Background And Objectives: Traumatic brain injury (TBI) is a well-established epilepsy risk factor and is common among service members. Deployment-related TBI, where combat/blast may be more common, may have different outcomes than nondeployment-related TBI. This work examined associations of all TBI exposures (not just combat), and epilepsy, while adjusting for comorbidities associated with epilepsy, among veterans by deployment status.
Methods: The cohort included post-9/11 veterans with ≥2 years of care in both Veterans Health Administration and Defense Health Agency systems. We identified epilepsy using codes, antiseizure medication, and service-connected disability for epilepsy. We conducted a logistic regression model with interaction terms for conditions by deployment history that adjusted for demographics and military characteristics.
Results: The cohort (n = 938,890) included post-9/11 veterans of whom 27,436 (2.92%) had epilepsy. Most veterans had a history of deployment (70.64%), referred to as "deployed." Epilepsy was more common among veterans who were never deployed ("nondeployed") (3.85% vs 2.54%). Deployed veterans were more likely to have had TBI, compared with the nondeployed veterans (33.94% vs 14.24%), but nondeployed veterans with moderate/severe TBI had higher odds of epilepsy compared with deployed veterans (adjusted odds ratio [aOR] 2.92, 95% CI 2.68-3.17 vs aOR 2.01, 95% CI 1.91-2.11). Penetrating TBI had higher odds of epilepsy among the deployed veterans (aOR 5.33, 95% CI 4.89-5.81), whereas the odds of epilepsy for mild TBI did not significantly differ by deployment status. Although most neurologic conditions were more prevalent among the nondeployed veterans, they were often associated with higher odds of epilepsy in the deployed veterans.
Discussion: Deployment history had a significant differential impact on epilepsy predictors. As expected, penetrating TBI had a greater epilepsy impact among deployed veterans perhaps due to combat/blast. Some epilepsy predictors (moderate/severe TBI, multiple sclerosis, and Parkinson disease) had a stronger association in the nondeployed veterans suggesting a potential healthy warrior effect in which such conditions preclude deployment. Other neurologic conditions (e.g., brain tumor, Alzheimer disease/frontotemporal dementia) had a greater epilepsy impact in the deployed veterans. This may be attributable to deployment-related exposures (combat injury, occupational exposures). A better understanding of deployment effects is critical to provide targeted epilepsy prevention in veterans and military service members.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10791059 | PMC |
http://dx.doi.org/10.1212/WNL.0000000000207943 | DOI Listing |
Pediatrics
January 2025
Division of Developmental-Behavioral Pediatrics, Stanford University School of Medicine, Stanford, California.
Objective: To assess the accuracy of a large language model (LLM) in measuring clinician adherence to practice guidelines for monitoring side effects after prescribing medications for children with attention-deficit/hyperactivity disorder (ADHD).
Methods: Retrospective population-based cohort study of electronic health records. Cohort included children aged 6 to 11 years with ADHD diagnosis and 2 or more ADHD medication encounters (stimulants or nonstimulants prescribed) between 2015 and 2022 in a community-based primary health care network (n = 1201).
J Occup Environ Med
December 2024
Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, USA.
Objectives: To assess combat and combat-related posttraumatic stress disorder (PTSD) as risk factors for heart disease and non-cardiac chronic disease comorbidity in deployed Vietnam veterans 50 years post-War.
Methods: A random sample of 735 Vietnam-deployed American Legionnaires was surveyed in 1984, 1998, and 2000 for combat exposure, probable PTSD, and history of diagnosed chronic illnesses.
Results: Twenty-eight percent reported a diagnosed heart condition; combat exposure in Vietnam was a significant predictor (OR = 1.
Background: Gulf War Illness (GWI) is a chronic multi-symptom illness that affects up to one-third of the 700,000 American military personnel deployed to the Persian Gulf region in 1990 and 1991. We conducted a randomized controlled trial to examine feasibility and the relative efficacy of two 12-week in-person group treatments (Tai Chi and Wellness) to address GWI symptoms of chronic pain, fatigue, and changes in mood and cognitive functioning.
Method: Male and female veterans were randomly assigned to Tai Chi (n = 27) or Wellness (n = 26) group interventions and assessed at four time points: baseline, post-treatment, 3-, and 9-month follow-up.
J Allergy Clin Immunol Glob
February 2025
Pulmonary, Allergy, Sleep and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, West Roxbury, Mass.
Background: Post-9/11 veterans were exposed to environmental and occupational pollutants during deployment.
Objective: Our aim was to determine associations between deployment-related exposures and sinusitis and rhinitis.
Methods: Between April 2018 and March 2020, veterans with land-based deployment after 9/11 who were living within 25 miles of 6 Department of Veteran Affairs medical centers were randomly chosen by using a Defense Manpower Data Center roster.
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