Overground and Virtual Reality Gait Speed Are Associated With Atypical Symptom Reporting in Active Duty Service Members With a History of Mild to Moderate Traumatic Brain Injury

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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Female Service Members and Symptom Reporting after Combat and Non-Combat-Related Mild Traumatic Brain Injury

Journal of Neurotrauma ◽

10.1089/neu.2016.4403 ◽

2017 ◽

Vol 34 (2) ◽

pp. 300-312 ◽

Cited By ~ 28

Author(s):

Tracey A. Brickell ◽

Sara M. Lippa ◽

Louis M. French ◽

Jan E. Kennedy ◽

Jason M. Bailie ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Symptom Reporting ◽

Service Members

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Relationships Between Subcortical Shape Measures and Subjective Symptom Reporting in US Service Members With Mild Traumatic Brain Injury

Journal of Head Trauma Rehabilitation ◽

10.1097/htr.0000000000000379 ◽

2018 ◽

Vol 33 (2) ◽

pp. 113-122 ◽

Cited By ~ 4

Author(s):

Jacob D. Bolzenius ◽

Benjamin S. C. Wade ◽

Carmen S. Velez ◽

Ann Marie Drennon ◽

Douglas B. Cooper ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Subjective Symptom ◽

Symptom Reporting ◽

Service Members

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A-116 Predicting Chronic Neurobehavioral Symptoms based on Acute Injury Characteristics and Symptoms in U.S. Military Service Members with and without history of TBI

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa068.116 ◽

2020 ◽

Vol 35 (6) ◽

pp. 909-909

Author(s):

Lippa S ◽

Bailie J ◽

Brickell T ◽

French L ◽

Hungerford L ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Military Service ◽

Service Members ◽

Injury Characteristics ◽

Military Service Members ◽

History Of ◽

Neurobehavioral Symptoms ◽

Severe Tbi

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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