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Neuropsychological Profiles of Deployment-Related Mild Traumatic Brain Injury: A LIMBIC-CENC Study
Nicola L de Souza1, Hannah M Lindsey1, Katherine Dorman1
1From the Department of Rehabilitation and Human Performance (N.L.D., K.D., C.E.), Icahn School of Medicine at Mount Sinai, New York, NY; Traumatic Brain Injury and Concussion Center (H.M.L., E.L.D., D.F.T., E.A.W.), Department of Neurology, University of Utah School of Medicine, Salt Lake City; George E. Wahlen VA Salt Lake City Healthcare System (H.M.L., E.L.D., D.F.T., E.A.W.), UT; VA Salt Lake City Health Care System (E.K., M.J.V.P.), Informatics, Decision-Enhancement and Analytic Sciences Center, UT; Department of Medicine (E.K., M.J.V.P.), Division of Epidemiology, University of Utah School of Medicine, Salt Lake City; Michael E. DeBakey VA Medical Center (D.S.M., R.S.S., M.T.), Houston, TX; The Menninger Psychiatric and Behavioral Services Department (D.S.M.), Baylor College of Medicine, Houston, TX; Department of Interdisciplinary Studies (J.S.P., Y.J.), School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ; Department of Physical Medicine and Rehabilitation (W.C.W., D.X.C.), School of Medicine, Virginia Commonwealth University, Richmond; Physical Medicine and Rehabilitation Service (W.C.W., D.X.C.), Richmond Veterans Affairs Medical Center, VA; Traumatic Brain Injury Center of Excellence (J.M.B.), Bethesda, MD; Naval Hospital Camp Pendleton (J.M.B.), Camp Pendleton, CA; General Dynamics Information Technology (J.M.B.), Fairfax, VA; Minneapolis VA Health Care System (N.D.D.), MN; Department of Psychiatry and Behavioral Sciences (N.D.D., S.R.S.), University of Minnesota, Minneapolis; Research and Academic Affairs Service Line (S.L.M., J.A.R.), W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC; Department of Translational Neuroscience (S.L.M., J.A.R.), Wake Forest School of Medicine, Winston-Salem, NC; VA Portland Health Care System (M.O.), Portland, OR; Oregon Health & Science University (M.O.), Department of Psychiatry and Department of Medicine Informatics and Clinical Epidemiology, Portland; Mid-Atlantic (VISN-6) Mental Illness Research, Education, and Clinical Center (MIRECC) (S.L.M., J.A.R.), Durham, NC; Department of Neurobiology and Anatomy (J.A.R.), Wake Forest School of Medicine, Winston-Salem, NC; H. Ben Taub Department of Physical Medicine and Rehabilitation (R.S.S., M.T.), Baylor College of Medicine, Houston, TX; Minneapolis VA Health Care System (S.R.S.), MN.
Service members and veterans with mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) exhibit distinct neuropsychological profiles. Understanding these profiles, influenced by injury context and PTSD comorbidity, is crucial for targeted treatment and improved recovery outcomes.
Area of Science:
- Neuroscience
- Military Medicine
- Psychotraumatology
Background:
- Traumatic brain injury (TBI) presents a significant health concern for US service members and veterans (SMV), often resulting in diverse psychological and cognitive challenges.
- Identifying distinct neuropsychological profiles associated with mild TBI (mTBI) and posttraumatic stress disorder (PTSD) is critical for understanding heterogeneous outcomes in this population.
Purpose of the Study:
- To identify and characterize neuropsychological profiles among a large cohort of US service members and veterans (SMV) with mild TBI (mTBI) and/or posttraumatic stress disorder (PTSD).
- To examine the associations between demographic variables, mTBI characteristics, and PTSD symptoms with identified symptom profiles.
Main Methods:
- Analysis of cross-sectional baseline data from 1,659 SMV enrolled in a prospective longitudinal study.
- Latent profile analysis utilized 35 indicators, including physical symptoms, depression, quality of life, sleep, postconcussive symptoms, and cognitive performance, to identify symptom profiles independently of mTBI and PTSD status.
- Subsequent examination of associations between demographic factors, mTBI history (deployment-related vs. non-deployment-related), and probable PTSD with profile membership.
Main Results:
- A 6-profile model demonstrated the best fit, categorizing SMV based on self-reported functioning (high, moderate, low) and cognitive performance (high, low).
- SMV with deployment-related mTBI were more likely to be in lower functioning profiles and meet criteria for probable PTSD.
- Conversely, SMV without mTBI or with non-deployment-related mTBI were predominantly in higher functioning profiles with a lower likelihood of probable PTSD.
Conclusions:
- Distinct neuropsychological profiles exist within the SMV population, influenced by the context of injury and the presence of probable PTSD.
- Comprehensive assessment of functioning and cognition can reveal subtle differences related to mTBI and PTSD, aiding in the identification of these profiles.
- Tailoring early treatment strategies based on identified neuropsychological profiles may enhance prognostication and facilitate recovery for SMV.
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