Factors associated with neurocognitive performance in OIF/OEF servicemembers with postconcussive complaints in postdeployment clinical settings

Abstract

Abstract-Cognitive difficulties are frequently reported byOperation Iraqi Freedom/Operation Enduring Freedom military personnel who sustained mild traumatic brain injuries (TBIs). The current study examined several potential factors that may contribute to self-reported cognitive difficulties in postdeployment clinical settings. Eighty-four subjects who sustained a mild or moderate TBI and reported cognitive difficulties underwent neurocognitive testing. Multiple regression analyses were used to determine the amount of variance in neurocognitive performance accounted for by the predictor variables (demographic, mechanism of injury, time since injury, headache severity, combat stress, postconcussive complaints, and effort/performance validity). The predictor variables collectively accounted for 51.7% of the variance in cognitive performance (F (8,72) = 11/99, p < 0.001). The most potent predictor of cognitive functioning was performance validity/ effort, which uniquely accounted for 16.3% of the variance (p < 0.01). Self-reported symptom severity, including postconcussive complaints, combat stress, and headache intensity, accounted for 7.2% of the variance (p < 0.05). Demographic factors and injury characteristics, such as time since injury and mechanism of injury, were not significant predictive factors of cognitive performance. The findings of the current study underscore the need to include measurement of effort as part of neurocognitive evaluation in postdeployment settings when evaluating cognitive complaints associated with mild TBI.

Pontine pathology mediates common symptoms of blast-induced chronic mild traumatic brain injury

“…); 5 however, blast-mTBIs often cause persistent PCS that are indistinguishable from other mTBIs. [6][7][8][9][10][11] Therefore, we examined mTBIs associated with blast overpressure exposure in both military veterans and a mouse model of blast-mTBI with attenuated head movement. 12 This approach avoids coup-contrecoup and "whiplash" injuries, while testing the hypothesis that blast-mTBIs provoke conserved post-concussive symptoms mediated by chronic pathological changes in brainstem nuclei.…”

Clinical Predictors of 3- and 6-Month Outcome for Mild Traumatic Brain Injury Patients with a Negative Head CT Scan in the Emergency Department: A TRACK-TBI Pilot Study

“…Regarding future directions, facilitating education and managing psychiatric issues may help reduce exposure and improve adherence to mTBI follow-up [51,52]. Comparison to military studies will also be of use, as the presence of psychiatric comorbidities, e.g., post-traumatic stress disorder (PTSD), consistently predicted poorer post-deployment outcome in deployed veterans compared to veteran controls, while demographics and injury mechanisms were less important [69][70][71]. This may be related to factors of intensity, and the frequency of trauma in military compared to civilian populations, as well as measures of resilience [72], which are ongoing topics of research.…”

Effect of the Suboccipital Musculature on Symptom Severity and Recovery after Mild Traumatic Brain Injury

“…39 Thus, rectus capitis-PMin atrophy may play a role in both the symptomatology and cognitive deficits after mTBI. Together, these findings may indicate a role for preventive strengthening exercises focused on the rectus capitis-PMin musculature in individuals at high-risk for mTBI.…”