Post-Traumatic Stress Disorder Symptoms Are Related to Cognition after Complicated Mild and Moderate Traumatic Brain Injury but Not Severe and Penetrating Traumatic Brain Injury

French, Louis M.; Brickell, Tracey A.; Driscoll, A; Glazer, Megan E; Tippett, Corie E.; Sullivan, Jamie; Lange, Rael T.

doi:10.1089/neu.2021.0120

Cited by 6 publications

(4 citation statements)

References 47 publications

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“…In addition, difficulties with executive functioning and concentration have been found to be predictive of the exacerbation of PTSD symptoms in veterans (Mota et al., 2016). Studies from our research group have also demonstrated associations between PTSD and worse objective cognitive performance (Lange et al., 2021; Lippa et al., 2021), a higher number of subjective cognitive complaints (Lange et al., 2020), and neurodegeneration as measured using blood‐based biomarkers (Pattinson et al., 2019) following TBI. It is plausible that subjective complaints of memory or attention may be early warning signs of a decline in a person's overall mental health and, in particular, early signs of the development of PTSD symptoms following a single traumatic event (e.g., motor vehicle accident) or multiple traumatic events over time (e.g., repeatedly witnessing fellow service members injured or killed in combat).…”

Section: Discussionmentioning

confidence: 79%

“…Concurrent traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) is common in military service members and veterans (SMVs; Lange et al., 2020). There is an accumulating body of evidence demonstrating that PTSD plays an important role in influencing outcomes following TBI (Lippa et al., 2021; Pattinson et al., 2019) and has a stronger influence on neurobehavioral outcomes following TBI than the severity of the TBI itself (Lange et al., 2020). As such, it is of particular interest to identify risk factors for PTSD to help identify targets for early clinical intervention in a TBI population.…”

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confidence: 99%

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Risk factors for the presence and persistence of posttraumatic stress symptoms following traumatic brain injury in U.S. service members and veterans

Lange

French

Baschenis

et al. 2022

Journal of Traumatic Stress

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This study aimed to identify risk factors predictive of the presence and persistence of posttraumatic stress disorder (PTSD) symptom reporting following traumatic brain injury (TBI). Participants were 1,301 U.S. service members and veterans (SMVs) divided into four groups: uncomplicated mild TBI (mTBI; n = 543); complicated mild, moderate, severe, and penetrating TBI (n = 230); injured controls (n = 340); and noninjured controls (n = 188). We examined 25 factors related to demographic, injury-related, military-specific, treatment/health care need, and mental health/social support variables. Seven factors were statistically associated with the presence of DSM-IV-TR symptom criteria for PTSD: premorbid IQ, combat exposure, depression, social participation, history of mTBI, need for managing mood and stress, and need for improving memory and attention, p < .001 (51.3% variance). When comparing the prevalence of these risk factors in a longitudinal cohort (n = 742) across four PTSD trajectory groups (i.e., asymptomatic, improved, developed, persistent), a higher proportion of participants in the persistent PTSD group reported worse depression, a lack of social participation, and history of mTBI. Additionally, a higher proportion of participants in the persistent and developed PTSD groups reported the need for managing mood/stress and improving memory/attention. When considered simultaneously, the presence of ≥ 1 or ≥ 2 risk factors was associated with a higher proportion of participants in the developed and persistent PTSD groups, ps < .001. These risk factors may be useful in identifying SMVs at risk for the development and/or persistence of PTSD symptoms who may need intervention.

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Section: Discussionmentioning

confidence: 79%

mentioning

confidence: 99%

Risk factors for the presence and persistence of posttraumatic stress symptoms following traumatic brain injury in U.S. service members and veterans

Lange

French

Baschenis

et al. 2022

Journal of Traumatic Stress

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“…S.M. Lippa et al [4], studying PTSD symptoms associated with cognitive function after TBI, found that the [21] demonstrated neuroimaging indicators of the combined effect of TBI and PTSD on the white matter of the brain in the form of a larger number of spatially heterogeneous areas of abnormally low fractional anisotropy, or "potholes", which was found in veterans with a history of mild TBI and was not associated with age, time after injury, PTSD, mood disorders or alcohol use with harmful effects [20][21][22]. However, A.R.…”

Section: Resultsmentioning

confidence: 99%

Influence of cognitive functioning on the effectiveness of treatment of veterans with post-traumatic stress disorder and mild traumatic brain injury

Smashna

2023

ijmmr

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A history of traumatic brain injury in veterans is associated with higher use of mental health services, regardless of psychiatric diagnoses, which makes it important to develop a comprehensive approach to treatment and evaluate its effectiveness. The study aimed to investigate the impact of cognitive functioning among 329 veterans with comorbid post-traumatic stress disorder and mild traumatic brain injury on the effectiveness of combination therapy. The following tests were used to assess cognitive functioning: the Ray-Osterritz test, the Symbolic Communication Test, the Stroop test, and the Verbal Fluency Test. Functioning was assessed using the World Health Organization Questionnaire for the Assessment of Disability. The effectiveness of the combination therapy was also assessed using the Four-Dimensional Symptom Inventory. The influence of cognitive functioning on the effectiveness of 8-week complex therapy for veterans with this comorbidity was confirmed. The results of the Trail Making Test had statistically significant negative correlations with the cognitive sphere scale (ρ = -0.237; p = 0.0117) and the integral index of the World Health Organization questionnaire for the assessment of disability (ρ= -0.192; p = 0.0424), as well as positive correlations with the scales of self-care (ρ = 0.2038; p = 0.0311) and daily activity (ρ = 0.2048; p = 0.0303). It was found that patients with post-traumatic stress disorder, mild traumatic brain injury and their comorbidity responded differently to therapy, which was determined by the clinical features of their cognitive processes, namely associative performance, control rigidity/flexibility, attention, working memory and executive function. The dynamics of cognitive functioning differed in each group. It was also found that cognitive symptoms were targeted by therapy, as evidenced by their reduction after the intervention. The data obtained will allow for a more efficient and comprehensive organization of specialised psychiatric care for veterans, and cognitive functioning is predictive of the effectiveness and duration of treatment

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“…Although the common definition of TBI entails a mechanical injury to the skull and brain tissue, a mild form of TBI that manifests without visible physical deformation of the skull has been well documented. Indeed, mild TBI is much more rampant in our soldiers and veterans [ 19 , 20 , 21 ]. Long-term symptoms of mild TBI may include chronic traumatic encephalopathy [ 22 ], Alzheimer’s disease [ 23 ], post-traumatic stress syndrome [ 24 ], and a realm of many symptoms of neurodegenerative disorders [ 25 ].…”

Section: Traumatic Brain Injury and Inflammationmentioning

confidence: 99%

Stem Cell Therapy for Sequestration of Traumatic Brain Injury-Induced Inflammation

Borlongan

Rosi

2022

IJMS

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Traumatic brain injury (TBI) is one of the leading causes of long-term neurological disabilities in the world. TBI is a signature disease for soldiers and veterans, but also affects civilians, including adults and children. Following TBI, the brain resident and immune cells turn into a “reactive” state, characterized by the production of inflammatory mediators that contribute to the development of cognitive deficits. Other injuries to the brain, including radiation exposure, may trigger TBI-like pathology, characterized by inflammation. Currently there are no treatments to prevent or reverse the deleterious consequences of brain trauma. The recognition that TBI predisposes stem cell alterations suggests that stem cell-based therapies stand as a potential treatment for TBI. Here, we discuss the inflamed brain after TBI and radiation injury. We further review the status of stem cells in the inflamed brain and the applications of cell therapy in sequestering inflammation in TBI.

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Post-Traumatic Stress Disorder Symptoms Are Related to Cognition after Complicated Mild and Moderate Traumatic Brain Injury but Not Severe and Penetrating Traumatic Brain Injury

Cited by 6 publications

References 47 publications

Risk factors for the presence and persistence of posttraumatic stress symptoms following traumatic brain injury in U.S. service members and veterans

Risk factors for the presence and persistence of posttraumatic stress symptoms following traumatic brain injury in U.S. service members and veterans

Influence of cognitive functioning on the effectiveness of treatment of veterans with post-traumatic stress disorder and mild traumatic brain injury

Stem Cell Therapy for Sequestration of Traumatic Brain Injury-Induced Inflammation

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