Assessment of Neuropsychological Function in Veterans With Blast-Related Mild Traumatic Brain Injury and Subconcussive Blast Exposure

Frontiers in Psychology

article

Ashley N. Clausen¹  Heather C. Bouchard²  VA Mid-Atlantic MIRECC Workgroup²  Kathleen A. Welsh-Bohmer⁴  Rajendra A. Morey² 

[1] Kansas City VA Medical Center, United States;Duke-University of North Carolina at Chapel Hill Brain Imaging and Analysis Center, Duke University, United States;VA Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham Veteran Affairs Healthcare System, United States;Department of Psychiatry and Behavioral Sciences, Duke University, United States;Center for Cognitive Neuroscience, Duke University, United States

关键词: subconcussive;    traumatic brain injury;    neuropsychological function;    military;    cognition;    head injuries;    blast concussion;   

DOI  :  10.3389/fpsyg.2021.686330

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

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.

【 授权许可】

CC BY