title: Neuropsychological outcome from blast versus non-blast: mild traumatic brain injury in U.S. military service members.
abstract: The purpose of this study was to compare the neuropsychological outcome from blast-related versus non-blast related mild traumatic brain injury (MTBI). Participants were 56 U.S. military service members who sustained an MTBI, divided into two groups based on mechanism of injury: (a) non-blast related (Non-blast; n = 21), and (b) blast plus secondary blunt trauma (Blast Plus; n = 35). All participants had sustained their injury in theatre whilst deployed during Operation Iraqi Freedom or Operation Enduring Freedom. Patients had been seen for neuropsychological evaluation at Walter Reed Army Medical Center on average 4.4 months (SD = 4.1) post-injury. Measures included 14 clinical scales from the Personality Assessment Inventory (PAI) and 12 common neurocognitive measures. For the PAI, there were no significant differences between groups on all scales (p > .05). However, medium effect sizes were found for the Depression (d = .49) and Stress (d = .47) scales (i.e., Blast Plus > Non-blast). On the neurocognitive measures, after controlling for the influence of psychological distress (i.e., Depression, Stress), there were no differences between the Non-blast and Blast Plus groups on all measures. These findings provide little evidence to suggest that blast exposure plus secondary blunt trauma results in worse cognitive or psychological recovery than blunt trauma alone. (JINS, 2012, 18, 595-605).
authors.affiliation: Department of Research, Defense and Veterans Brain Injury Center, North Bethesda, Maryland 20852, USA. rlange@dvbic.org
authors.forename: Rael T
authors.initials: RT
authors.lastname: Lange
authors.forename: Sonal
authors.initials: S
authors.lastname: Pancholi
authors.forename: Tracey A
authors.initials: TA
authors.lastname: Brickell
authors.forename: Sara
authors.initials: S
authors.lastname: Sakura
authors.forename: Aditya
authors.initials: A
authors.lastname: Bhagwat
authors.forename: Victoria
authors.initials: V
authors.lastname: Merritt
authors.forename: Louis M
authors.initials: LM
authors.lastname: French
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000704:Analysis of Variance; D001753:Blast Injuries / Q000150:complications* / Q000523:psychology; D001930:Brain Injuries / Q000150:complications* / Q000209:etiology / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006772:Hospitals, Military / Q000706:statistics & numerical data; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008889:Military Personnel; D009483:Neuropsychological Tests; D010555:Personality Inventory; D014481:United States; D055815:Young Adult