Jason M Bailie1, Jan E Kennedy, Louis M French, Kathryn Marshall, Olga Prokhorenko, Sarah Asmussen, Matthew W Reid, Felicia Qashu, Tracey A Brickell, Rael T Lange. 1. Defense and Veterans Brain Injury Center, Bethesda, MD (Drs Bailie, Kennedy, French, Prokhorenko, Reid, Asmussen, Qashu, Brickell, and Lange and Ms Marshall); Walter Reed National Military Medical Center, National Intrepid Center of Excellence, Bethesda, MD (Drs French, Brickell, and Lange); Uniformed Services University of the Health Sciences, Departments of Neurology (Drs French and Brickell) and Center for Neuroscience and Regenerative Medicine (Dr French) Bethesda, MD; University of British Columbia, Vancouver, BC (Dr Lange); San Antonio Military Medical Center, Department of Neurology, San Antonio, TX (Drs Kennedy and Reid); Naval Medical Center San Diego, Department of Physical Medicine and Rehabilitation (Dr Bailie); Marine Corps Base Camp Pendleton (Dr Asmussen); General Dynamic Information Technology, Frederick, MD (Drs Kennedy, Prokhorenko, Asmussen, Brickell, Reid, and Lange and Ms Marshall); and American Hospital Services Group LLC, Exton, PA (Dr Bailie).
Abstract
OBJECTIVE: To explore the taxonomy of combat-related mild traumatic brain injury (mTBI) based on symptom patterns. PARTICIPANTS: Up to 1341 military personnel who experienced a combat-related mTBI within 2 years of evaluation. MEASURES: Neurobehavioral Symptom Inventory and PTSD Checklist-Civilian Version (PCL-C). RESULTS: Cluster analysis revealed the following 4 subtypes: primarily psychiatric (posttraumatic stress disorder) group, a cognitive group, a mixed symptom group, and a good recovery group. The posttraumatic stress disorder cluster (21.9% of the sample) reported symptoms related to hyperarousal and dissociation/depression with few complaints related to cognition or headaches. The cognitive group (21.5% of the sample) had primarily cognitive and headache complaints with few mood symptoms. The mixed profile cluster included 18.6% of the sample and was characterized by a combination of mood complaints (hyperarousal and dissociation/depression), cognitive complaints, and headaches. The largest cluster (37.8% of the sample) had an overall low symptom profile and was labeled the "good recovery" group. CONCLUSIONS: The results support a unique taxonomy for combat-related mTBI. The clinical differences among these subtypes indicate a need for unique treatment resources and programs.
OBJECTIVE: To explore the taxonomy of combat-related mild traumatic brain injury (mTBI) based on symptom patterns. PARTICIPANTS: Up to 1341 military personnel who experienced a combat-related mTBI within 2 years of evaluation. MEASURES: Neurobehavioral Symptom Inventory and PTSD Checklist-Civilian Version (PCL-C). RESULTS: Cluster analysis revealed the following 4 subtypes: primarily psychiatric (posttraumatic stress disorder) group, a cognitive group, a mixed symptom group, and a good recovery group. The posttraumatic stress disorder cluster (21.9% of the sample) reported symptoms related to hyperarousal and dissociation/depression with few complaints related to cognition or headaches. The cognitive group (21.5% of the sample) had primarily cognitive and headache complaints with few mood symptoms. The mixed profile cluster included 18.6% of the sample and was characterized by a combination of mood complaints (hyperarousal and dissociation/depression), cognitive complaints, and headaches. The largest cluster (37.8% of the sample) had an overall low symptom profile and was labeled the "good recovery" group. CONCLUSIONS: The results support a unique taxonomy for combat-related mTBI. The clinical differences among these subtypes indicate a need for unique treatment resources and programs.
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