The Relationships Among Premilitary Vocational Aptitude Assessment, Traumatic Brain Injury, and Postdeployment Cognitive Functioning in Combat Veterans

Background. Traumatic brain injury (TBI) is associated with altered white matter organization and impaired cognitive functioning. Objective. We aimed to investigate changes in white matter and cognitive functioning following computerized cognitive training. Methods. Sixteen adolescents with moderate-to-severe TBI (age 15.6 ± 1.8 years, 1.2-4.6 years postinjury) completed the 8-week BrainGames program and diffusion weighted imaging (DWI) and cognitive assessment at time point 1 (before training) and time point 2 (after training). Sixteen healthy controls (HC) (age 15.6 ± 1.8 years) completed DWI assessment at time point 1 and cognitive assessment at time point 1 and 2. Fixel-based analyses were used to examine fractional anisotropy (FA), mean diffusivity (MD), and fiber cross-section (FC) on a whole brain level and in tracts of interest. Results. Patients with TBI showed cognitive impairments and extensive areas with decreased FA and increased MD together with an increase in FC in the body of the corpus callosum and left superior longitudinal fasciculus (SLF) at time point 1. Patients improved significantly on the inhibition measure at time point 2, whereas the HC group remained unchanged. No training-induced changes were observed on the group level in diffusion metrics. Exploratory correlations were found between improvements on verbal working memory and reduced MD of the left SLF and between increased performance on an information processing speed task and increased FA of the right precentral gyrus. Conclusions. Results are indicative of positive effects of BrainGames on cognitive functioning and provide preliminary evidence for neuroplasticity associated with cognitive improvements following cognitive intervention in TBI.

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Postconcussive Symptom Reporting Among US Combat Veterans With Mild Traumatic Brain Injury From Operation Iraqi Freedom

Journal of Head Trauma Rehabilitation ◽

10.1097/htr.0b013e3182596382 ◽

2013 ◽

Vol 28 (1) ◽

pp. 59-67 ◽

Cited By ~ 40

Author(s):

Andrew J. MacGregor ◽

Amber L. Dougherty ◽

Janet J. Tang ◽

Michael R. Galarneau

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Combat Veterans ◽

Operation Iraqi Freedom ◽

Symptom Reporting ◽

Iraqi Freedom

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A quantitative review of the effects of traumatic brain injury on cognitive functioning

International Review of Psychiatry ◽

10.1080/09540260310001606728 ◽

2003 ◽

Vol 15 (4) ◽

pp. 341-349 ◽

Cited By ~ 377

Author(s):

David J. Schretlen ◽

Anne M. Shapiro

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Cognitive Functioning ◽

Quantitative Review

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Cognitive functioning and post-concussion symptoms following mild traumatic brain injury over a three-month period

10.5353/th_b4154760 ◽

2008 ◽

Author(s):

Yung, Florence Kwok

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Cognitive Functioning ◽

Mild Traumatic Brain Injury

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Is Computerized Cognitive Testing Useful in Children and Adolescents with Moderate-to-Severe Traumatic Brain Injury?

Journal of the International Neuropsychological Society ◽

10.1017/s1355617717000066 ◽

2017 ◽

Vol 23 (4) ◽

pp. 304-313 ◽

Cited By ~ 6

Author(s):

Vickie Plourde ◽

Brian L. Brooks

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Reaction Time ◽

Cognitive Functioning ◽

Children And Adolescents ◽

Severe Traumatic Brain Injury ◽

Effect Sizes ◽

Medium Effect ◽

Control Group ◽

Severe Tbi

AbstractObjectives: Children and adolescents with moderate-to-severe traumatic brain injury (TBI) present with short and long-term neuropsychological deficits following their injury. The aim of this study was to investigate the utility of a brief computerized test battery for evaluating cognitive functioning sub-acutely following a TBI. Methods: Participants (n=33) sustained a moderate-to-severe TBI, were between 8 and 18 years old, and were assessed using CNS Vital Signs (CNSVS) within 6 months post-injury (median=0.6 month). Participants with TBI were matched to 33 healthy controls based on age, sex, and handedness to compare their cognitive functioning on the CNSVS battery. Results: Children and adolescents with moderate-to-severe TBI had significantly lower scores and large effect sizes on Reaction Time, Complex Attention, and Cognitive Flexibility domains, as well as medium effect sizes on two Visual Memory test scores and one Psychomotor Speed test score. A significantly higher percentage of participants with TBI had cognitive impairment on Reaction Time domain score compared to the control group. Finally, CNSVS domain scores correctly categorized 76% of participants as either group with TBI or control group. Conclusions: CNSVS may be a useful tool for screening cognitive abilities in children and adolescents who are early in their recovery from a moderate-to-severe TBI, particularly when a rapid screening evaluation can help guide management, interventions, and track recovery. (JINS, 2017, 23, 304–313)

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Parallel recovery of consciousness and sleep in acute traumatic brain injury

Neurology ◽

10.1212/wnl.0000000000003508 ◽

2016 ◽

Vol 88 (3) ◽

pp. 268-275 ◽

Cited By ~ 20

Author(s):

Catherine Duclos ◽

Marie Dumont ◽

Caroline Arbour ◽

Jean Paquet ◽

Hélène Blais ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Cognitive Functioning ◽

Acute Phase ◽

Mixed Model ◽

Hospitalized Patients ◽

Wrist Actigraphy ◽

Severe Tbi ◽

Acute Traumatic Brain Injury ◽

Nighttime Sleep

Objective:To investigate whether the progressive recuperation of consciousness was associated with the reconsolidation of sleep and wake states in hospitalized patients with acute traumatic brain injury (TBI).Methods:This study comprised 30 hospitalized patients (age 29.1 ± 13.5 years) in the acute phase of moderate or severe TBI. Testing started 21.0 ± 13.7 days postinjury. Consciousness level and cognitive functioning were assessed daily with the Rancho Los Amigos scale of cognitive functioning (RLA). Sleep and wake cycle characteristics were estimated with continuous wrist actigraphy. Mixed model analyses were performed on 233 days with the RLA (fixed effect) and sleep-wake variables (random effects). Linear contrast analyses were performed in order to verify if consolidation of the sleep and wake states improved linearly with increasing RLA score.Results:Associations were found between scores on the consciousness/cognitive functioning scale and measures of sleep-wake cycle consolidation (p < 0.001), nighttime sleep duration (p = 0.018), and nighttime fragmentation index (p < 0.001). These associations showed strong linear relationships (p < 0.01 for all), revealing that consciousness and cognition improved in parallel with sleep-wake quality. Consolidated 24-hour sleep-wake cycle occurred when patients were able to give context-appropriate, goal-directed responses.Conclusions:Our results showed that when the brain has not sufficiently recovered a certain level of consciousness, it is also unable to generate a 24-hour sleep-wake cycle and consolidated nighttime sleep. This study contributes to elucidating the pathophysiology of severe sleep-wake cycle alterations in the acute phase of moderate to severe TBI.

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