Vietnam Head Injury Study Reveals Late Cognitive Decline

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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.

About Rolf Gainer Ph.D.

Dr. Rolf Gainer is the founder of the Neurologic Rehabilitation Institute at Brookhaven Hospital in Tulsa, Oklahoma as well as the Neurological Rehabilitation Institute of Ontario, in Toronto, Canada. Dr. Gainer is a psychologist with more than twenty-five years of experience in the treatment and rehabilitation of individuals with brain injuries and a dual diagnosis. Dr. Gainer has designed and operated innovative rehabilitation programs in the United States and Canada for individuals who have been regarded as difficult to serve. He is currently involved in conducting two outcome studies related to the long-term issues faced by individuals with brain injuries and a dual diagnosis. He has presented papers throughout the United States and Canada in many professional conferences and educational forums.

3 Responses to Vietnam Head Injury Study Reveals Late Cognitive Decline

  1. Gordie Scott June 30, 2014 at 5:01 pm #

    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. Rolf B. Gainer, PhD July 2, 2014 at 11:12 am #

    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 October 13, 2014 at 7:53 am #

    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.

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