Studies, papers and presentations.
An independent index of the research shaping how militaries understand blast overpressure, blast-related traumatic brain injury and warfighter brain health, across Australia, New Zealand, the United States, the United Kingdom and Canada.
Where Vigil has presented, contributed or authored material, it is marked clearly. Everything else is third-party work catalogued for visibility, not endorsement.
ADF Blast Exposure Study
Australian Department of Defence · April 2026
Australian Defence Force programme to gauge the cumulative effects of blast exposure on serving personnel, announced by Defence in April 2026.
Project CEREBRO
Australian Defence · Ongoing
Australian programme investigating blast overpressure exposure, neurological outcomes and protective measures for serving personnel.
REBLAST
U.S. Department of Defense · Ongoing
Repeated Exposure to Blast Longitudinal Assessment Study, tracking neurological, cognitive and physiological outcomes in service members exposed to blast overpressure across training and operations.
INVICTA
U.S. Department of Defense · Ongoing
Longitudinal U.S. military study examining brain health, blast exposure history and clinical outcomes in service members and veterans.
Millennium Cohort Study
Naval Health Research Center · Ongoing since 2001
The largest prospective study of U.S. military service members and veterans, examining the long-term health effects of military service, including TBI, mental health and blast exposure.
ADVANCE
King's College London / Imperial College London · Ongoing
Armed Services Trauma Rehabilitation Outcome study, a 20-year cohort tracking the long-term physical, mental and neurological health of UK personnel injured on operations in Afghanistan.
BIOSAP
Imperial College London / UK MoD · Ongoing
Blast Injury Outcomes Study of Armed Forces Personnel, examining the medium- and long-term effects of blast injury on UK service personnel.
Mobile MEG
UK research consortium · Ongoing
Deployable magnetoencephalography programme developing wearable MEG to detect functional brain changes from blast overpressure exposure in field conditions.
BLAST EMFASIS
Uniformed Services University (USU) · Ongoing
Baseline and Longitudinal Assessment STudy of EOD Males and Females for Alterations in Symptoms, Intellectual and Sensory function, among the first studies examining the acute effects of blast overpressure exposure in female EOD technicians, expanding the scope of blast research beyond historically male cohorts.
CONQUER
Uniformed Services University (USU) · Ongoing
COmbat and traiNing QUeryable Exposure/event Repository, monitors, quantifies and reports blast overpressure exposure on service members during training events such as breaching, heavy weapons and artillery exercises. Has recorded over 450,000 sensor triggers from BlackBox Biometrics (B3) wearable sensors.
New Zealand Breacher Study
New Zealand Defence Force / research collaborators · 2018
Longitudinal study of New Zealand Defence Force soldiers exposed to repeated low-level blast during breacher training, combining serum neurotrauma biomarkers, behavioural assessment and brain imaging.
CAF Long-Range Rifle Brain Response Study
Seeburrun, University of Waterloo · 2024
University of Waterloo investigation of brain response in Canadian Armed Forces volunteers firing long-range rifles, using instrumented mouthguards and a finite element head model to quantify recoil-related loading.
Neurocognitive Effects of Repetitive Low-Level Blast Overpressure in Humans — Baseline Report
UNSW for DVA · 2026
DVA-commissioned rapid evidence assessment by UNSW examining the current certainty of evidence for neurocognitive effects of repetitive low-level blast overpressure exposure in humans. Baseline report; the first formal Australian consolidation of the rLLB literature.
Research Review on Traumatic Brain Injury and PTSD
Traumatic Brain Injury Center of Excellence (TBICoE) · January 2026
TBICoE Clinical Translation Office synthesis of the comorbidity of mild TBI and post-traumatic stress disorder in service members and veterans. Current as of December 2025; covers prevalence, symptom overlap, diagnostic challenges and treatment considerations.
A Review of U.S. Military Traumatic Brain Injury Studies: Trends, Gaps, and Opportunities
Hoch, Martinez, Bakhshi et al., RAND Health Quarterly 13(2):7 · March 2026
RAND review mapping two decades of U.S. military TBI research, identifying trends, gaps and opportunities. Useful as an ontology-level view of where the field has invested and where it has not.
Blast Exposure and Brain Health in Active Duty Service Members
Belding et al., JAMA Network Open · 2021
Cross-sectional analysis linking cumulative low-level blast exposure during training and operations to neurobehavioural symptoms in active-duty US service members.
Chronic Neuropathologies of Single and Repetitive TBI: Substrates of Dementia?
Stone et al., Nature Reviews Neurology · 2014
Foundational review of the neuropathological consequences of single and repetitive head injury and their relationship to long-term neurodegeneration.
Repeated Low-Level Blast Exposure: A Descriptive Human Subjects Study
Carr et al., Military Medicine · 2016
Characterises symptom burden and exposure history in breachers and instructors regularly exposed to low-level blast in training environments.
Development of a Blast Exposure Estimator from a Department-Wide Blast Exposure Survey in the US Marine Corps
Modica et al., Military Medicine · 2021
Methodology for quantifying lifetime occupational blast exposure across an entire service branch, a template for cumulative-dose tracking.
Close-Range Blast Exposure Is Associated with Altered Functional Connectivity in Veterans
Robinson et al., Human Brain Mapping · 2015
fMRI evidence that close-range blast exposure correlates with altered resting-state functional connectivity, independent of mTBI diagnosis.
Serum Brain Biomarker Level, Neurocognitive Performance, and Self-Reported Symptom Changes in Soldiers Repeatedly Exposed to Low-Level Blast
Tate et al., Journal of Neurotrauma · 2013
Detected acute changes in serum brain biomarkers and neurocognitive performance across a single breaching course, early evidence of subclinical injury.
Blast in Context: The Neuropsychological and Neurocognitive Effects of Long-Term Occupational Exposure to Repeated Low-Level Explosives on Canadian Breachers
Vartanian et al., Frontiers in Neurology · 2020
Canadian Armed Forces study showing neurocognitive and neuropsychological decrements among breachers with long careers of low-level blast exposure.
Diffusion Tensor Imaging in Blast-Related Mild Traumatic Brain Injury
Wilde et al., Journal of Head Trauma Rehabilitation · 2018
DTI evidence of microstructural white-matter changes in service members with blast-related mTBI compared with orthopaedically injured controls.
Military-Related Traumatic Brain Injury and Neurodegeneration
McKee & Robinson, Alzheimer's & Dementia · 2014
Review tying military TBI exposure, including blast, to long-term neurodegenerative disease, including chronic traumatic encephalopathy.
Investigation of Cavitation as a Possible Damage Mechanism in Blast-Induced Traumatic Brain Injury
Goeller et al., Journal of Neurotrauma · 2012
Experimental evidence that intracranial cavitation may be a mechanism of injury in blast-induced TBI, informing helmet and protection design.
Blast-Related Mild Traumatic Brain Injury: Mechanisms of Injury and Impact on Clinical Care
Elder et al., Mount Sinai Journal of Medicine · 2010
Clinically oriented review of blast mTBI mechanisms and the implications for diagnosis, triage and rehabilitation in military populations.
Outcome Trends after US Military Concussive Traumatic Brain Injury
Mac Donald et al., Journal of Neurotrauma · 2017
Five-year longitudinal outcomes in US service members after concussive TBI sustained in combat, persistent neurobehavioural and functional decline.
Repetitive Blast Exposure in Mice and Combat Veterans Causes Persistent Cerebellar Dysfunction
Meabon et al., Science Translational Medicine · 2016
Combined animal and veteran data showing that repeated blast exposure produces lasting cerebellar microstructural and functional impairment.
Characterisation of Interface Astroglial Scarring in the Human Brain after Blast Exposure: A Post-Mortem Case Series
Shively, Perl et al., The Lancet Neurology · 2016
Landmark post-mortem case series identifying a distinctive astroglial scarring pattern at tissue interfaces in blast-exposed service members.
Effects of Blast Exposure on Psychiatric and Health Symptoms in Combat Veterans
Martindale et al., Journal of Psychiatric Research · 2021
Cumulative blast exposure independently predicts higher psychiatric and somatic symptom burden in post-9/11 combat veterans.
Impact of Repeated Blast Exposure on Active-Duty United States Special Operations Forces
Edlow et al., PNAS · 2024
Multimodal imaging and biomarker study in active-duty SOF linking higher repeated blast exposure to changes in brain structure, function and neuropsychiatric health.
Optimizing Brain Health of United States Special Operations Forces
Bonvie et al., Journal of Special Operations Medicine · 2023
Human Performance Optimization framework for detecting, monitoring and mitigating repeated blast brain injury across the SOF career lifecycle.
The Neurological Impact of Repetitive Low-Level Blast Overpressure Exposure
Sutherland, McDonald, Spitz, Kelaher, O'Brien & Shultz, Journal of Neurotrauma · 2026
Australian-led narrative review (Monash University and the Department of Defence) synthesising 2010–2025 human evidence on repeated low-level blast, exposure contexts, mechanisms, clinical findings, biomarkers, imaging, and gaps for occupational brain-health surveillance.
The Role of Very Low Level Blast Overpressure in Symptomatology
Sajja et al., Frontiers in Neurology · 2019
Examines whether very low-level blast overpressure events, below thresholds traditionally considered injurious, contribute to acute and persistent symptom burden in exposed personnel.
Brain Protection Task Force: 75th Ranger Regiment — Innovation at the Speed of Relevance
Kratchman, Wells, Ripperger & Oh, Infantry (U.S. Army) · Spring 2026
75th Ranger Regiment account of standing up a Brain Protection Task Force to track blast exposure, protect cognitive performance and embed brain health into unit readiness.
Insula Network Microstructural Injury Links Low-Level Blast Exposure to Clinical Depression in Military Special Operations Forces Soldiers
McEvoy, Crabtree, Murray et al., medRxiv preprint (US SOCOM, VA Puget Sound, UNC, UW) · 15 May 2026
Preprint linking cumulative low-level blast exposure to microstructural injury in insula networks and clinical depression in SOF soldiers. Approved for public release by US SOCOM and US ASOCOM public affairs.
Neurocognitive Performance Deficits Related to Immediate and Acute Blast Overpressure Exposure
LaValle et al., Frontiers in Neurology · 2019
Documents measurable neurocognitive performance decrements in service members in the immediate and acute window after low-level blast overpressure exposure during training.
Relation of Repeated Low-Level Blast Exposure with Symptomology Similar to Concussion
Carr et al., Journal of Head Trauma Rehabilitation · 2015
Finds that repeated low-level blast exposure in breaching populations is associated with concussion-like symptomology even in the absence of a diagnosed mTBI event.
Blast Exposure and Long-Term Diagnoses Among Veterans: A Millennium Cohort Study Investigation of High-Level and Low-Level Blast
Martindale, Kolaja, Belding et al., Frontiers in Neurology · 2025
Large Millennium Cohort analysis linking both high- and low-level blast exposure histories to elevated long-term medical and psychiatric diagnoses in US veterans.
Potential Health and Performance Effects of High-Level and Low-Level Blast: A Scoping Review of Two Decades of Research
Belding et al., Frontiers in Neurology · 2021
Scoping review mapping twenty years of research on high- and low-level blast exposure and their downstream effects on health, cognition and operational performance.
Repeated Occupational Exposure to Low-Level Blast in the Canadian Armed Forces: Effects on Hearing, Balance, and Ataxia
Nakashima, Vartanian, Rhind et al., Military Medicine · 2022
Canadian Armed Forces study showing measurable auditory, vestibular and ataxic effects in personnel with sustained occupational low-level blast exposure histories.
Longitudinal Investigation of Neurotrauma Serum Biomarkers, Behavioral Characterization, and Brain Imaging in Soldiers following Repeated Low-Level Blast Exposure (New Zealand Breacher Study)
Kamimori et al., Military Medicine · 2018
New Zealand Defence Force breacher study combining serum biomarkers, behaviour and imaging to characterise the longitudinal neurobiological footprint of repeated low-level blast.
Functional and Structural Neuroimaging Correlates of Repetitive Low-Level Blast Exposure in Career Breachers
Stone, Avants, Tustison et al., Journal of Neurotrauma · 2020
Identifies functional and structural neuroimaging differences in career breachers compared with controls, supporting cumulative low-level blast as a driver of measurable brain change.
Distinct Functional MRI Connectivity Patterns and Cortical Volume Variations Associated with Repetitive Blast Exposure in Special Operations Forces Members
Diociasi et al., Radiology · 2025
fMRI connectivity and cortical volume study in active-duty SOF showing exposure-related patterns distinguishable from controls without overt mTBI diagnoses.
Neurological Effects of Repeated Blast Exposure in Special Operations Personnel
Stone, Avants, Tustison et al., Journal of Neurotrauma · 2024
Multimodal study of US Special Operations personnel linking cumulative blast exposure to neurological, cognitive and imaging-detectable changes.
Circulating Brain-Reactive Autoantibody Profiles in Military Breachers Exposed to Repetitive Occupational Blast
Rhind et al., International Journal of Molecular Sciences · 2024
Identifies distinctive brain-reactive autoantibody profiles in military breachers, suggesting an immunological signature of repetitive occupational blast exposure.
Neuroinflammation at the Gray–White Matter Interface in Active-Duty U.S. Special Operations Forces
Edlow, Tseng, Gilmore et al., Neurotrauma Reports · 2024
PET-based evidence of neuroinflammation localised to the gray–white matter interface, a region biomechanically vulnerable to blast, in active-duty SOF personnel.
Chronic Traumatic Encephalopathy in Blast-Exposed Military Veterans and a Blast Neurotrauma Mouse Model
Goldstein et al., Science Translational Medicine · 2012
Landmark paper linking blast exposure in military veterans to CTE-type tau pathology, supported by parallel findings in a blast neurotrauma mouse model.
Chronic Traumatic Encephalopathy in the Brains of Military Personnel
Priemer et al., New England Journal of Medicine · 2022
Neuropathological case series in NEJM identifying CTE in the brains of military personnel, including individuals without documented contact-sport histories.
Mild TBI and Risk of Parkinson Disease: A Chronic Effects of Neurotrauma Consortium Study
Gardner et al., Neurology · 2018
CENC cohort analysis showing that mild TBI, including military exposures, is associated with elevated long-term risk of Parkinson disease.
A Review of U.S. Military Traumatic Brain Injury Studies
Hoch, Martinez, Bakhshi, Hieber, Presser, Tartaglia, RAND Corporation · 2024
RAND Corporation review examining trends, gaps and opportunities across U.S. military traumatic brain injury research.
Examining the Role of Military Breacher and Sniper and the Effects of mTBI
McMaster Health Forum · 2023
Rapid evidence profile examining the association between Military Breachers and Range Staff (MBRS) roles, repeated sub-concussive blast exposure and mild traumatic brain injury in Canadian Armed Forces personnel.
One Is Not Like the Other — Repetitive Low-Level Blast
Lam et al., DRDC / University of Toronto · 2026
Canadian-led neuroimaging study examining the neural response to repetitive low-level blast exposure in experienced military personnel, including snipers and breachers.
One mild Traumatic Brain Injury, more than double the risk of the injuries that ground a soldier
Posis et al., JAMA Network Open · 2026
Naval Health Research Center cohort: a single mild TBI more than doubles the risk of the musculoskeletal injuries that take a soldier off the line. Strengthens the dose–response case for treating mTBI as a force-readiness issue, not just a clinical one.
AI screening of 3.64 million US veteran medical records for TBI signal
Military Medicine · 2026
A new Military Medicine study used machine learning to read 3.64 million veteran records and surface previously undetected traumatic brain injury. Shows the scale of missed diagnosis when relying on clinical coding alone.
Health of UK Service Personnel Deployed to Iraq and Afghanistan — Phase 4
Sharp et al., King's Centre for Military Health Research · 2026
Fourth phase of the KCMHR 20-year cohort following UK personnel who served in Iraq and Afghanistan. Tracks probable PTSD, common mental disorder, alcohol misuse and self-harm, and again shows the field still under-measures blast exposure.
Health Burden in Treatment-Seeking Special Operations Personnel
Published in The Lancet · 2026
222 active-duty, treatment-seeking SOF personnel. 92.8% sleep disruption, 83.3% pain, 82.4% cardiometabolic disruption, 81.1% mental health burden. Reframes the SOF clinical picture as a multi-system load, not a mental-health-only problem.
Combat Crew vs Special Operators — Clinical Comparison
JAMA Network Open (NICoE / Walter Reed data) · 2026
JAMA Network Open analysis comparing combat crew members with special operators in a clinical population. Shows convergent symptom burdens across communities exposed to repeated blast, not just the SOF cohort the field has focused on.
Brain Protection Task Force: 75th Ranger Regiment
Kratchman, Wells, Ripperger & Oh, Infantry (Army) · 2026
Spring 2026 Infantry article documenting the 75th Ranger Regiment's Brain Protection Task Force. A practical operational case study in instrumenting, measuring and reducing low-level blast exposure inside an active SOF unit.
Insula Network Microstructural Injury Links Low-Level Blast Exposure to Clinical Depression in SOF Soldiers
McEvoy, Crabtree, Murray et al. · 2026
Identifies microstructural injury in the insula network as a candidate mechanism linking cumulative low-level blast exposure to clinical depression in Special Operations soldiers. Moves the conversation from symptoms to imaging-backed pathology.
Career Blast Exposure and Cognitive Function in Combat Veterans
1,036 combat-exposed service members and veterans · 2026
Tested whether career blast exposure from training and operations affects cognitive function, using the Blast Exposure Threshold dose metric across 1,036 combat-exposed service members and veterans. Adds dose-response evidence to the operational-blast literature.
Long-Term Outcomes Ten Years After Combat-Related Brain Injury
More than 1,000 combat-exposed veterans · 2026
Followed more than 1,000 combat-exposed veterans and service members for an average of ten years after their brain injuries. The finding: outcomes do not stabilise at the injury date — symptom burden continues to evolve over the decade that follows.
Long-Range Rifle Fire and Brain Response
Canadian Armed Forces study (2026) · 2026
Measured what firing a long-range rifle does inside the brain. Direct in-vivo measurement of brain response to operator-side blast from heavy-calibre rifle fire, relevant to snipers and instructors.
Brain Injury Risk in Female Service Members — 222-Person Study
US military female warfighter cohort · 2026
Examined 222 female service members and veterans, comparing those with and without blast exposure. Confirms a population the field has under-studied since 2013 and shows comparable injury patterns to male cohorts.
Neurocognitive Effects of Repetitive Low-Level Blast (rLLB) Overpressure Exposure in Humans — A Rapid Review
DVA commissioned literature review · 2026
DVA-commissioned rapid review consolidating the human evidence on repetitive low-level blast overpressure exposure and neurocognitive outcomes. Significant because it places the Australian system on the record for what is known.
Combat Helmets and Brain Injury — Review
Military Medicine · 2026
Military Medicine review of combat helmets and brain injury. Helmets are effective at stopping fragments and preventing penetrating injury but were never designed to attenuate the overpressure wave that drives blast-related TBI.
Blast Injury and Long-Term Psychiatric Disability — 15-Year IDF Cohort
Journal of Psychiatric Research · 2025
15-year follow-up of more than 7,600 Israeli Defense Force personnel. Blast injury roughly doubled the risk of long-term psychiatric disability, even without a recorded head injury.
Ibogaine for PTSD, Anxiety, Depression and Cognition in Veterans with TBI
Stanford Medicine, Nature Mental Health · 2025
Stanford-led study showing ibogaine, a plant-based psychedelic, produced large improvements in PTSD, anxiety, depression and cognitive dysfunction in veterans with traumatic brain injury from combat exposure.
Ibogaine plus Magnesium in 30 Special Operations Veterans
Stanford-led pilot · 2025
Investigated the effects of ibogaine hydrochloride combined with magnesium on 30 Special Operations veterans with TBI and psychiatric symptoms. Pilot evidence that motivated the larger Nature Mental Health follow-on.
MASHIEN Study Protocol — Slamming Impact Exposure on High-Speed Boats
BMJ Open · 2025
Multi-Agency Study on Human Impact Exposure onboard High-Speed Boats. Protocol for mapping which levels of repeated slamming impact are sustainable versus harmful for crews and embarked forces.
Orientation Effects in Blast Exposure Dosimetry
Catherine E. Johnson & Nicholas Kuehl, Scientific Reports · 2025
Scientific Reports paper tackling a core flaw in how blast exposure is measured: sensor orientation relative to the blast wave matters far more than current dosimetry assumes. Has direct implications for every wearable-sensor study to date.
New Classification of Traumatic Brain Injury
The Lancet Neurology · 2025
Nearly 100 neurology experts from 14 countries proposed a new classification of TBI, moving beyond the outdated 'mild, moderate, severe' Glasgow Coma Scale framing toward a biology- and mechanism-aware system.
TBICoE Information Paper — Neurodegenerative Disease Risk after TBI
Defense Health Agency, Traumatic Brain Injury Center of Excellence · 2025
TBICoE information paper consolidating the US Department of Defense position on the long-term neurodegenerative disease risk following service-related traumatic brain injury. A reference document for clinicians and policy.
TBICoE Information Paper — Creatine and Traumatic Brain Injury
Defense Health Agency, Traumatic Brain Injury Center of Excellence · 2025
TBICoE information paper reviewing the evidence for creatine supplementation as an adjunct in traumatic brain injury recovery. Worth reading alongside the broader performance-nutrition literature for warfighters.
PTSD, mTBI, Deployment and Sleep — International Review
Systematic review · 2025
Systematic review and meta-analysis of the interactions between blast-induced mild TBI, PTSD severity, deployment history and sleep disruption. Confirms the field can no longer treat these as separable conditions.
Machine Learning Prediction of Persistent Post-Concussive Symptoms
Service-member mTBI cohort · 2025
Machine learning applied to service-member data to predict which mTBI patients are likely to develop long-term symptoms. Early step toward stratified care pathways rather than one-size-fits-all rehab.
Long-term Impact of Military-relevant Brain Injury — LIMBIC-CENC
VA / DoD consortium · 2024
LIMBIC-CENC: the largest military brain injury study in history, tracking the long-term impact of military-relevant brain injury across a multi-decade veteran cohort. Foundational reference for US chronic-effects evidence.
Bilateral, Two-Level Cervical Sympathetic Block for Post-Traumatic Stress
Mulvaney et al. · 2024
Reviewed paper highlighting the role of bilateral, two-level cervical sympathetic blocks as a procedural option for symptom relief in service members and veterans with post-traumatic stress and blast-related injury.
Mild TBI in U.S. Service Members — Clinical Complexity
Frontiers in Neurology · 2024
One of five essential mTBI papers recommended by Prof. Robert Vink (Chair, Connectivity TBI). Unpacks the clinical complexity of mild traumatic brain injury in U.S. service members and why single-mechanism framings keep failing.
mTBI and PTSD — Understanding the Overlap
Stein & McAllister, American Journal of Psychiatry (2009) · 2009
Pivotal 2009 paper by Stein and McAllister mapping the symptomatic and mechanistic overlap between post-traumatic stress and mild TBI. Still cited as the entry point for clinicians trying to separate the two.
Project BeACON
Vigil Australia · Active
Vigil-led national collaboration uniting the SASR, Commando, Infantry and Clearance Diver associations to coordinate brain-injury support for serving members and veterans, including pathways into Home Base, with the goal of an Australian model for diagnosis, care and recovery.
Project PATHFINDER
PATHFINDER Working Group · Position paper — July 2025
Veteran-led coordination framework for safe, evidence-based access to psychedelic-assisted therapy for Australian veterans. Maps credible providers, develops governance and clinical safeguards, and lays the groundwork for a DVA-backed trial, to prevent the harm pattern seen in unregulated medicinal-cannabis commercialisation.