title: Comparing the Neuropsychological Test Performance of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans with and without Blast Exposure, Mild Traumatic Brain Injury, and Posttraumatic Stress Symptoms.
abstract: To compare neuropsychological test performance of Veterans with and without mild traumatic brain injury (MTBI), blast exposure, and posttraumatic stress disorder (PTSD) symptoms. We compared the neuropsychological test performance of 49 Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans diagnosed with MTBI resulting from combat blast-exposure to that of 20 blast-exposed OEF/OIF Veterans without history of MTBI, 23 OEF/OIF Veterans with no blast exposure or MTBI history, and 40 matched civilian controls. Comparison of neuropsychological test performance across all four participant groups showed a complex pattern of mixed significant and mostly nonsignificant results, with omnibus tests significant for measures of attention, spatial abilities, and executive function. The most consistent pattern was the absence of significant differences between blast-exposed Veterans with MTBI history and blast-exposed Veterans without MTBI history. When blast-exposed Veteran groups with and without MTBI history were aggregated and compared to non-blast-exposed Veterans, there were significant differences for some measures of learning and memory, spatial abilities, and executive function. However, covariation for severity of PTSD symptoms eliminated all significant omnibus neuropsychological differences between Veteran groups. Our results suggest that, although some mild neurocognitive effects were associated with blast exposure, these neurocognitive effects might be better explained by PTSD symptom severity rather than blast exposure or MTBI history alone.
authors.affiliation: 1Portland VA Medical Center,Portland,Oregon.
authors.forename: Daniel
authors.initials: D
authors.lastname: Storzbach
authors.affiliation: 1Portland VA Medical Center,Portland,Oregon.
authors.forename: Maya Elin
authors.identifier: http://orcid.org/0000-0002-6436-444X
authors.initials: ME
authors.lastname: O'Neil
authors.affiliation: 1Portland VA Medical Center,Portland,Oregon.
authors.forename: Saw-Myo
authors.initials: SM
authors.lastname: Roost
authors.affiliation: 1Portland VA Medical Center,Portland,Oregon.
authors.forename: Halina
authors.initials: H
authors.lastname: Kowalski
authors.affiliation: 5Department of Physical Medicine and Rehabilitation,Harvard Medical School,Boston,Massachusetts.
authors.forename: Grant L
authors.initials: GL
authors.lastname: Iverson
authors.affiliation: 2Oregon Health & Science University Department of Psychiatry,Portland,Oregon.
authors.forename: Laurence M
authors.initials: LM
authors.lastname: Binder
authors.affiliation: 9Department of Psychiatry and Behavioral Sciences,University of Washington,Seattle,Washington.
authors.forename: Jesse R
authors.initials: JR
authors.lastname: Fann
authors.affiliation: 1Portland VA Medical Center,Portland,Oregon.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Huckans
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000704:Analysis of Variance; D001753:Blast Injuries / Q000150:complications; D001930:Brain Injuries / Q000150:complications* / Q000209:etiology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000209:etiology; D015599:Trauma Severity Indices; D014728:Veterans
keywords: Blast injuries; Brain injuries; Cognitive symptoms; Combat disorders; Explosions; Military personnel; Post-traumatic; Stress disorders