• Kelly J Miller, Brian J Ivins, and Karen A Schwab.
• Defense and Veterans Brain Injury Center, Rockville, MD 20852, USA. kelly.j.miller2.ctr@us.army.mil
• J Head Trauma Rehabil. 2013 Jan 1; 28 (1): 31-8.

ObjectiveTo investigate the potential cumulative impact of mild traumatic brain injury (MTBI) on postconcussive symptoms.ParticipantsA total of 224 active duty soldiers reporting MTBI within 1 year of testing. For 101, this MTBI was their only reported traumatic brain injury (TBI); 123 had sustained at least 1 additional MTBI during their lifetime. A No TBI control group (n = 224) was included for comparison.Main MeasureSelf-report symptoms data via questionnaire. Within time since injury subgroups (≤3 months; Post-3 months), symptom endorsement (no symptoms, 1 or 2 symptoms, 3+ symptoms) among soldiers with 1 MTBI was compared with that of soldiers with 2 or more MTBIs. Injured soldiers' symptom endorsement was compared with that of soldiers who had not sustained a TBI.ResultsAmong the recently injured (≤3 months), those with 2 or more MTBIs endorsed significantly more symptoms than those with 1 MTBI: 67% of soldiers with 2 or more MTBIs reported 3+ symptoms, versus 29% of One MTBI soldiers. Among Post-3 month soldiers, there were no significant differences between MTBI groups. Overall, soldiers with MTBI endorsed significantly more symptoms than those without TBI.ConclusionPast experience of MTBI may be a risk factor for increased symptom difficulty for several months postinjury. Clinicians should ascertain lifetime history of brain injury when evaluating patients for MTBI.

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