Low-level military blast exposure impacts

About a million post-9/11 service members and veterans are thought to have been exposed to low-level occupational blast exposures (OBEs) during military activities, and Cizik School of Nursing at UTHealth Houston Assistant Professor Sara Mithani, PhD, RN, will use a new four-year grant to study the neurological effects on both veterans and their caregivers.

While 60% of those exposed to repeated low-level blasts report long-term neurological symptoms, including cognitive and behavioral changes, many don’t qualify for traumatic brain injury (TBI) or post-traumatic stress disorder diagnoses. This leaves them – and their families – navigating complex health challenges with limited resources and support, Mithani explained.

“These service members and veterans often display symptoms like headache, sleep disturbance, fatigue, memory problems, and behavioral changes that require assistance from caregivers, but they fall through the cracks of our current diagnostic and support systems,” Mithani explained. “What’s particularly concerning is that we know very little about how caring for someone with these post-OBE symptoms affects the caregivers themselves.”

Mithani will serve as the early career principal investigator on an Emerging Topics Research Award from the U.S. Department of Defense, Congressionally Directed Medical Research Programs, Traumatic Brain Injury and Psychological Health Research Program. Partnering with her as senior principal investigator is Mary Jo Pugh, PhD, RN, a professor at the Eccles School of Medicine at the University of Utah. Total funding for the project, “Functional Outcomes and Biomarkers in Occupational Blast Exposure (FOB: OBE): The Impact on Service Members, Veterans, and Their Families,” is $2.08 million, with $950,000 directed to Mithani’s work.

The team will examine the molecular and psychological mechanisms of OBE and their adverse effects on the brain from the perspectives of both military personnel and their caregivers. Using an innovative partnership model, Mithani will lead biomarker collection and analyses for both populations, while Pugh will focus on caregiver recruitment and multimodal phenotype analysis. Both investigators will collaborate closely across all aspects of the study.

The researchers will analyze blood biomarkers and neurocognitive function from service members/veterans who participated in the Long-term Impact of Military Relevant Brain Injury Consortium longitudinal study, comparing those with high versus low OBE symptom expression. For caregivers, the team will collect new data through the Elizabeth Dole Foundation National Caregiver Convening, in partnership with co-investigator Roxana Delgado, PhD, MS, a professor at The University of Texas Health Science Center at San Antonio. They will employ self-reported survey measures, app-based cognitive assessments, and blood biomarkers.

“We will use traditional statistical methods and machine learning to explore differences between the high- and low-symptom expression groups among the caregivers,” Mithani said. “A better understanding of the interplay and distinctions between biological and psychosocial experiences of those who have experienced OBEs and their caregivers can lead to better care provision and symptom management for people who have served and their families.”