Citation

Lippa SM, French LM, Bell RS, Brickell TA, Lange R. J. Neurotrauma 2019; ePub(ePub): ePub.

Affiliation

11300 Rockville Pikesuite 1100North Bethesda, Maryland, United States, 20852; rlange@dvbic.org.

Copyright

(Copyright © 2019, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2019.6696

PMID

31559904

Abstract

This study examines long-term neuropsychological outcome following Moderate, Severe, and Penetrating Traumatic Brain Injury (TBI) in U.S. military service members and veterans (SMVs). Eighty-five SMVs with a history of Moderate (n=18), Severe (n=17), or Penetrating (n=26) TBI, or an injury without TBI (i.e., Trauma Control [TC], n=24) were assessed five or more years (M=69.4 months; SD=35.6) post-injury. All passed performance validity tests. Participants completed a battery of neurocognitive tests and a personality inventory. Five cognitive domain composites, each comprised of four test scores, and an overall test battery mean (OTBM) were computed. The Penetrating TBI group performed worse than the TC group and/or Moderate TBI group on most cognitive domains and the OTBM. The Severe TBI group also performed worse than the TC group and Moderate TBI group on Processing Speed and the OTBM, and worse than the TC group on Attention/Working Memory. Just over half of participants with Severe (56%) or Penetrating (64%) TBI met criteria for mild neurocognitive disorder, with Processing Speed the most commonly impaired domain. Additionally, 80% of TBI participants had one or more clinically elevated scales on the MMPI-2-RF, with Somatic Complaints the most common elevation. There was substantial heterogeneity in cognitive and psychological functioning. In sum, there was significantly reduced cognitive and psychological functioning many years following Severe and Penetrating TBI in SMVs. However, cognitive and psychological dysfunction were highly variable, with a substantial minority of SMVs having good outcome. Long-term individualized support is necessary for individuals following Moderate, Severe, and Penetrating TBI.

Language: en

Keywords

HEAD TRAUMA; MILITARY INJURY; NEUROPSYCHOLOGY; Penetrating Ballistic-like Brain Injury; TRAUMATIC BRAIN INJURY