The Army reservist who killed 18 people in what became Maine’s deadliest mass shooting in the state’s history, sparking a massive manhunt before he was found dead last year, had traumatic brain injuries, a news scan shows. 

Robert Card had significant evidence of traumatic brain injuries, including degeneration in the nerve fibers that allow for communication between different areas of the brain, inflammation and small blood vessel injury, according to a brain tissue analysis by researchers from Boston University that was released Wednesday. 

The analysis was conducted by Dr. Ann McKee of Boston University’s Chronic Traumatic Encephalopathy (CTE) Center and released by Card’s family. It comes ahead of Army officials’ appearance Thursday before a special commission investigating the Oct. 25 shootings.

Card had been an instructor at an Army hand grenade training range, where it is believed he was exposed to thousands of low-level blasts. 

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“Robert Card had evidence of traumatic brain injury. In the white matter, the nerve fibers that allow for communication between different areas of the brain, there was significant degeneration, axonal and myelin loss, inflammation, and small blood vessel injury. There was no evidence of chronic traumatic encephalopathy (CTE),” McKee said in a statement released through the Concussion Legacy Foundation.

“These findings align with our previous studies on the effects of blast injury in humans and experimental models,” she added. “While I cannot say with certainty that these pathological findings underlie Mr. Card’s behavioral changes in the last 10 months of life, based on our previous work, brain injury likely played a role in his symptoms.”

Card’s family members also apologized for the attack in the statement, saying “how deeply sorry and heartbroken we are for all the victims, survivors, and their loved ones, and to everyone in Maine and beyond who was affected and traumatized by this tragedy.” 

“We know it does not fully explain Robert’s actions, nor is it an excuse for the horrific suffering he caused, but we thank Dr. McKee for helping us understand his brain damage and how it may have impacted his mental health and behavior,” they wrote. “By releasing these findings, we hope to raise awareness of traumatic brain injury among military service members, and we encourage more research and support for military service members with traumatic brain injuries. Our hearts remain with the victims, survivors, and their families.”

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The family also thanked the Maine Chief Medical Examiner’s office for requesting the brain analysis. 

Democratic Gov. Janet Mills established the commission, comprised of former judges and prosecutors who are reviewing the facts surrounding the Oct. 25 shootings, as well as the police response. Police and the Army were both warned that Card was suffering from deteriorating mental health in the months that preceded the shootings.

Some of the 40-year-old Card’s relatives warned police that he was displaying paranoid behavior and that they were concerned about his access to guns. 

Body camera video of police interviews with reservists before Card’s two-week hospitalization in upstate New York last summer also showed fellow reservists expressing worry and alarm about his behavior and weight loss. Card was hospitalized in July after he shoved a fellow reservist and locked himself in a motel room during training. 

Later, in September, a fellow reservist told an Army superior he was concerned Card was going to “snap and do a mass shooting.” Card was found dead of a self-inflicted gunshot wound after the biggest search in state history.

Thursday’s hearing in Augusta is the seventh and final one currently slated for the commission. Commission chair Daniel Wathen said at a hearing with victims earlier this week that an interim report could be released by April 1.

Democrats in Maine are looking to make changes to the state’s gun laws in the wake of the shootings. 

The Associated Press contributed to this report.