Mild Traumatic Brain Injury in U.S. Soldiers Returning from Iraq

Hoge, Charles W.; McGurk, Dennis; Thomas, Jeffrey L.; Cox, Anthony L.; Engel, Charles C.; Castro, Carl A.

doi:10.1056/nejmoa072972

Cited by 2,548 publications

(2,270 citation statements)

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“…Owing to increased awareness of the prevalence of TBI and high rates of co-occurrence between PTSD and TBI among OEF/OIF Veterans (Hoge et al, 2008;Carlson et al, 2011), few studies have examined the effect of PTSD on neuropsychological test performance independent of the effect of TBI. The Neurocognition Deployment Health Study (NDHS) examined cognitive functioning among soldiers before and after deployment to Iraq (OIF) and found an interaction between PTSD symptom severity and time since deployment on sustained attention (Marx et al, 2009a).…”

Section: Attention and Executive Functioningmentioning

confidence: 99%

“…Studies of OEF/OIF military Veterans are complicated by the variable and often lengthy duration between the time of injury(ies) and formal neuropsychological assessment, high rates of co-occurrence between mTBI and PTSD in this population (e.g., Carlson et al, 2011;Hoge et al, 2008), symptom overlap between mTBI and PTSD, as well as the potential influence of post-secondary gain (e.g., Nelson, Hoelzle, McGuire, Gerrier-Auerbach, Charlesworth, & Sponheim, 2010).…”

Section: Neuropsychology Of Mtbimentioning

confidence: 99%

“…Although resilience is the most common outcome, as many as 20% of returning military personnel are affected with PTSD (Hoge et al, 2004). Further, approximately 15-20% returning service members reported a probable TBI during their deployment ((e.g., Belanger, Uomoto, & Vanderploeg, 2009;Tanielian & Jaycox, 2009;Terrio et al, 2009;Hoge et al, 2008;Schneiderman, Braver, & Kang, 2008;Vasterling et al, 2006). Thus, the recovery and reintegration of a significant minority of returning military personnel will be affected by these conditions.…”

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Neuropsychological Sequelae of PTSD and TBI Following War Deployment among OEF/OIF Veterans

et al. 2012

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Posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) are highly prevalent among Veterans of the conflicts in Iraq and Afghanistan. These conditions are associated with common and unique neuropsychological and neuroanatomical changes. This review synthesizes neuropsychological and neuroimaging studies for both of these disorders and studies examining their co-occurrence. Recommendations for future research, including utilizing combined neuropsychological and advanced neuroimaging techniques to study these disorders alone and in concert, are presented. It is clear from the dearth of literature that more attention in the literature should be given to examining temporal relationships between PTSD and mTBI, risk and resilience factors associated with both disorders and their co-occurrence, and mTBI-specific factors such as time since injury and severity of injury, utilizing comprehensive, yet targeted cognitive tasks.

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Section: Attention and Executive Functioningmentioning

confidence: 99%

Section: Neuropsychology Of Mtbimentioning

confidence: 99%

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Neuropsychological Sequelae of PTSD and TBI Following War Deployment among OEF/OIF Veterans

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“…A number of studies have been performed to delineate the etiology and establish the existence of NBS in mild TBI; the findings have been controversial and inconclusive. Hoge et al 53 studied soldiers with mild TBI and a variety of postinjury symptoms. After adjustments for PTSD and depression, mild TBI was no longer significantly associated with symptoms except headache.…”

Section: Discussionmentioning

confidence: 99%

Neurobehavioral sequelae of traumatic brain injury

Riggio

Wong

2009

Mount Sinai J Medicine

106

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The neurobehavioral sequelae of traumatic brain injury consist of a spectrum of somatic and neuropsychiatric symptoms. The neuropsychiatric symptoms are divided into cognitive and behavioral presentations. In the literature, these neurobehavioral sequelae have been called postconcussive symptoms, postconcussive syndrome, and postconcussive disorder; however, the authors of this review do not use this terminology because the symptoms are not restricted to patients with concussion but instead can be found in all traumatic brain injury patients of all injury severities. The development of neurobehavioral sequelae after traumatic brain injury is a multifactorial process. The patient evaluation requires a multidisciplinary approach in order to delineate physiologic dysfunction and place deficits in the context of the patient's preinjury and postinjury psychiatric status. Consequently, the evaluation of the posttraumatic brain injury patient with neurobehavioral sequelae requires a carefully structured history and physical examination with an emphasis on neurological and psychiatric function. Adjunctive evaluations must be tailored to the patient with neuroimaging, neurophysiological, and neuropsychiatric testing. Maximized outcomes may be achieved by the performance of a careful and detailed assessment that places complaints within the context of the individual.

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“…The relationship between mild TBI and PTSD has been reviewed in two recent epidemiologic studies of US soldiers returning from Iraq and Afghanistan (Hoge et al, 2008;Schneiderman et al, 2008). In one study on 2525 soldiers, 4.9% reported injury with loss of consciousness, 10.3% reported injuries with altered mental status, and 17.2% reported other injuries during deployment.…”

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confidence: 99%

Common biochemical defects linkage between post-traumatic stress disorders, mild traumatic brain injury (TBI) and penetrating TBI

Prasad¹,

Bondy

2015

Brain Research

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AnxietyPsychological damage a b s t r a c t Post-traumatic stress disorder (PTSD) is a complex mental disorder with psychological and emotional components, caused by exposure to single or repeated extreme traumatic events found in war, terrorist attacks, natural or man-caused disasters, and by violent personal assaults and accidents. Mild traumatic brain injury (TBI) occurs when the brain is violently rocked back and forth within the skull following a blow to the head or neck as in contact sports, or when in close proximity to a blast pressure wave following detonation of explosives in the battlefield. Penetrating TBI occurs when an object penetrates the skull and damages the brain, and is caused by vehicle crashes, gunshot wound to the head, and exposure to solid fragments in the proximity of explosions, and other combat-related head injuries. Despite clinical studies and improved understanding of the mechanisms of cellular damage, prevention and treatment strategies for patients with PTSD and TBI remain unsatisfactory. To develop an improved plan for treating and impeding progression of PTSD and TBI, it is important to identify underlying biochemical changes that may play key role in the initiation and progression of these disorders. This review identifies three common biochemical events, namely oxidative stress, chronic inflammation and excitotoxicity that participate in the initiation and progression of these conditions. While these features are separately discussed, in many instances, they overlap. This review also addresses the goal of developing novel treatments and drug regimens, aimed at combating this triad of events common to, and underlying, injury to the brain.

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Mild Traumatic Brain Injury in U.S. Soldiers Returning from Iraq

Cited by 2,548 publications

References 38 publications

Neuropsychological Sequelae of PTSD and TBI Following War Deployment among OEF/OIF Veterans

Neuropsychological Sequelae of PTSD and TBI Following War Deployment among OEF/OIF Veterans

Neurobehavioral sequelae of traumatic brain injury

Common biochemical defects linkage between post-traumatic stress disorders, mild traumatic brain injury (TBI) and penetrating TBI

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