• Jack W Tsao, Lauren A Stentz, Minoo Rouhanian, Robin S Howard, Briana N Perry, F Jay Haran, Paul F Pasquina, Mikias Wolde, Carolyn E Taylor, Radhames Lizardo, Scott Liu, Eusebio Flores, Alia H Creason, and Katalina Sher.
• From the University of Tennessee Health Science Center (J.W.T.); Children's Foundation Research Center (J.W.T.), Le Bonheur Children's Hospital, Memphis, TN; Uniformed Services University of the Health Sciences (J.W.T., F.J.H., P.F.P.); Walter Reed National Military Medical Center (L.A.S., M.R., R.S.H., B.N.P., P.F.P., M.W., C.E.T., K.S.), Bethesda, MD; Naval Medical Center San Diego (R.L.), CA; Naval Medical Center Portsmouth (S.L.); Neuroscience Consultants, PLC (E.F.), Reston; and Information Innovators, Inc (A.H.C.), Springfield, VA. jtsao@uthsc.edu.
• Neurology. 2017 Nov 7; 89 (19): 2010-2016.

ObjectiveTo examine whether blast exposure alone and blast-associated concussion result in similar neurologic and mental health symptoms.MethodsA 14-item questionnaire was administered to male US Marines on their return from deployment in Iraq and/or Afghanistan.ResultsA total of 2,612 Marines (median age 22 years) completed the survey. Of those, 2,320 (88.9%) reported exposure to ≥1 blast during their current and/or prior deployments. In addition, 1,022 (39.1%) reported ≥1 concussion during the current deployment, and 731 (28.0%) had experienced at least 1 prior lifetime concussion. Marines were more likely to have sustained a concussion during the current deployment if they had a history of 1 (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.2-2.0) or ≥1 (OR 2.3, 95% CI 1.7-3.0) prior concussion. The most common symptoms were trouble sleeping (38.4%), irritability (37.9%), tinnitus (33.8%), and headaches (33.3%). Compared to those experiencing blast exposure without injury, Marines either experiencing a concussion during the current deployment or being moved or injured by a blast had an increased risk of postinjury symptoms.ConclusionsThere appears to be a continuum of increasing total symptoms from no exposure to blast exposure plus both current deployment concussion and past concussion. Concussion had a greater influence than blast exposure alone on the presence of postdeployment symptoms. A high blast injury score can be used to triage those exposed to explosive blasts for evaluation.© 2017 American Academy of Neurology.

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