Award-winning University of Utah research shows that brain changes from military concussions can persist for years in veterans.
University of Utah Department of Neurology researchers have received national recognition for advancing our understanding of brain injury in veterans. David Tate, PhD, and colleagues were awarded the AMSUS Military Medicine Journal Article of the Year Award for their study examining long-term brain changes after mild traumatic brain injury (mTBI), often called concussion.
The honor reflects a rigorous review process led by the journal’s editorial board, which evaluated studies based on scientific quality, innovation, and potential impact. After months of review, Tate’s study, “Persistent MRI Findings Unique to Blast and Repetitive Mild TBI: Analysis of the CENC/LIMBIC Cohort Injury Characteristics,” rose to the top.
New Insights into Brain Injury in Veterans
For years, researchers have known that some people continue to experience symptoms long after a concussion. But it has been difficult to measure those changes objectively.
Tate and his collaborators set out to better understand what happens in the brain over time after mTBI, especially among veterans and service members, who may face unique risks such as blast exposure.
The study used advanced MRI techniques to examine the brains of thousands of veterans enrolled in a large, long-term national research program. Some participants had a history of mTBI; others did not.
“We’re looking for patterns that might help us understand whether there are lasting changes—structural and functional changes—in the brain that we can actually see with MRI,” Tate said.
How Different Types of mTBI Affect the Brain
At first glance, the results were surprising. When researchers compared all participants with mTBI to those without, they did not find clear, consistent differences in brain scans.
But a deeper look told a different story. When the team examined specific types of injuries, patterns began to emerge: Blast-related injuries, common in military settings, were linked to changes in the brain’s “white matter,” described by Tate as “the communication fibers or wiring of the brain; essentially, the connections between different parts of the brain.” The changes were most noticeable in central areas that help the two halves of the brain communicate.
Repeated injuries were associated with changes in gray matter structures involved in memory and processing, including the hippocampus and parts of the cortex. Interestingly, some of these regions were actually larger in people with more injuries; a pattern the researchers suggest may reflect inflammation or other biological responses like plasticity, rather than simple damage. However, this finding requires additional investigation before the underlying pathological changes are fully understood.
Importantly, these differences were still visible years after the injury occurred; on average, about eight years later. This is highly unexpected, especially if the cause is inflammation, which highlights both the novelty of the article and the need for further research.
Some Effects of Concussion Last for Years
Many people recover well after a concussion. But for some veterans, symptoms such as memory problems, sleep issues, or mood changes can persist. This study helps validate those experiences.
“We’re beginning to see imaging findings that match what patients have been reporting for years,” Tate said.
Even when individuals appear to function well day to day, subtle changes in the brain may still be present. Researchers are especially interested in whether these changes could affect brain health later in life, including how the brain ages.
Long-Term Brain Health After TBI
The study also highlights that not all brain injuries are the same. Factors such as how the injury occurred, how many times it happened, and even related conditions like post-traumatic stress disorder (PTSD) can influence brain changes.
That complexity is one reason large, long-term studies like this one are so valuable. Participants in the program undergo regular evaluations, including brain imaging, cognitive testing, and health assessments, every five years.
This approach allows researchers to track how the brain changes over time and to identify patterns that smaller studies might miss.
What This Means for Veterans, and What Comes Next
Tate and his colleagues are now working to understand how mTBI-related changes evolve as veterans age. They also hope to learn whether treatments such as rehabilitation therapies or medications can slow or reduce these effects.
Ultimately, the goal is to improve care for veterans and others living with the long-term effects of brain injury.
“This research is helping us move toward better answers,” Tate said. “Not just about what’s happening in the brain, but how we can help veterans and services members who are still struggling.”
