Daniel Perl ’63

Since the term “shell shock” was first used during WWI, it’s become a well-known fact that military servicemembers are at greater risk for experiencing mental health conditions that disrupt their quality of life. Though historically understood as what is now called PTSD, a solely psychological condition, Dr. Daniel Perl ’63’s work is changing the narrative and showing how classic PTSD symptoms can be linked to physical injuries from big explosions.

“The work of my team established, for the first time, that blast exposure was capable of producing a specific pattern of brain damage,” Perl says. “We essentially described a new disease and defined its pathology.”

A neuropathologist, Perl was researching CTE in athletes in 2010 when the Uniformed Services University (USU) asked him to be part of a new effort to understand traumatic brain injury from blast exposure in those serving in the military. Recognizing the national importance of the issue, he couldn’t turn down the opportunity. Perl is now the director of DoD/USU Brain Tissue Repository and studies the brains of deceased service- members, looking for the specific type of blast exposure scarring that he identified in 2012. Many were sudden deaths — from suicide, drug overdose or other incidents — leaving loved ones to wonder how brain injury might have contributed to mental health symptoms.

“Through brain donation, we can often provide answers to [the family’s] questions, which offers a degree of closure to their uncertainty about the issues the deceased faced,” he says.

Currently, the blast-induced traumatic brain injury that Perl discovered can only be diagnosed after death. But his team is working to develop more sophisticated imaging techniques; ideally, blast damage would be revealed in living patients who struggle with PTSD hallmarks like disrupted sleep or severe anxiety. If successful, this breakthrough could change how mental health conditions are diagnosed and treated in veterans, and help prevent others from being hurt.

“This information will help determine when service- members have experienced too much blast exposure and should be reassigned to less dangerous assignments,” Perl says. “This approach could be the first step toward the prevention of the problem.”

— Emily Driehaus