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Veterans and Chronic Traumatic Encephalopathy (CTE)

Veteran and warrior Eric DeLion, who may have CTE due to military service, looks out window
Warrior Eric DeLion

Eric DeLion was in the line of fire, especially during his second tour in Iraq in 2005. The Marine veteran was exposed to multiple attacks and explosions, and he remembers blasts strong enough to blow out tires and destroy the engine of the vehicle he was traveling in.

Even though the vehicles were destroyed, “us inside, for the most part, didn’t sustain any physical, visual injuries,” he recalled.

There were no visible signs on the outside, but the impacts caused traumatic brain injury (TBI).

Invisible injuries are unfortunately common among post-9/11 veterans like Eric, who were exposed to blasts that can cause physical damage to the structure of the brain.

According to Veterans Affairs, about 414,000 veterans have been diagnosed with some form of traumatic brain injury between 2000 and 2019. In some cases, suspected injuries can amount to real symptoms with no clear diagnosis, leaving veterans and their families wondering: Is it TBI, is post-traumatic stress disorder (PTSD) making it worse, or could it be CTE, a disease associated with repeated head injuries?

Although researchers have more questions than answers, here are five things we do know about CTE: 

  1. CTE stands for Chronic Traumatic Encephalopathy, a disease first described in boxers in 1928. Symptoms can show up years or decades after head traumas occurred and they include confusion, thinking/memory issues, changes in behavior, and difficulty focusing. A 2012 scientific study linked repeated head traumas, including repeated exposure to blasts, to CTE in veterans. 
  2. Currently, CTE is only suspected during a person’s life. The disease is diagnosed after death. Like Alzheimer’s disease, degenerative changes in the brain can only be seen after an autopsy. For instance, the accumulation of tau protein – which is similar, but not the same in Alzheimer’s and CTE – can only be confirmed by analyzing brain tissue after the person with symptoms has died. 
  3. CTE can develop before we notice it. If one part of your brain is damaged, another part of your brain can take over to circumvent the problem. This can also happen with Alzheimer’s disease and even stroke. Therefore, subtle changes can begin before anyone notices. That’s an important motivation for researchers to find ways to accurately diagnose CTE during a person’s lifetime. 
  4. There is no known treatment for CTE. Researchers are focusing on ways to capture images of tau protein in the brain, which might lead to ways to diagnose, monitor, and eventually stop the spread of tau protein (disease progression) to other parts of the brain.
  5. Researchers are looking for markers that will help identify CTE during a person’s lifetime. That includes positron emission tomography (PET scan) imaging techniques to see tau protein accumulation in the brain.

Research efforts include a collaboration between Veterans Affairs, Boston University, and the Concussion Legacy Foundation (CLF), which seeks avenues to diagnosis, treatment, and better outcomes during life. The joint effort also includes CLF’s Project Enlist, which was funded in part by Wounded Warrior Project® (WWP). Project Enlist encourages veterans with head trauma symptoms to consider donating their brains for posthumous research, including molecular studies, posthumous neuropathology (brain bank), and identifying risk factors.

In the meantime, increasing awareness and avoiding repeated injuries is one way to minimize risk for veterans. Another one is facilitating access to rehabilitation services.

Wounded Warrior Project addresses head traumas through several programs and services. WWP's Independence Program helps warriors and families living with moderate to severe TBI to overcome obstacles and exceed goals. WWP's Warrior Care Network® is a partnership with four top academic medical centers that treat post-traumatic stress disorder and TBI. Clinical treatments at Warrior Care Network sites improve symptoms and quality of life.

The posthumous research at the Veterans Affairs-Boston University-CLF Brain Bank and other leading brain banks, can lead to crucial discoveries about CTE.

Hope and Second Chances

Eric, like many other combatants, continued to work through countless blast injuries, faithfully protecting his unit after each attack.

“This is no exaggeration whatsoever – we got mortared or rocketed daily,” Eric said. That second tour in Iraq took him to Fallujah and Ramadi, where there was no break from combat.

“We’d either wake up from mortar attacks or rocket attacks and we would jump up from our hooch (a Marine’s shelter in the field) and go under the bunkers. Even back on the base at Camp Ramadi – we weren’t safe.”

In another incident, he was thrown inside a vehicle and had a concussion.

“We got hit and the blast knocked me off my feet and threw me against the side of the Humvee. I just laid there, and I thought I was dead. I couldn’t hear anything,” Eric said. 

The impacts, coupled with PTSD, took a toll on Eric. He suffered headaches, short-term memory lapses, and mood swings. He eventually was medically retired – even though he very much wanted to stay on active duty. When Eric’s life started to unravel, his platoon sergeant took him to the nearest Navy hospital and had him admitted. 

“It was definitely rough because I wasn’t myself, and it took me awhile to adjust to my new normal,” Eric said.

Eric was not alone during that rough transition. He first connected with other veterans at a WWP event, and felt at home immediately, while participating in physical wellness activities and endurance racing. He continued attending WWP connection events.

“Wounded Warrior Project gave me a sense of hope that I’m going to make it through this,” Eric said.

While Eric’s outcome was good and he can advocate for other veterans and enjoy being a loving father, he is aware many other veterans are still fighting battles at home. 

“I only hope that my fellow brothers and sisters in arms find help, so they know they are not alone,” he said. “Although the wars might not be talked about anymore, we are not forgotten. There are still people and organizations like Wounded Warrior Project that care for us. So, I say never quit and never give up hope!”

For more info, call the WWP Resource Center: 1-888-WWPALUM (997.2586).

Contact: Raquel Rivas – Public Relations, rrivas@woundedwarriorproject.org, 904.426.9783

About Wounded Warrior Project
Since 2003, Wounded Warrior Project® (WWP) has been meeting the growing needs of warriors, their families, and caregivers — helping them achieve their highest ambition. Learn more.

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