Does Blast Mild Traumatic Brain Injury Have an Impact on PTSD Severity? A Systematic Review and Meta-Analysis

Abstract

Blast mild traumatic brain injury (mTBI) is a unique injury in the military population and post-traumatic stress disorder (PTSD) is shown to be linked with it. The main purpose of the systematic review was to understand the impact of blast mTBI on PTSD symptom severity. We systematically searched Pubmed, Web of Science, Embase (Ovid), APAPsycINFO (Ovid) and Medline (R) and In-Process, In-Data-Review and Other Non-Indexed Citations (Ovid). Data extraction and quality assessment was completed using the AXIS tool. Statistical analysis was undertaken to determine differences between blast mTBI and the control group (no blast and no TBI in military personnel) and a meta-analysis using the random effects model was used to calculate between-study heterogeneity and variance through I2 and Tau2, respectively. Additionally, the likelihood of PTSD, analysed using the average PTSD Checklist (PCL) score, was also determined based. Statistically higher PCL scores were found in the blast mTBI group compared to control groups, but high heterogeneity was found between the studies (p < 0.001, I2 = 84%, Tau2 = 0.44). Furthermore, all studies reported that blast mTBI had probable PTSD, but this was not the case for the control group. Blast mTBI appears to impact on PTSD symptom severity and the likelihood of developing PTSD, which healthcare professionals need to be aware of. The high heterogeneity present in the studies means that caution must be exercised when interpreting the data from this study. However, future studies require more well-defined, high-quality studies to answer the question of how blast mTBI affects PTSD symptom severity.