Cognitive Change Associated with Self-Reported Mild Traumatic Brain Injury Sustained During the OEF/OIF Conflicts

• Published in: Clinical neuropsychologist 2012-01, Vol.26 (3), p.473-489
• Main Authors: Roebuck-Spencer, Tresa M., Vincent, Andrea S., Twillie, David A., Logan, Bret W., Lopez, Mary, Friedl, Karl E., Grate, Stephen J., Schlegel, Robert E., Gilliland, Kirby
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Afghan Campaign 2001; ANAM; Biological and medical sciences; Brain Injuries - complications; Brain Injuries - psychology; Cognition Disorders - diagnosis; Cognition Disorders - etiology; Computerized testing; Female; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; Iraq War, 2003-2011; Male; Medical sciences; Mild traumatic brain injury; Military deployment; Military TBI; Neuropsychological Tests; Organic mental disorders. Neuropsychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Self Report; Trauma Severity Indices; Traumas. Diseases due to physical agents; Young Adult
• ISSN: 1385-4046; 1744-4144
• DOI: 10.1080/13854046.2011.650214

Traumatic brain injury (TBI) has received much attention due to high rates of this injury in Service Members returning from the Iraq/Afghanistan conflicts. This study examined cognitive performance in Service Members tested with ANAM prior to and following deployment. The sample was divided into a control group (n = 400) reporting no TBI injury prior to or during most recent deployment, and a group who self-reported a TBI injury (n = 502) during most recent deployment. This latter group was divided further based on self-report of post-concussion symptoms at post-deployment testing. All three groups performed similarly at pre-deployment. The group reporting TBI with active symptoms performed worst at post-deployment and included the highest percentage of individuals showing significant decline in cognitive performance over time (30.5%). A small sample of symptomatic individuals with a non-TBI reported injury did not demonstrate similar declines in performance, suggesting that active symptoms alone cannot account for these findings. Of those reporting a TBI injury during deployment, 70% demonstrated no significant change in cognitive performance compared with baseline. Although the exact etiology of observed declines is uncertain, findings indicate that individuals who self-report TBI during deployment with active symptomatology at post-deployment are at greatest risk for declines in cognitive performance. These individuals can be identified using self-report and brief computer-based testing. Importantly, the majority of active-duty individuals reporting TBI during deployment do not present with lasting significant cognitive impairment, a finding consistent with the civilian literature on mild TBI.