Mild Traumatic Brain Injury

Vos, Pieter E.; Alekseenko, Y.; Battistin, Leontino; Ehler, Edvard; Gerstenbrand, F; Mureșanu, Dafin F.; Потапов, А. А.; Stepan, C. A.; Traubner, P; Vécsei, László; Wild, K. von

doi:10.1007/978-0-387-76978-3_22

Cited by 46 publications

(22 citation statements)

References 115 publications

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“…However, for the purposes of research, our preference is to classify those patients with evidence of intracranial abnormality and LOC/PTA in the mild range as having a "complicated MTBI" (rather than a moderate TBI). The importance of the distinction between complicated and uncomplicated MTBI has been discussed by one of the authors elsewhere (Iverson & Lange, 2011;Iverson, Lange, Gaetz, & Zasler, 2007). In this sample, many patients with LOC/PTA in the mild range also had missing CT/MRI scan information (36.1%).…”

Section: Participantsmentioning

confidence: 97%

Influence of poor effort on neuropsychological test performance in U.S. military personnel following mild traumatic brain injury

Lange

Pancholi

Bhagwat

et al. 2012

Journal of Clinical and Experimental Neuropsychology

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The purpose of this study was to examine the influence of poor effort on neuropsychological test performance in military personnel following mild traumatic brain injury (MTBI). Participants were 143 U.S. service members who sustained a TBI, divided into three groups based on injury severity and performance on the Word Memory Test and four embedded markers of poor effort: MTBI-pass (n = 87), MTBI-fail (n = 21), and STBI-pass (n = 35; where STBI denotes severe TBI). Patients were evaluated at the Walter Reed Army Medical Center on average 3.9 months (SD = 3.4) post injury. The majority of the sample was Caucasian (84.6%), was male (93.0%), and had 12+ years of education (96.5%). Measures included the Personality Assessment Inventory (PAI) and 13 common neurocognitive measures. Patients in the MTBI-fail group performed worse on the majority of neurocognitive measures, followed by the Severe TBI-Pass group and the MTBI-pass group. Using a criterion of three or more low scores <10th percentile, the MTBI-fail group had the greatest rate of impairment (76.2%), followed by the Severe TBI-Pass group (34.3%) and MTBI-pass group (16.1%). On the PAI, the MTBI-fail group had higher scores on the majority of clinical scales (p < .05). There were a greater number of elevated scales (e.g., 5 or more elevated mild or higher) in the MTBI-fail group (71.4%) than in the MTBI-pass group (32.2%) and Severe TBI-Pass group (17.1%). Effort testing is an important component of postacute neuropsychological evaluations following combat-related MTBI. Those who fail effort testing are likely to be misdiagnosed as having severe cognitive impairment, and their symptom reporting is likely to be inaccurate.

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Section: Participantsmentioning

confidence: 97%

Influence of poor effort on neuropsychological test performance in U.S. military personnel following mild traumatic brain injury

Lange

Pancholi

Bhagwat

et al. 2012

Journal of Clinical and Experimental Neuropsychology

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“…Following an mTBI, it is estimated that 12-44% of individuals experience some degree of depression within the first 3 months [20]. Given that intracranial abnormalities following traumatic brain injury are likely to involve frontal and temporal lobes [21] and the above-mentioned fronto-limbicsubcortical structures implicated in depression, it is not surprising that depression is a commonly-observed biological consequence of traumatic brain injuries of all severities [22].…”

Section: Traumatic Brain Injury and Depressionmentioning

confidence: 99%

A review of post-concussion syndrome and psychological factors associated with concussion

2014

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“…However, this literature is multifaceted and complex. For example, numerous studies have found that self‐reported symptoms following mTBI are influenced by a large number of non‐brain‐injury–related factors, such as personal injury litigation; concurrent medical problems; orthopedic injuries; chronic pain; PTSD; depression; anxiety; premorbid personality; and a variety of psychosocial explanations, such as the “nocebo effect” and the “good old days bias” (for a detailed discussion, see Iverson & Lange, , ; McCrae, ).…”

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confidence: 99%

Posttraumatic Stress Disorder is a Stronger Predictor of Long‐Term Neurobehavioral Outcomes Than Traumatic Brain Injury Severity

Lange

French

Bailie³

et al. 2020

Journal of Traumatic Stress

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Concurrent posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) is common in military populations. The purpose of this study was to examine long‐term neurobehavioral outcomes in service members and veterans (SMVs) with versus without PTSD symptoms following TBI of all severities. Participants were 536 SMVs prospectively enrolled from three military medical treatment facilities who were recruited into three experimental groups: TBI, injured controls (IC), and noninjured controls (NIC). Participants completed the PTSD Checklist, Neurobehavioral Symptom Inventory, and the TBI–Quality of Life (TBI‐QOL) and were divided into six subgroups based on the three experimental categories, two PTSD categories (i.e., present vs. absent), and two broad TBI severity categories (unMTBI, which included uncomplicated mild TBI; and smcTBI, which included severe TBI, moderate TBI, and complicated mild TBI): (a) NIC/PTSD‐absent, (b) IC/PTSD‐absent, (c) unMTBI/PTSD‐absent, (d) unMTBI/PTSD‐present, (e) smcTBI/PTSD‐absent, and (f) smcTBI/PTSD‐present. There were significant main effects across the six groups for all TBI‐QOL measures, ps < .001. Select pairwise comparisons revealed significantly lower scores, p < .001, on all TBI‐QOL measures in the PTSD‐present groups when compared to the PTSD‐absent groups within the same TBI severity classification, ds = 0.90–2.11. In contrast, when controlling for PTSD, there were no significant differences among the TBI severity groups for any TBI‐QOL measures. These results provide support for the strong influence of PTSD but not TBI severity on neurobehavioral outcomes following TBI. Concurrent PTSD and TBI of all severities should be considered a risk factor for poor long‐term neurobehavioral outcomes that require ongoing monitoring.

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Mild Traumatic Brain Injury

Cited by 46 publications

References 115 publications

Influence of poor effort on neuropsychological test performance in U.S. military personnel following mild traumatic brain injury

Influence of poor effort on neuropsychological test performance in U.S. military personnel following mild traumatic brain injury

A review of post-concussion syndrome and psychological factors associated with concussion

Posttraumatic Stress Disorder is a Stronger Predictor of Long‐Term Neurobehavioral Outcomes Than Traumatic Brain Injury Severity

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