title: Cognitive change associated with self-reported mild traumatic brain injury sustained during the OEF/OIF conflicts.
abstract: Traumatic brain injury (TBI) has received much attention due to high rates of this injury in Service Members returning from the Iraq/Afghanistan conflicts. This study examined cognitive performance in Service Members tested with ANAM prior to and following deployment. The sample was divided into a control group (n=400) reporting no TBI injury prior to or during most recent deployment, and a group who self-reported a TBI injury (n=502) during most recent deployment. This latter group was divided further based on self-report of post-concussion symptoms at post-deployment testing. All three groups performed similarly at pre-deployment. The group reporting TBI with active symptoms performed worst at post-deployment and included the highest percentage of individuals showing significant decline in cognitive performance over time (30.5%). A small sample of symptomatic individuals with a non-TBI reported injury did not demonstrate similar declines in performance, suggesting that active symptoms alone cannot account for these findings. Of those reporting a TBI injury during deployment, 70% demonstrated no significant change in cognitive performance compared with baseline. Although the exact etiology of observed declines is uncertain, findings indicate that individuals who self-report TBI during deployment with active symptomatology at post-deployment are at greatest risk for declines in cognitive performance. These individuals can be identified using self-report and brief computer-based testing. Importantly, the majority of active-duty individuals reporting TBI during deployment do not present with lasting significant cognitive impairment, a finding consistent with the civilian literature on mild TBI.
authors.affiliation: Cognitive Science Research Center (CSRC), University of Oklahoma, Norman, OK 73072, USA. tresa@ou.edu
authors.forename: Tresa M
authors.initials: TM
authors.lastname: Roebuck-Spencer
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Vincent
authors.forename: David A
authors.initials: DA
authors.lastname: Twillie
authors.forename: Bret W
authors.initials: BW
authors.lastname: Logan
authors.forename: Mary
authors.initials: M
authors.lastname: Lopez
authors.forename: Karl E
authors.initials: KE
authors.lastname: Friedl
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Grate
authors.forename: Robert E
authors.initials: RE
authors.lastname: Schlegel
authors.forename: Kirby
authors.initials: K
authors.lastname: Gilliland
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001930:Brain Injuries / Q000150:complications* / Q000523:psychology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D009483:Neuropsychological Tests; D057566:Self Report; D015599:Trauma Severity Indices; D055815:Young Adult