The U.S. Army is launching a comprehensive study into how repeated exposure to powerful weapon systems — including sniper rifles, anti-armor launchers, and heavy artillery — may affect soldiers' brain health over time.

The goal is to better understand how repetitive, low-level blast overpressure contributes to long-term neurological damage, even when injuries are not immediately apparent.

A senior non-commissioned officer who frequently trains with the Carl Gustaf recoilless rifle described the impact starkly: “I would equate it to getting a concussion in football, where you have headaches, nausea,” he told Task & Purpose. “I mean, I’ve literally seen people throw up after so many rounds.”

The Carl Gustaf, an 84mm shoulder-fired weapon capable of disabling tanks, produces intense concussive shockwaves with every shot.

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Soldiers who regularly train with it — or with other “tier 1” weapons like .50 caliber sniper rifles, howitzers, and breaching explosives — may be at risk of accumulating subtle brain trauma over time.

Unlike past research that focused primarily on single, acute traumatic brain injuries (TBIs), this new effort will focus on the cumulative effects of smaller, repeated blasts.

“There’s been a lot of research on impacts following moderate to severe TBI and even mild TBI because that’s so common in the military,” said Megan Douglas, a clinical research psychologist at the Walter Reed Army Institute of Research.

“But things like repetitive head injuries, those subclinical groups, I don’t think we’ve looked as much about them.”

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Since 2000, over half a million U.S. troops have been diagnosed with TBIs, with nearly 82% classified as “mild.” Despite the term, these injuries can lead to memory and mood disorders, sleep disturbances, headaches, and increased risk for PTSD, according to previous studies compiled by the Center for New American Security.

The Army’s new research aims to examine “dose-specific effects of exposure to weapons,” identifying how the intensity and frequency of blast overpressure correlate with long-term cognitive and psychological issues.

The findings could ultimately shape Department of War policies on safe exposure limits, training schedules, and personnel placement.

One study will compare groups with high exposure to tier 1 weapons — including infantry, artillery, and special operations personnel — to those with lower exposure, such as combat medics.

This comparison may help isolate factors like occupational role, training frequency, or even individual sleep patterns that increase vulnerability to brain injuries.

“The goals can be across many different potential intervention points, whether we prevent exposure because of risk factors or we mitigate exposure through safety measures,” Douglas explained.

Variability in training conditions also affects exposure. For instance, a special operations soldier might perform wall and door breaching exercises up to 21 days per quarter with multiple charges per day, while regular units might do just 10 charges a year.

Even observers at a distance — such as forward observers or fire support teams — may still be exposed to dozens or hundreds of rounds during exercises.

“There were days that we would get dozens and dozens of Carl Gustaf rounds and then at the end of it, you’re ‘like my head hurts,’” one soldier said.

Differences in ammunition also matter. A mortar or artillery round may use the same propelling charge whether it's live or training-grade, but on the receiving end, live rounds deliver much greater blast pressure. For shoulder-fired weapons, the difference between training and live rounds is even more pronounced.

Long-term outcomes may also be tied to personal habits. A former special operations artillery officer noted that holistic health practices in elite units — prioritizing sleep, nutrition, and mental well-being — seemed to protect soldiers from more severe cognitive decline.

“There were people in special operations with multiple IED hits, severe TBI, multiple Purple Hearts that were in far better mental shape simply because they prioritize sleep for their two-decade career or eating right,” he said.

“Whereas you’ll see conventional soldiers say they’re burned out after a short amount of time because they’re not probably as healthy.”

The studies will collect a broad array of data from participating soldiers — including neuropsychological testing, mood assessments, PTSD symptoms, sleep patterns, medical history, and prior concussions. The intent is to see whether specific combinations of factors predict a higher risk for degenerative conditions like chronic traumatic encephalopathy (CTE), the disease commonly seen in professional football players.

“It’s similar to what we’ve seen with TBI or sports concussion research where we know that they’re at risk for these neurodegenerative issues later down the road,” Douglas said.

“But they will actually be doing a blinded adjudication where they are looking at these aspects and saying whether they think they would be at risk.”

Despite the military’s push to destigmatize mental health concerns, some soldiers may still be hesitant to participate. Douglas emphasized that all data will be anonymized and protected.

“What you say is not gonna be shared with others outside of very specific safety issues like if they intend to take their life or something like that. It will not be documented in their medical chart,” she said.

“This is not for clinical purposes. It’s not for career decision purposes.”

With this research, the Army hopes to set a new standard for understanding — and ultimately reducing — the long-term neurological toll of military service.

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