Analysis of Story Recall in Military Veterans With and Without Mild Traumatic Brain Injury: Preliminary Results

Purpose The purpose of this study was to determine whether detailed analysis of story recall performance reveals significant differences between veterans with and without history of mild traumatic brain injury (mTBI). Method Twenty-one military veterans participated, with 7 reporting history of mTBI. All participants were administered the Logical Memory I and II subtests from the Wechsler Memory Scale–Fourth Edition (Wechsler, 2009). Responses were scored for total correct ideas (TCI) and total words produced (TWP). Results Although the groups did not differ in scaled scores, other measures did reveal significant differences. After a delay, the mTBI group showed a greater drop in TCI relative to the control group. Additionally, the control group showed an increase in TWP when the recall was delayed versus immediate; a pattern not observed for the mTBI group. Conclusions The mTBI and control groups did not significantly differ in scaled scores. However, group differences were observed in TCI and TWP. The findings suggest that, relative to the control group, the mTBI group were less successful in retrieving episodic information and eliciting self-cueing. Small sample size limited data interpretation, and larger sample sizes are needed to confirm the findings. The results indicate that veterans with mTBI may present with symptoms persisting beyond the acute state of the injury.

Download Full-text

Examining Microstructural White Matter in Active Duty Soldiers with a History of Mild Traumatic Brain Injury and Traumatic Stress

The Open Neuroimaging Journal ◽

10.2174/1874440001711010046 ◽

2017 ◽

Vol 11 (1) ◽

pp. 46-57 ◽

Cited By ~ 7

Author(s):

Michael N. Dretsch ◽

Rael T. Lange ◽

Jeffery S. Katz ◽

Adam Goodman ◽

Thomas A. Daniel ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

White Matter ◽

Mild Traumatic Brain Injury ◽

Psychological Health ◽

Traumatic Stress ◽

Diffusion Tensor ◽

Active Duty ◽

Control Group ◽

History Of

Background:There is a high comorbidity of posttraumatic stress (PTS) and mild traumatic brain injury (mTBI), with largely overlapping symptomatology, in military service members.Objective:To examine white matter integrity associated with PTS and mTBI as assessed using diffusion tensor imaging (DTI).Method:Seventy-four active-duty U.S. soldiers with PTS (n = 16) and PTS with co-morbid history of mTBI (PTS/mTBI; n = 28) were compared to a military control group (n = 30). Participants received a battery of neurocognitive and clinical symptom measures. The number of abnormal DTI values was determined (>2 SDs from the mean of the control group) for fractional anisotropy (FA) and mean diffusivity (MD), and then compared between groups. In addition, mean DTI values from white matter tracts falling into three categories were compared between groups: (i) projection tracts: superior, middle, and inferior cerebellar peduncles, pontine crossing tract, and corticospinal tract; (ii) association tracts: superior longitudinal fasciculus; and (iii) commissure tracts: cingulum bundle (cingulum-cingulate gyrus and cingulum-hippocampus), and corpus callosum.Results:The comorbid PTS/mTBI group had significantly greater traumatic stress, depression, anxiety, and post-concussive symptoms, and they performed worse on neurocognitive testing than those with PTS alone and controls. The groups differed greatly on several clinical variables, but contrary to what we hypothesized, they did not differ greatly on primary and exploratory analytic approaches of hetero-spatial whole brain DTI analyses.Conclusion:The findings suggest that psychological health conditions rather than pathoanatomical changes may be contributing to symptom presentation in this population.

Download Full-text

B-72 The Relationship between Anxiety and Postconcussive Symptomology in patients with Mild Traumatic Brain Injury

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz034.155 ◽

2019 ◽

Vol 34 (6) ◽

pp. 1020-1020

Author(s):

K Cornett

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Injury Severity ◽

Small Sample ◽

Future Research ◽

Control Group ◽

Patient Report ◽

The Relationship ◽

Report Measure

Abstract Objective Research literature has demonstrated the role that pre-morbid anxiety has in prolonging recovery from mild traumatic brain injury (mTBI). The aim of this investigation is to clarify the degree of the relationship between anxiety and postconcussive symptomology in patients with mTBI. Method This study compared scores from a patient-report measure of anxiety, the General Anxiety Disorder-7 (GAD-7), to scores from a patient-report measure of postconcussion symptom severity, the Neurobehavioral Symptom Inventory (NSI). Participants were recruited from September 2018 to December 2019 who had been referred for clinical evaluation to Rehabilitation Institute of Washington’s Brain Injury Services (a privately-run, interdisciplinary, outpatient clinic). 39 adult participants (30 males and nine females) completed both the GAD-7 and NSI. No control group was used. Injury severity level was ascertained via review of the medical records. Patients underwent an abbreviated evaluation with a clinical neuropsychologist. As a part of this initial evaluation, patients completed an intake packet, which included the NSI and GAD-7. Results The relationship between the ordinal variables (i.e., anxiety and postconscussive symptomology) was assessed using spearman’s rho. Anxiety had a strong, statistically significant relationship with postconcussive symptomology (rho = 0.670, p = 0.000). Conclusions Anxiety and postconcussive symptomology severity are associated in this population of patients with mTBI. Limitations of this current investigation include a small sample size and no control group. This study indicates the need for controlled studies in future research to address the above-encountered limitations. Nevertheless, this study lends support to the prevalence of anxiety in those with elevated postconcussive symptomology and the need to monitor this in assessment and treatment.

Download Full-text

APOE-ε4 Genotype is Associated with Elevated Post-Concussion Symptoms in Military Veterans with a Remote History of Mild Traumatic Brain Injury

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acy082 ◽

2018 ◽

Vol 34 (5) ◽

pp. 706-712 ◽

Cited By ~ 4

Author(s):

Victoria C Merritt ◽

Kristina M Lapira ◽

Alexandra L Clark ◽

Scott F Sorg ◽

Madeleine L Werhane ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Military Veterans ◽

Primary Outcome Measure ◽

Apoe Ε4 ◽

Stress Symptoms ◽

History Of ◽

Ε4 Allele

Abstract Objective We evaluated the influence of the APOE-ε4 allele on post-concussive symptoms in military Veterans with a remote history of mild traumatic brain injury (mTBI). Method Participants (N = 77) were administered neuropsychiatric measures, on average, approximately 5 years following their most recent mTBI and provided a DNA sample for APOE genotyping. Veterans were divided into two groups based on their ε4 status (n = 14 ε4+, n = 63 ε4–). The Neurobehavioral Symptom Inventory (NSI) was the primary outcome measure, from which a total score was derived, as well as three symptom clusters (somatic, cognitive, and affective). Results ANCOVAs showed a significant main effect of ε4 genotype on the NSI total score and somatic symptom cluster after adjusting for posttraumatic stress symptoms and mTBI history (p = .019–.028, ηp2 = .064–.073), such that ε4+ Veterans endorsed significantly greater symptoms than ε4– Veterans. Conclusions Our findings suggest that genetic risk may help to explain the poorer long-term outcomes often observed in this population.

Download Full-text

The Utility of the Mayo-Portland Adaptability Inventory Participation Index (M2PI) in US Military Veterans With a History of Mild Traumatic Brain Injury

Journal of Head Trauma Rehabilitation ◽

10.1097/htr.0000000000000405 ◽

2019 ◽

Vol 34 (1) ◽

pp. 30-35 ◽

Cited By ~ 2

Author(s):

Justin OʼRourke ◽

Edan Critchfield ◽

Jason Soble ◽

Kathleen Bain ◽

Chrystal Fullen ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Military Veterans ◽

Us Military ◽

History Of ◽

Participation Index

Download Full-text

Association of gut microbiota with cerebral cortex and cerebrovascular abnormality in human mild traumatic brain injury

10.1101/2020.07.19.211227 ◽

2020 ◽

Author(s):

Lijun Bai ◽

Tianhui Li ◽

Ming Zhang ◽

Shan Wang ◽

Shuoqiu Gan ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Gut Microbiota ◽

Mild Traumatic Brain Injury ◽

Small Sample Size ◽

Small Sample ◽

Diagnostic Model ◽

Mild Tbi ◽

Cerebrovascular Injury ◽

Α Diversity

AbstractKey roles of the gut–brain axis in brain injury development have been suggested in various mouse models; however, little is known about its functional significance in human mild traumatic brain injury (TBI). Here, we decipher this axis by profiling the gut microbiota in 98 acute mild TBI patients and 62 matched controls, and subgroup of them also measured circulating mediators and applied neuroimaging. Mild TBI patients had increased α-diversity and different overall microbial compositions compared with controls. 25-microbial genus classifiers distinguish patients from controls with an area under the receiver operating characteristic curve (AUC) of 0.889, while adding serum mediators and neuroimaging features further improved performance even in a small sample size (AUC = 0.969). Numerous correlations existed between gut bacteria, aberrant cortical thickness and cerebrovascular injury. Co-occurrence network analysis revealed two unique gut–brain axes in patients: 1) altered intestinal Lachnospiraceae_NK4A136_group and Eubacterium_ruminantium_group-increased serum GDNF-subcallosal hypertrophy and cerebrovascular injury; 2) decreased intestinal Eubacterium_xylanophilum_group–upregulated IL-6–thinned anterior insula. Our findings provide a new integrated mechanistic understanding and diagnostic model of mild TBI.

Download Full-text