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By On December 19th, 2007

Vietnam Head Injury Study Reveals Late Cognitive Decline

Veterans the Vietnam War who received penetrating brain injuries are demonstrating continuing late effects with a faster decline in cognitive  function than vets who returned uninjured. Jordan Grafman, Ph.D., of the National Institute of Neurological Disorders and Stroke, made on online report of his veterans study in Brain, 2007. Grafman was able to differentiate the TBI group with penetrating  injuries from individuals with dementia.He cautioned clinicians to evaluate their patients neurobehavioral status carefully to avoid confusion with the frank signs of dementia. Individuals with higher intelligence as measured on the Armed Forces Qualification Test (AFQT) were found to be "protective in terms of later decline" according to Grafman. Specific areas of brain atrophy in the left parietal and right frontal regions were associated with greater decline. Other indicators were: severity and location of injury, education, intellectual development and genetic endowment.Laterality (left, right or bilateral) was not a factor in AFQT scores . Injuries to the caudate nucleus was found to be as important as AFQT scores in predicting score changes from baseline to the present.

In another study which focused on a swapping of information between the front and back of the brain, conducted by Randy Buckner, Ph.D. of Harvard's Center for Brain Science and reported in the December 6, 2007 issue of Neuron, the reduced communication was associated with degradation of white matter linking elements known as the default network. This network is associated with the functions of remembering and planning.

While these two studies are not related, the reality is that brain injury hastens cognitive decline, particularly the features that are associated with the functional loss of aging. As the injury has caused a disruption of neural tracts, as the person ages the effects of the injury may trigger the loss of more functions.

The issues associated with the aging process for individuals with a brain injury is becoming more important as the number of people living with the long term effects of brain injury increases. Can these studies help us to identify treatment which can slow the cognitive decline or identify strategies to preserve function? The group of young men and women returning from Iraq and Afghanistan will increase the number of brain injury survivors who are likely to experience age related functional changes. We need to learn as much as we can from studies involving older survivors to address the future needs.

4 Responses

  1. Gordie Scott says:

    I was a Navy corpsman who served with the 1st Marine Division during the Vietnam War. I
    spent my entire tour in Quang Nam Province, which had the reputation for being a very dangerous area. 14,000 Marines were killed during the Vietnam War, and 10,000 of those lives were lost in this one province. I distinctly remember an area that was known as the Arizona Territory. It was considered to be the most heavily booby-trapped area of the country. I was exposed to IED’s on a regular basis, & have just learned that I have a mTBI..

    I remember feeling “woozy” throughout my career, & had some very bad headaches which I “wrote off” as tension headaches. I had a test run by a Neurologist 2 years ago & was
    eventually diagnosed with MCI. Upon getting the results (with my wife present), I was advised
    that this is a diagnosis that will change. That diagnosis was recently changed to a mTBI.
    During the initial testing process, I was asked by a technician if I was ever left unconscious &
    I had no recollection being in that situation. But that question stimulated my brain to eventually
    recall being unconscious for some time as the result of an IED. I now recall one of the Marines
    shaking me & saying “Doc, this is no time to be taking a nap.” I went nearly 4 1/2 decades before that memory was stimulated. I now have cognitive impairment, short term memory loss, hearing deficiencies, tinnitus & occasional loss of balance among a number of other symptoms that are affecting my life. One of my closest friends who I worked with over 32
    years ago, recently told me that “I was deaf”. He stated that other employees thought that I
    was either ignoring them or was simply being aloof. If I knew then what I know now, my life
    would have been a lot different. I needed medical attention & didn’t know it. And, I was a
    combat medic! Now I actually feel that I was one of the lucky ones. Over 58,000 Vietnam veterans came home in body bags, & I constantly think about them. May Almighty God continue to care for these heroes. They deserve it!

    Any TBI is a very serious injury. I have excellent doctors @ Hines Hospital who have been
    wonderful to work with. In hind site, I often wonder how my life would have played out if I
    didn’t have an mTBI. I have my C & P in two weeks regarding this injury, & trust that a favorable ruling will be made. I hope that today’s veterans will have the opportunity to get better care than those of us who served during the Vietnam War. I don’t know of one Vietnam
    Veteran who wishes any harm to our current or future veterans. Each generation learns from
    the previous generation. I wish all of today’s veterans will feel the support of all Americans, & will continue to received the BEST medical care available. May God bless all of you!

  2. Thank you for sharing your personal story with the readers of NeuroNotes. The information about mTBI is certainly more available to today’s returning soldiers than it was to people returning from Vietnam. Yet, although diagnosis and treatment is more accessible today, we know that many individuals are likely to have similar experiences to yours. That being, the presence of some symptoms and many years before the symptoms are identified as the long-term effects of mTBI.
    I agree with your hope that today’s veterans have a better opportunity for care and treatment than was afforded to the Vietnam-era vets. We are following the veterans’ brain injuries closely at the Neurologic Rehabilitation Institute at Brookhaven Hospital. We believe the the veterans deserve the best possible care throughout their lifetimes.

  3. glen witt says:

    I have been involved in the Vietnam head injury study, but they have lost track of me. I would like to continue to be involved. my mailing address is glen witt, 5014 west pomeroy road, edgerton Wisconsin 53534 p. s. I am doing very well and think i can contribute a great deal to the study.

  4. SHELIA GREGG says:

    My husband is a U.S. Army Vietnam veteran who is presently involved in a number of medical tests. He is 70% PTSD (chronic), 50% Hearing Loss, 10% Tinnitis, 0% ED rated service connected. He is suffering from (not yet service connected/rated): Essential Tremors, Touretts Syndrome, Stage 3 Renal Disease, Hypertension, Type 2 Diabetes, chronic gastritis and duenditis, depression, anxiety, mild aortic root dilation, mild ascending aorta dilation, mild hypertrophic left ventricular, sleep impairment, 2 inguinal hernias and diffuse fatty liver disease. He was involved in several battles where he was exposed (as a tank commander) to combat blast. In one such battle his tank took a direct hit which caused the tank drivers death and as my husband had just left the tank to retrieve bodies he was spared, however, he was close to the blast and was thrown and landed on his head. He was dazed, had complete hearing loss for four days with Tinnitis which he has 24 hours a day to this very day. He had blood seepage from his ears for 3 days after this incident. His medic was killed in this battle. My husband was awarded 2 combat bronze stars with “v” device and 2 oakleaf clusters. He received no medical care as he was still in the jungle for days after this incident. He was sent home 2 weeks later. At time of leaving the service approximately a month later he was given a hearing assessment and was diagnosed with concussive ruptured tympanic membranes. We still have the original testing. My husband has been told by the VA there is nothing they can do for his left ear and that he actually had fusing of bones in his ear from the blast impact. Recently he had an MRI during which they found T2 changes and chronic microvascular ischemia of the brain. The “non-VA” neurologist says this is an old brain scaring. Would you think that he may have had a tbi? The VA doesn’t seem to want to assess him for anything and have denied him unemployability even though he hasn’t been able to find a job in over 14 years. He is known to have outbursts of anger, bouts with depression and anxiety issues and this is following him throughout his attempts to get a job. The GI doctor tells him he shouldn’t work at anything manual because of the gastric issues and the hernias (but they aren’t service connected as yet) and the GI doctor won’t sign a statement connecting the Gastric issues to the PTSD, depression, anxiety, hypertension, fatty liver disease, etc. Does PTSD, depression, anxiety, sleep impairment and the many other issues they have diagnosed him with relate to gastric issues? Readings of research I have done say they do but how do one get a doctor to admit that they do?

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