TY - JOUR
T1 - The Military Injuries
T2 - Understanding Post-Traumatic Epilepsy Study: Understanding Relationships among Lifetime Traumatic Brain Injury History, Epilepsy, and Quality of Life
AU - Pugh, Mary Jo
AU - Kennedy, Eamonn
AU - Gugger, James J.
AU - Mayo, Jamie
AU - Tate, David
AU - Swan, Alicia
AU - Kean, Jacob
AU - Altalib, Hamada
AU - Gowda, Shaila
AU - Towne, Alan
AU - Hinds, Sidney
AU - Van Cott, Anne
AU - Lopez, Maria R.
AU - Jaramillo, Carlos A.
AU - Eapen, Blessen C.
AU - McCafferty, Randall R.
AU - Salinsky, Martin
AU - Cramer, Joyce
AU - McMillan, Katherine K.
AU - Kalvesmaki, Andrea
AU - Diaz-Arrastia, Ramon
N1 - Publisher Copyright:
© 2021, Mary Ann Liebert, Inc., publishers.
PY - 2021/10/15
Y1 - 2021/10/15
N2 - Understanding risk for epilepsy among persons who sustain a mild (mTBI) traumatic brain injury (TBI) is crucial for effective intervention and prevention. However, mTBI is frequently undocumented or poorly documented in health records. Further, health records are non-continuous, such as when persons move through health systems (e.g., from Department of Defense to Veterans Affairs [VA] or between jobs in the civilian sector), making population-based assessments of this relationship challenging. Here, we introduce the MINUTE (Military INjuries - Understanding post-Traumatic Epilepsy) study, which integrates data from the Veterans Health Administration with self-report survey data for post-9/11 veterans (n = 2603) with histories of TBI, epilepsy and controls without a history of TBI or epilepsy. This article describes the MINUTE study design, implementation, hypotheses, and initial results across four groups of interest for neurotrauma: 1) control; 2) epilepsy; 3) TBI; and 4) post-traumatic epilepsy (PTE). Using combined survey and health record data, we test hypotheses examining lifetime history of TBI and the differential impacts of TBI, epilepsy, and PTE on quality of life. The MINUTE study revealed high rates of undocumented lifetime TBIs among veterans with epilepsy who had no evidence of TBI in VA medical records. Further, worse physical functioning and health-related quality of life were found for persons with epilepsy + TBI compared to those with either epilepsy or TBI alone. This effect was not fully explained by TBI severity. These insights provide valuable opportunities to optimize the resilience, delivery of health services, and community reintegration of veterans with TBI and complex comorbidity.
AB - Understanding risk for epilepsy among persons who sustain a mild (mTBI) traumatic brain injury (TBI) is crucial for effective intervention and prevention. However, mTBI is frequently undocumented or poorly documented in health records. Further, health records are non-continuous, such as when persons move through health systems (e.g., from Department of Defense to Veterans Affairs [VA] or between jobs in the civilian sector), making population-based assessments of this relationship challenging. Here, we introduce the MINUTE (Military INjuries - Understanding post-Traumatic Epilepsy) study, which integrates data from the Veterans Health Administration with self-report survey data for post-9/11 veterans (n = 2603) with histories of TBI, epilepsy and controls without a history of TBI or epilepsy. This article describes the MINUTE study design, implementation, hypotheses, and initial results across four groups of interest for neurotrauma: 1) control; 2) epilepsy; 3) TBI; and 4) post-traumatic epilepsy (PTE). Using combined survey and health record data, we test hypotheses examining lifetime history of TBI and the differential impacts of TBI, epilepsy, and PTE on quality of life. The MINUTE study revealed high rates of undocumented lifetime TBIs among veterans with epilepsy who had no evidence of TBI in VA medical records. Further, worse physical functioning and health-related quality of life were found for persons with epilepsy + TBI compared to those with either epilepsy or TBI alone. This effect was not fully explained by TBI severity. These insights provide valuable opportunities to optimize the resilience, delivery of health services, and community reintegration of veterans with TBI and complex comorbidity.
KW - epilepsy
KW - health outcomes
KW - post-traumatic epilepsy
KW - quality of life
KW - traumatic brain injury
UR - http://www.scopus.com/inward/record.url?scp=85117283983&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85117283983&partnerID=8YFLogxK
U2 - 10.1089/neu.2021.0015
DO - 10.1089/neu.2021.0015
M3 - Article
C2 - 34353118
AN - SCOPUS:85117283983
SN - 0897-7151
VL - 38
SP - 2841
EP - 2850
JO - Journal of neurotrauma
JF - Journal of neurotrauma
IS - 20
ER -