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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.00949

Neurocognitive Performance Deficits Related to Immediate and Acute Blast Overpressure Exposure

 Christina LaValle1*, Walter Carr1,  Michael J. Egnoto1*, Anthony Misistia1, Jonathan Salib1, Alejandro Ramos1 and  Gary H. Kamimori1
  • 1Walter Reed Army Institute of Research, United States

Addressing the concerns surrounding blast injury for the military community is a pressing matter. Specifically, sub-concussive blast effects, or those blast effects which do not yield a medical diagnosis but can result in symptom reporting and negative self-reported outcomes, are becoming increasingly important. This work evaluates explosive blast overpressure and impulse effects at the sub-concussive level on neurocognitive performance assessed with the Defense Automated Neurobehavioral Assessment (DANA) across seven breacher training courses conducted by the US Military. The results reported here come from 202 healthy, male military volunteer participants. Findings indicate that the neurocognitive task appearing most sensitive to identifying performance change is the DANA Procedural Reaction Time (PRT) subtask which may involve a sufficient level of challenge to reliably detect a small, transient cognitive impairment among a healthy undiagnosed population. The blast characteristic that was consistently associated with performance change was peak overpressure. Overall, this study provides evidence that increasing blast overpressure, defined as peak overpressure experienced in a training day, can lead to transient degradations in neurocognitive performance as seen on the DANA PRT subtask, which may generalize to other capabilities.

Keywords: Blast (explosion) wave-induced neurotrauma, Overpressure (abnormally high pressure), Neurocognitive performance, breachers, Explosive overpressure

Received: 02 Apr 2019; Accepted: 16 Aug 2019.

Edited by:

Ibolja Cernak, Independent researcher

Reviewed by:

Harvey Pollard, Uniformed Services University of the Health Sciences, United States
Ralph G. Depalma, United States Department of Veterans Affairs, United States
Andrew J. Baker, St. Michael's Hospital, Canada  

Copyright: © 2019 LaValle, Carr, Egnoto, Misistia, Salib, Ramos and Kamimori. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Ms. Christina LaValle, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States, christina.r.lavalle.ctr@mail.mil
Dr. Michael J. Egnoto, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States, michael.j.egnoto.ctr@mail.mil