Post-traumatic amnesia and the nature of post-traumatic stress disorder after mild traumatic brain injury

Abstract

The prevalence and nature of post-traumatic stress disorder (PTSD) following mild traumatic brain injury (MTBI) is controversial because of the apparent paradox of suffering PTSD with impaired memory for the traumatic event. In this study, 1167 survivors of traumatic injury (MTBI: 459, No TBI: 708) were assessed for PTSD symptoms and post-traumatic amnesia during hospitalization, and were subsequently assessed for PTSD 3 months later ( N = 920). At the follow-up assessment, 90 (9.4%) patients met criteria for PTSD (MTBI: 50, 11.8%; No-TBI: 40, 7.5%); MTBI patients were more likely to develop PTSD than no-TBI patients, after controlling for injury severity (adjusted odds ratio: 1.86; 95% confi dence interval, 1.78-2.94). Longer post-traumatic amnesia was associated with less severe intrusive memories at the acute assessment. These fi ndings indicate that PTSD may be more likely following MTBI, however, longer post-traumatic amnesia appears to be protective against selected re-experiencing symptoms. ( JINS , 2009, 15, 862-867 .)

Predictive factors of chronic post-traumatic stress disorder 6 months after a road traffic accident

“…In contrast, a British study of road traffic accident casualties found PTSD after 3 months to be more frequent among subjects who could not remember the accident, but this link was no longer observed 1 year after the accident (Mayou et al, 2000). Another study has suggested that an amnesia whose duration was inferior to 1 h may increase likelihood of PTSD while an amnesia duration superior to 1 h was associated with less severe intrusive or avoidant symptoms (Feinstein et al, 2002;Bryant et al, 2009). We did not find such a different relation in link with the duration of amnesia; another study has shown that amnesia surrounding the traumatic event did not protect individuals from the severity, or even the presence, of certain intrusive symptoms (Turnbull et al, 2001).…”

Reduced prefrontal MEG alpha-band power in mild traumatic brain injury with associated posttraumatic stress disorder symptoms

“…Multiple studies have reported an increased incidence of post-traumatic stress disorder (PTSD) in active-duty service members (Hoge et al, 2008;Schneiderman et al 2008;Yurgil et al, 2014;Stein et al, 2015) and civilians (Bryant et al, 2009;Bryant et al, 2010) with a history of mild traumatic brain injury (mTBI). Amongst veterans who have been deployed to Iraq or Afghanistan, a history of mild TBI is associated with a 2.37 fold increase in the prevalence of PTSD (Schneiderman et al 2008).…”

Predictors of Recovery From Posttraumatic Amnesia

“…A significant regression equation was found (F (3,35) =4.301, p=0.011, R 2 =0.269). Right parietal lesions significantly predicted FIM change (b=215.265, p=0.011), as did bilateral parietal lesions (b=221.407, p=0.013).…”

“…Although PTA has been the favored term for the post-TBI confusional period, debate on the nature of the cognitive deficits has been ongoing for nearly as long as the term's existence; the debate particularly centers on whether the deficits observed are primarily the result of delirium/ confusion versus episodic memory deficits versus attention impairment. 4,35,36 A recent study used the term acute traumatic encephalopathy to stratify the cognitive deficits into categories of coma, posttraumatic delirium, PTA, and posttraumatic dysexecutive syndrome, which are conceptualized as occurring in temporal sequence after recovery of function in an ascending pattern from the brainstem toward the cortex. 37 This follows the hypothesis of biochemical and localizationist theories of emergence from disorder of consciousness, which involves recovery of function at the brainstem level first, followed by the diencephalon and then the telencephalon.…”