Assessment of Neuropsychological Function in Veterans With Blast-Related Mild Traumatic Brain Injury and Subconcussive Blast Exposure
Objective: The majority of combat-related head injuries are associated with blast exposure. While Veterans with mild traumatic brain injury (mTBI) report cognitive complaints and exhibit poorer neuropsychological performance, there is little evidence examining the effects of subconcussive blast expo...
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2021-06-01
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doaj-8284f9a161a64f7c8b7b2654365633e82021-06-28T06:51:33ZengFrontiers Media S.A.Frontiers in Psychology1664-10782021-06-011210.3389/fpsyg.2021.686330686330Assessment of Neuropsychological Function in Veterans With Blast-Related Mild Traumatic Brain Injury and Subconcussive Blast ExposureAshley N. Clausen0Ashley N. Clausen1Ashley N. Clausen2Heather C. Bouchard3Heather C. Bouchard4VA Mid-Atlantic MIRECC Workgroup5Kathleen A. Welsh-Bohmer6Rajendra A. Morey7Rajendra A. Morey8Rajendra A. Morey9Rajendra A. Morey10Kansas City VA Medical Center, Kansas City, MO, United StatesDuke-University of North Carolina at Chapel Hill Brain Imaging and Analysis Center, Duke University, Durham, NC, United StatesVA Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham Veteran Affairs Healthcare System, Durham, NC, United StatesDuke-University of North Carolina at Chapel Hill Brain Imaging and Analysis Center, Duke University, Durham, NC, United StatesVA Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham Veteran Affairs Healthcare System, Durham, NC, United StatesDuke-University of North Carolina at Chapel Hill Brain Imaging and Analysis Center, Duke University, Durham, NC, United StatesDepartment of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, United StatesDuke-University of North Carolina at Chapel Hill Brain Imaging and Analysis Center, Duke University, Durham, NC, United StatesVA Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham Veteran Affairs Healthcare System, Durham, NC, United StatesDepartment of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, United StatesCenter for Cognitive Neuroscience, Duke University, Durham, NC, United StatesObjective: The majority of combat-related head injuries are associated with blast exposure. While Veterans with mild traumatic brain injury (mTBI) report cognitive complaints and exhibit poorer neuropsychological performance, there is little evidence examining the effects of subconcussive blast exposure, which does not meet clinical symptom criteria for mTBI during the acute period following exposure. We compared chronic effects of combat-related blast mTBI and combat-related subconcussive blast exposure on neuropsychological performance in Veterans.Methods: Post-9/11 Veterans with combat-related subconcussive blast exposure (n = 33), combat-related blast mTBI (n = 26), and controls (n = 33) without combat-related blast exposure, completed neuropsychological assessments of intellectual and executive functioning, processing speed, and working memory via NIH toolbox, assessment of clinical psychopathology, a retrospective account of blast exposures and non-blast-related head injuries, and self-reported current medication. Huber Robust Regressions were employed to compare neuropsychological performance across groups.Results: Veterans with combat-related blast mTBI and subconcussive blast exposure displayed significantly slower processing speed compared with controls. After adjusting for post-traumatic stress disorder and depressive symptoms, those with combat-related mTBI exhibited slower processing speed than controls.Conclusion: Veterans in the combat-related blast mTBI group exhibited slower processing speed relative to controls even when controlling for PTSD and depression. Cognition did not significantly differ between subconcussive and control groups or subconcussive and combat-related blast mTBI groups. Results suggest neurocognitive assessment may not be sensitive enough to detect long-term effects of subconcussive blast exposure, or that psychiatric symptoms may better account for cognitive sequelae following combat-related subconcussive blast exposure or combat-related blast mTBI.https://www.frontiersin.org/articles/10.3389/fpsyg.2021.686330/fullsubconcussivetraumatic brain injuryneuropsychological functionmilitarycognitionhead injuries |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ashley N. Clausen Ashley N. Clausen Ashley N. Clausen Heather C. Bouchard Heather C. Bouchard VA Mid-Atlantic MIRECC Workgroup Kathleen A. Welsh-Bohmer Rajendra A. Morey Rajendra A. Morey Rajendra A. Morey Rajendra A. Morey |
spellingShingle |
Ashley N. Clausen Ashley N. Clausen Ashley N. Clausen Heather C. Bouchard Heather C. Bouchard VA Mid-Atlantic MIRECC Workgroup Kathleen A. Welsh-Bohmer Rajendra A. Morey Rajendra A. Morey Rajendra A. Morey Rajendra A. Morey Assessment of Neuropsychological Function in Veterans With Blast-Related Mild Traumatic Brain Injury and Subconcussive Blast Exposure Frontiers in Psychology subconcussive traumatic brain injury neuropsychological function military cognition head injuries |
author_facet |
Ashley N. Clausen Ashley N. Clausen Ashley N. Clausen Heather C. Bouchard Heather C. Bouchard VA Mid-Atlantic MIRECC Workgroup Kathleen A. Welsh-Bohmer Rajendra A. Morey Rajendra A. Morey Rajendra A. Morey Rajendra A. Morey |
author_sort |
Ashley N. Clausen |
title |
Assessment of Neuropsychological Function in Veterans With Blast-Related Mild Traumatic Brain Injury and Subconcussive Blast Exposure |
title_short |
Assessment of Neuropsychological Function in Veterans With Blast-Related Mild Traumatic Brain Injury and Subconcussive Blast Exposure |
title_full |
Assessment of Neuropsychological Function in Veterans With Blast-Related Mild Traumatic Brain Injury and Subconcussive Blast Exposure |
title_fullStr |
Assessment of Neuropsychological Function in Veterans With Blast-Related Mild Traumatic Brain Injury and Subconcussive Blast Exposure |
title_full_unstemmed |
Assessment of Neuropsychological Function in Veterans With Blast-Related Mild Traumatic Brain Injury and Subconcussive Blast Exposure |
title_sort |
assessment of neuropsychological function in veterans with blast-related mild traumatic brain injury and subconcussive blast exposure |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Psychology |
issn |
1664-1078 |
publishDate |
2021-06-01 |
description |
Objective: The majority of combat-related head injuries are associated with blast exposure. While Veterans with mild traumatic brain injury (mTBI) report cognitive complaints and exhibit poorer neuropsychological performance, there is little evidence examining the effects of subconcussive blast exposure, which does not meet clinical symptom criteria for mTBI during the acute period following exposure. We compared chronic effects of combat-related blast mTBI and combat-related subconcussive blast exposure on neuropsychological performance in Veterans.Methods: Post-9/11 Veterans with combat-related subconcussive blast exposure (n = 33), combat-related blast mTBI (n = 26), and controls (n = 33) without combat-related blast exposure, completed neuropsychological assessments of intellectual and executive functioning, processing speed, and working memory via NIH toolbox, assessment of clinical psychopathology, a retrospective account of blast exposures and non-blast-related head injuries, and self-reported current medication. Huber Robust Regressions were employed to compare neuropsychological performance across groups.Results: Veterans with combat-related blast mTBI and subconcussive blast exposure displayed significantly slower processing speed compared with controls. After adjusting for post-traumatic stress disorder and depressive symptoms, those with combat-related mTBI exhibited slower processing speed than controls.Conclusion: Veterans in the combat-related blast mTBI group exhibited slower processing speed relative to controls even when controlling for PTSD and depression. Cognition did not significantly differ between subconcussive and control groups or subconcussive and combat-related blast mTBI groups. Results suggest neurocognitive assessment may not be sensitive enough to detect long-term effects of subconcussive blast exposure, or that psychiatric symptoms may better account for cognitive sequelae following combat-related subconcussive blast exposure or combat-related blast mTBI. |
topic |
subconcussive traumatic brain injury neuropsychological function military cognition head injuries |
url |
https://www.frontiersin.org/articles/10.3389/fpsyg.2021.686330/full |
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