Plasma Tau and Amyloid Are Not Reliably Related to Injury Characteristics, Neuropsychological Performance, or White Matter Integrity in Service Members with a History of Traumatic Brain Injury

Abstract Objective Recovery following traumatic brain injury (TBI) is complex. Often following mild TBI, recovery occurs within days or weeks, though this is not always the case. Following more severe TBI, some recover quickly, while many never fully recover. This study examines acute predictors of chronic neurobehavioral symptoms in U.S. military service members (Age: M = 33.9 years, SD = 10.2) without injury (n = 86), or with history of uncomplicated mild traumatic brain injury (TBI; n = 56), complicated mild, moderate, or severe TBI (mod-sev TBI; n = 43), or bodily injury (n = 25). Method Participants completed the Neurobehavioral Symptom Inventory (NSI), Posttraumatic Stress Disorder Checklist, Alcohol Use Disorder Checklist, Combat Exposure Scale, and TBI Quality of Life and passed symptom validity tests at 0–8 months and ≥ 2 years post-injury. Forward stepwise logistic regression included 26 potential predictors (demographics, injury characteristics, military characteristics, and self-report measures at baseline) of International Statistical Classification of Diseases and Related Health Problems-10 Postconcussional Syndrome (PCSy) at follow-up. Results Cognitive Concerns (Exp(B) = .896, p = .001), Sleep (Exp(B) = 1.874, p < .001), Somatosensory Symptoms (Exp(B) = 1.194, p = .012), and mod-sev TBI (Exp(B) = 2.959, p = .045) significantly predicted follow-up PCSy. When baseline NSI symptoms were removed from the model, Cognitive Concerns (Exp(B) = .902, p < .001), Post-traumatic stress (Exp(B) = 1.173, p = .001), and Resilience (Exp(B) = .950, p < .031) significantly predicted PCSy. For all included measures in both models, higher symptoms at baseline predicted increased likelihood of follow-up PCSy. Both models correctly classified 81.3% of participants. Conclusion Findings suggest patients reporting psychological distress and cognitive concerns acutely should be targeted for treatment to mitigate prolonged neurobehavioral symptoms.

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White Matter Hyperintensities Are Not Related to Symptomatology or Cognitive Functioning in Service Members with a Remote History of Traumatic Brain Injury

Neurotrauma Reports ◽

10.1089/neur.2021.0002 ◽

2021 ◽

Vol 2 (1) ◽

pp. 245-254

Author(s):

Sara M. Lippa ◽

Kimbra Kenney ◽

Gerard Riedy ◽

John Ollinger ◽

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

White Matter ◽

Cognitive Functioning ◽

White Matter Hyperintensities ◽

Service Members ◽

History Of

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B-58 Post-traumatic Stress Symptoms Are Associated with Worse Neuropsychological Functioning, but not Diffusion Tensor Imaging Findings, in Military Service Members Following Mild Traumatic Brain Injury.

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz034.141 ◽

2019 ◽

Vol 34 (6) ◽

pp. 1004-1004

Author(s):

R Lange ◽

S Lippa ◽

T Brickell ◽

P Yeh ◽

L French

Keyword(s):

Traumatic Brain Injury ◽

Diffusion Tensor Imaging ◽

Brain Injury ◽

White Matter ◽

Military Service ◽

Diffusion Tensor ◽

White Matter Integrity ◽

Service Members ◽

Military Service Members ◽

The Brain

Abstract Objective The purpose of this study was to examine neurobehavioral and neurocognitive functioning, and white matter integrity (using Diffusion Tensor Imaging [DTI]), in service members with versus without PTSD following mild traumatic brain injury (MTBI). Method Participants were 101 U.S. military service members who had sustained an uncomplicated MTBI (n = 80) or an injury without TBI (i.e., Injured Control [IC], n = 21) prospectively enrolled from the Walter Reed National Military Medical Center (Bethesda, Maryland). Participants completed a battery of neuropsychological tests, as well as DTI of the brain, on average 4-years post-injury. Measures of FA, MD, AD, and RD were generated for 18 regions of interest [ROIs]. Participants in the MTBI group were divided into two sub-groups based on DSM-IV-TR diagnostic criteria for PTSD: MTBI/PTSD-Present (n = 22) and MTBI/PTSD-Absent (n = 58). Results The MTBI/PTSD-Present group reported a significantly higher number of postconcussion symptoms, had higher scores on the majority of MMPI-2-RF scales, and had worse scores on the vast majority of cognitive domains (i.e., Attention, Processing Speed, Immediate Memory, Delayed Memory, Executive Functioning, Visuospatial Ability) compared to both the MTBI/PTSD-Absent group (all p’s < .05) and IC/PTSD-Absent group (all p’s < .05). For the DTI variables, there were no significant group differences for all DTI measures in all regions of the brain, with the exception of a handful of measures (i.e., right cingulum–cingulate gyrus, and bilaterally in the corticospinal tract). Conclusion These results provide support for a (a) strong relationship between PTSD and poor neurobehavioral and neurocognitive outcome following MTBI, and (b) weak relationship between PTSD and white matter integrity following MTBI.

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PTSD confounds detection of compromised cerebral white matter integrity in military veterans reporting a history of mild traumatic brain injury

Brain Injury ◽

10.1080/02699052.2016.1219057 ◽

2016 ◽

Vol 30 (12) ◽

pp. 1491-1500 ◽

Cited By ~ 10

Author(s):

Nicholas D. Davenport ◽

Greg J. Lamberty ◽

Nathaniel W. Nelson ◽

Kelvin O. Lim ◽

Michael T. Armstrong ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

White Matter ◽

Mild Traumatic Brain Injury ◽

Military Veterans ◽

White Matter Integrity ◽

Cerebral White Matter ◽

History Of

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Blood Biomarkers Relate to Cognitive Performance Years after Traumatic Brain Injury in Service Members and Veterans

Journal of the International Neuropsychological Society ◽

10.1017/s1355617720001071 ◽

2020 ◽

pp. 1-7

Author(s):

Sara M. Lippa ◽

Jessica Gill ◽

Tracey A. Brickell ◽

Louis M. French ◽

Rael T. Lange

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Cognitive Outcome ◽

Service Members ◽

Neurocognitive Performance ◽

Blood Biomarkers ◽

Post Injury ◽

Blood Draw ◽

Neurofilament Light ◽

History Of

Abstract Objective: This study examines the relationship of serum total tau, neurofilament light (NFL), ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1), and glial fibrillary acidic protein (GFAP) with neurocognitive performance in service members and veterans with a history of traumatic brain injury (TBI). Method: Service members (n = 488) with a history of uncomplicated mild (n = 172), complicated mild, moderate, severe, or penetrating TBI (sTBI; n = 126), injured controls (n = 116), and non-injured controls (n = 74) prospectively enrolled from Military Treatment Facilities. Participants completed a blood draw and neuropsychological assessment a year or more post-injury. Six neuropsychological composite scores and presence/absence of mild neurocognitive disorder (MNCD) were evaluated. Within each group, stepwise hierarchical regression models were conducted. Results: Within the sTBI group, increased serum UCH-L1 was related to worse immediate memory and delayed memory (R2Δ = .065–.084, ps < .05) performance, while increased GFAP was related to worse perceptual reasoning (R2Δ = .030, p = .036). Unexpectedly, within injured controls, UCH-L1 and GFAP were inversely related to working memory (R2Δ = .052–.071, ps < .05), and NFL was related to executive functioning (R2Δ = .039, p = .021) and MNCD (Exp(B) = 1.119, p = .029). Conclusions: Results suggest GFAP and UCH-L1 could play a role in predicting poor cognitive outcome following complicated mild and more severe TBI. Further investigation of blood biomarkers and cognition is warranted.

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