CHARLOTTESVILLE, VA — Recovery from mild traumatic brain injury (mTBI) and posttraumatic stress, which are prevalent in military servicemembers, is complicated because the conditions share objective and subjective cognitive symptoms.
A recent study investigated the effects of remote mTBI characteristics and current posttraumatic stress symptoms on neuropsychological performance in 152 veterans with a history of remote mTBI and current cognitive concerns.
For the study, published in the Journal of Neuropsychology, participants completed clinical neuropsychological evaluations within a VAs Level-II TBI/Polytrauma outpatient clinic (i.e., a tertiary trauma-care center for U.S. military veterans outside a research or teaching hospital setting).1
The University of Virginia Health System-led study team conducted archival data analysis of mTBI injury characteristics, clinical diagnoses, scores on the Posttraumatic Stress Disorder Checklist-Military Version (PCL-M) and performance on tests of processing speed, attention and executive function. The VA St. Louis Healthcare System and the Rocky Mountain Network Clinical Resource Hub at the VA Salt Lake City Health Care System also participated in the research.
“Hierarchical linear regression demonstrated that elevated PCL-M scores were associated with slower performance on trail making test (TMT) Parts A and B (p < .016),” the authors wrote. “PCL-M symptoms moderated the effect of alteration of consciousness (AOC) on TMT performance, with endorsement of AOC associated with better performance, but only when PCL-M scores were high (p < .005).”
They added that “follow-up mediation analyses demonstrated that PCL-M score fully mediated the relationship between AOC and TMT-A performance and partially mediated the relationship between AOC and TMT-B performance.”
Deemed nonsignificant were post-hoc analyses meant to separate the impact of processing speed on TMT-B.
“Remote mTBI characteristics, specifically AOC, were not associated with decrements in cognitive performance,” the researchers concluded. “Posttraumatic symptoms were associated with worse processing speed, suggesting that psychological distress and psychopathology are contributing factors in understanding and treating persistent cognitive distress following remote mTBI.”
- Thompson RC, Melinder MRD, Daly HA, Warren SL. Disentangling effects of remote mild traumatic brain injury characteristics and posttraumatic stress on processing speed and executive function in veterans. J Neuropsychol. 2024 Jan 11. doi: 10.1111/jnp.12360. Epub ahead of print. PMID: 38212957.