.

“Dr. Christine Mac Donald, Associate Professor in the Department of Neurological Surgery, the James and Gaye Pigott Endowed Chair at the UW School of Medicine, and Research Director of the Sports Institute at UW Medicine, is an expert in advanced MRI methods and the application of these imaging methods to concussion and traumatic brain injury. For the past decade she has lead large-scale, multi-center, international clinical research studies in the United States, Italy, Germany and Afghanistan. Her work has given further insight into changes in the brain following injury. Thank you to our sponsors: Multicare, UW School of Medicine Alumni Association, Providence Health Care, Spokane County Medical Society, and Spokane Regional Health District.”
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