Before he ended his life, Ryan Larkin made his family promise to donate his brain to science.
The 29-year-old Navy SEAL was convinced years of exposure to blasts had badly damaged his brain, despite doctors telling him otherwise. He had downloaded dozens of research papers on traumatic brain injury out of frustration that no one was taking him seriously, his father said.
“He knew,” Frank Larkin said. “I’ve grown to understand that he was out to prove that he was hurt, and he wasn’t crazy.”
In 2017, a postmortem study found that Ryan Larkin, a combat medic and instructor who taught SEALs how to breach buildings with explosives, had a pattern of brain scarring unique to service members who’ve endured repeated explosions.
Seven years later, an Army reservist who carried out a high-profile mass shooting was also found to have brain damage, underscoring how much the research and technology needed to fully understand and treat traumatic brain injury is still lagging, experts and advocates said.
No scan can detect that level of brain trauma while a person is alive, according to Dr. Russell Gore, a medical director with the Shepherd Center’s SHARE Military Initiative, which treats veterans and service members with brain injuries. And while there is a tool that may be able to track some changes, it is mostly limited to research purposes.
“It’s a little bit of fringe medicine right now,” Gore said. “We’re really at an infant stage in terms of our clinical ability to assess traumatic brain injury.”
Earlier this month, the gunman behind Maine’s deadliest mass shooting put a national spotlight on the issue when doctors said they determined traumatic brain injury “likely played a role” in his behavioral changes.
Robert Card fatally shot 18 people in Lewiston, Maine, last October before dying by suicide at age 40, authorities said.
He enlisted in the Army Reserve in 2002 and had no combat deployments, officials said. But his family said he had been exposed to thousands of low-level blasts as a longtime instructor at an Army hand grenade training range.
Card’s postmortem brain study found “significant degeneration” and inflammation in the white matter — the nerve fibers that allow for communication between different areas of the brain, according to Dr. Ann McKee, the neurologist at Boston University’s Chronic Traumatic Encephalopathy (CTE) Center who led the study.
In a brief statement, McKee said there was no evidence of CTE, a condition found in football players who suffer repeated blows to the head.
The statement did not paint a full picture of Card’s health or trauma history, and the full analysis was not made public. McKee and the Boston University CTE Center declined to be interviewed, and Card’s family did not immediately comment.
But the findings, including the absence of CTE, mirror other postmortem scans of service members’ brains, according to Dr. James Stone, who was enlisted by NATO in 2021 to help develop guidelines for preventing serious brain injuries in service members. He said those guidelines are expected to be released this year.
Stone, an imaging expert who has studied low-level blasts in military personnel for nearly two decades, said Card’s injury “seemed pretty profound.”
“We need to, as soon as possible, answer the question of how much is too much when it comes to safe levels of exposures,” he said.
In a statement, the Army said Card’s findings were “concerning” and that it was currently updating guidance on how to mitigate risks from blast overpressure. A spokesperson said the Army’s goal is to require tracking of exposed personnel and documentation of training environments that exceed certain blast thresholds, beginning later this year.
The efforts come a year after the…
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