Victoria C Merritt1, Sarah M Jurick1,2, Laura D Crocker1,2, Molly J Sullan1, McKenna S Sakamoto1, Delaney K Davey1, Samantha N Hoffman3, Amber V Keller1, Amy J Jak1,2,4. 1. Research & Psychology Services, VA San Diego Healthcare System (VASDHS), San Diego, CA, USA. 2. Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA. 3. San Diego Joint Doctoral Program in Clinical Psychology, State University/University of California San Diego (SDSU/UCSD), San Diego, CA, USA. 4. Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, USA.
Abstract
OBJECTIVE: The purpose of this study was to evaluate relationships between multiple mild traumatic brain injuries (mTBIs) and objective and subjective clinical outcomes in a sample of combat-exposed Veterans, adjusting for psychiatric distress and combat exposure. METHOD: In this cross-sectional study, 73 combat-exposed Iraq/Afghanistan Veterans were divided into three groups based on mTBI history: 0 mTBIs (n = 31), 1-2 mTBIs (n = 21), and 3+ mTBIs (n = 21). Veterans with mTBI were assessed, on average, 7.78 years following their most recent mTBI. Participants underwent neuropsychological testing and completed self-report measures assessing neurobehavioral, sleep, and pain symptoms. RESULTS: MANCOVAs adjusting for psychiatric distress and combat exposure showed no group differences on objective measures of attention/working memory, executive functioning, memory, and processing speed (all p's > .05; ηp2 = .00-.06). In contrast, there were significant group differences on neurobehavioral symptoms (p's = < .001-.036; ηp2 = .09-.43), sleep difficulties (p = .037; ηp2 = .09), and pain symptoms (p < .001; ηp2 = .21). Pairwise comparisons generally showed that the 3+ mTBI group self-reported the most severe symptoms, followed by comparable symptom reporting between the 0 and 1-2 mTBI groups. CONCLUSIONS: History of multiple, remote mTBIs is associated with elevated subjective symptoms but not objective neuropsychological functioning in combat-exposed Veterans. These results advance understanding of the long-term consequences of repetitive mTBI in this population and suggest that Veterans with 3+ mTBIs may especially benefit from tailored treatments aimed at ameliorating specific neurobehavioral, sleep, and pain symptoms. Published by Oxford University Press 2020.
OBJECTIVE: The purpose of this study was to evaluate relationships between multiple mild traumatic brain injuries (mTBIs) and objective and subjective clinical outcomes in a sample of combat-exposed Veterans, adjusting for psychiatric distress and combat exposure. METHOD: In this cross-sectional study, 73 combat-exposed Iraq/Afghanistan Veterans were divided into three groups based on mTBI history: 0 mTBIs (n = 31), 1-2 mTBIs (n = 21), and 3+ mTBIs (n = 21). Veterans with mTBI were assessed, on average, 7.78 years following their most recent mTBI. Participants underwent neuropsychological testing and completed self-report measures assessing neurobehavioral, sleep, and pain symptoms. RESULTS:MANCOVAs adjusting for psychiatric distress and combat exposure showed no group differences on objective measures of attention/working memory, executive functioning, memory, and processing speed (all p's > .05; ηp2 = .00-.06). In contrast, there were significant group differences on neurobehavioral symptoms (p's = < .001-.036; ηp2 = .09-.43), sleep difficulties (p = .037; ηp2 = .09), and pain symptoms (p < .001; ηp2 = .21). Pairwise comparisons generally showed that the 3+ mTBI group self-reported the most severe symptoms, followed by comparable symptom reporting between the 0 and 1-2 mTBI groups. CONCLUSIONS: History of multiple, remote mTBIs is associated with elevated subjective symptoms but not objective neuropsychological functioning in combat-exposed Veterans. These results advance understanding of the long-term consequences of repetitive mTBI in this population and suggest that Veterans with 3+ mTBIs may especially benefit from tailored treatments aimed at ameliorating specific neurobehavioral, sleep, and pain symptoms. Published by Oxford University Press 2020.
Authors: Scott F Sorg; Madeleine L Werhane; Victoria C Merritt; Alexandra L Clark; Kelsey A Holiday; Karen L Hanson; Amy J Jak; Dawn M Schiehser; Lisa Delano-Wood Journal: J Head Trauma Rehabil Date: 2021 Nov-Dec 01 Impact factor: 2.710
Authors: Oshin Vartanian; Catherine Tenn; Shawn G Rhind; Ann Nakashima; Alex P Di Battista; Lauren E Sergio; Diana J Gorbet; Douglas D Fraser; Angela Colantonio; Kristen King; Quan Lam; Doug Saunders; Rakesh Jetly Journal: Front Neurol Date: 2020-12-03 Impact factor: 4.003
Authors: Heather R Siedhoff; Shanyan Chen; Hailong Song; Jiankun Cui; Ibolja Cernak; David X Cifu; Ralph G DePalma; Zezong Gu Journal: Front Neurol Date: 2022-01-13 Impact factor: 4.003