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Neuropsychological Performance and Functional Capacity Following Mild Traumatic Brain Injury in Veterans
Jillian M R Clark1, Zanjbeel Mahmood, Amy J Jak
1Center of Excellence for Stress and Mental Health (Drs Clark, Jak, and Twamley), Mental Health Service (Drs Clark and Jak), and Research Service (Ms Mahmood and Dr Twamley), VA San Diego Healthcare System, San Diego, California; Department of Psychiatry, University of California San Diego, La Jolla (Drs Jak and Twamley); SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California (Ms Mahmood); VA Portland Health Care System, Portland, Oregon (Drs Huckans, O'Neil, Roost, and Storzbach); Department of Psychiatry, Oregon Health & Science University, Portland (Drs Huckans, O'Neil, Roost); VA Puget Sound Health Care System, Seattle, Washington (Drs Williams, Turner, and Pagulayan); Departments of Rehabilitation Medicine (Drs Williams and Turner) and Psychiatry and Behavioral Sciences (Dr Pagulayan), University of Washington School of Medicine, Seattle.
Mild traumatic brain injury (mTBI) is linked to reduced functional capacity in veterans. Improving verbal memory skills may enhance daily functioning after mTBI.
Area of Science:
- Neuroscience
- Psychology
- Rehabilitation Medicine
Background:
- Mild traumatic brain injury (mTBI) is common in military veterans and can lead to persistent cognitive and functional deficits.
- Understanding the relationship between cognitive impairments and functional capacity is crucial for effective rehabilitation strategies.
Purpose of the Study:
- To investigate the association between neuropsychological functioning and performance-based functional capacity in veterans with mTBI.
- To explore the moderating roles of age and psychiatric symptoms (PTSD, depression) in this relationship.
Main Methods:
- A cross-sectional analysis of 119 Iraq/Afghanistan veterans with a history of mTBI was conducted.
- Neuropsychological performance was assessed using a global deficit score (GDS).
- Functional capacity was measured using the UCSD Performance-based Skills Assessment-Brief, with PTSD and depression symptoms also evaluated.
Main Results:
- Worse neuropsychological performance (higher GDS) and greater PTSD symptom severity correlated with poorer communication and overall functional capacity.
- The global deficit score (GDS) was a significant predictor of functional capacity, independent of PTSD symptom severity.
- Verbal learning and memory performance was the strongest neuropsychological predictor of functional capacity.
Conclusions:
- Neuropsychological functioning, particularly in verbal learning and memory, is moderately associated with performance-based functional capacity in veterans with mTBI.
- Interventions targeting verbal memory may improve functional capacity in this population, even when accounting for PTSD symptoms.
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