We consider an interesting study published in January 2025, which sought to answer whether the long-term consequences of mild traumatic brain injury (mTBI) were associated with the context in which it occurred. The findings suggested that mTBI sustained in traumatic contexts may lead to greater long-term disability and post concussive symptoms.
The Study
The study was carried out by Emily J Van Etten, Arielle R Knight and Tristan A Colaizzi. The complete abstract of the study can be read here.
The study involved a sample size of 567 post-9/11 veterans and included:
- 183 individuals with no TBI.
- 189 individuals with mTBI, not sustained in a traumatic context.
- 195 individuals with mTBI, sustained in a traumatic context.
It primarily measured PTSD severity, post concussive symptoms, and self-reported disability.
Results revealed that the veterans in the third cohort had greater PTSD severity, post concussive symptoms and disability than the veterans in the first and second cohorts. This suggests that sustaining mTBI in a traumatic context leads to a worse outcome compared to sustaining mTBI in a non-traumatic context. We know however that PTSD is a common condition in veterans.
Interestingly, there were no significant differences in any outcome measure between the individuals in the first and second cohorts. This suggests that the long-term prognosis of individuals who sustain mTBI is good when the injury is not sustained in a traumatic context.
The study concluded that mTBI was only associated with significant long-term consequences when it co-occurred with psychological trauma. This suggests that the biological and physiological effects of mTBI might play a role in temporarily reinforcing PTSD symptoms, which could, in turn, contribute to the development of persistent post concussive symptoms and disability. This finding introduces a new perspective on how mTBI and PTSD might interact, with implications for both diagnosis and treatment.
The authors of the study believe this is the first study of its kind to show a possible link between the long-term effects of mTBI and sustaining such injury in a traumatic context.
The result of the study should be noted with caution, however, as there were several limitations identified, and further research is required.
Claims handling implications
We often see cases for subtle brain injury when the index accident involves what might be considered an innocuous bump. However, if the index accident circumstances were objectively traumatic, this study highlights the potential for long-term consequences of the injury, depending of course on the specific facts of the case.
It can be difficult to identify what is a traumatic event as trauma is subjective. Early involvement in a claimant’s rehabilitation could not only quicken that claimant’s recovery process and reduce the overall claim value, but it could also provide important information as to whether the circumstances of the accident were traumatic to that specific claimant.
Conversely, where a claimant is still complaining about long standing effects of a mTBI when such injury had not been sustained in a traumatic context, consider whether there could be an alternative explanation for ongoing difficulties.
Due to the findings of the study in question being novel and further research being required to address the limitations of the study, the link between long term consequences of mTBI and the injury being sustained traumatically should not be relied upon as fact. However, it is an interesting observation and will hopefully pave the way for further research, not only to further investigate the link between the two but best treatment practice to follow, particularly from a neuropsychological perspective, to achieve maximum recovery for the claimant and potentially prevent these long-term effects from manifesting.