Post-Traumatic Stress Disorder Symptoms Are Related to Cognition after Complicated Mild and Moderate Traumatic Brain Injury but Not Severe and Penetrating Traumatic Brain Injury
Although post-traumatic stress disorder (PTSD) has been associated with worse cognitive outcomes after mild traumatic brain injury (TBI), its impact has not been evaluated after more severe TBI. This study aimed to determine whether PTSD symptoms are related to cognition after complicated mild, mode...
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| Veröffentlicht in: | Journal of neurotrauma 2021-11, Vol.38 (22), p.3137-3145 |
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| container_title | Journal of neurotrauma |
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| creator | Lippa, Sara M French, Louis M Brickell, Tracey A Driscoll, Angela E Glazer, Megan E Tippett, Corie E Sullivan, Jamie K Lange, Rael T |
| description | Although post-traumatic stress disorder (PTSD) has been associated with worse cognitive outcomes after mild traumatic brain injury (TBI), its impact has not been evaluated after more severe TBI. This study aimed to determine whether PTSD symptoms are related to cognition after complicated mild, moderate, severe, and penetrating TBI. Service members (
= 137) with a history of complicated mild/moderate TBI (
= 64) or severe/penetrating TBI (
= 73) were prospectively enrolled from United States Military Treatment Facilities. Participants completed a neuropsychological assessment one year or more post-injury. Six neuropsychological composite scores and an overall test battery mean (OTBM) were considered. Participants were excluded if there was evidence of invalid responding. Hierarchical linear regressions were conducted evaluating neuropsychological performance. The interaction between TBI severity and PTSD Checklist-Civilian version total score was significant for processing speed (β = 0.208,
= 0.034) and delayed memory (β = 0.239,
= 0.021) and trended toward significance for immediate memory (β = 0.190,
= 0.057) and the OTBM (β = 0.181,
= 0.063). For each of these composite scores, the relationship between PTSD symptoms and cognition was stronger in the complicated mild/moderate TBI group than the severe/penetrating TBI group. Within the severe/penetrating TBI group, PTSD symptoms were unrelated to cognitive performance. In contrast, within the complicated mild/moderate TBI group, PTSD symptoms were significantly related to processing speed (R
Δ = 0.077, β = -0.280,
= 0.019), immediate memory (R
Δ = 0.197, β = -0.448,
|
| doi_str_mv | 10.1089/neu.2021.0120 |
| format | Article |
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= 137) with a history of complicated mild/moderate TBI (
= 64) or severe/penetrating TBI (
= 73) were prospectively enrolled from United States Military Treatment Facilities. Participants completed a neuropsychological assessment one year or more post-injury. Six neuropsychological composite scores and an overall test battery mean (OTBM) were considered. Participants were excluded if there was evidence of invalid responding. Hierarchical linear regressions were conducted evaluating neuropsychological performance. The interaction between TBI severity and PTSD Checklist-Civilian version total score was significant for processing speed (β = 0.208,
= 0.034) and delayed memory (β = 0.239,
= 0.021) and trended toward significance for immediate memory (β = 0.190,
= 0.057) and the OTBM (β = 0.181,
= 0.063). For each of these composite scores, the relationship between PTSD symptoms and cognition was stronger in the complicated mild/moderate TBI group than the severe/penetrating TBI group. Within the severe/penetrating TBI group, PTSD symptoms were unrelated to cognitive performance. In contrast, within the complicated mild/moderate TBI group, PTSD symptoms were significantly related to processing speed (R
Δ = 0.077, β = -0.280,
= 0.019), immediate memory (R
Δ = 0.197, β = -0.448,
< 0.001), delayed memory (R
Δ = 0.176, β = -0.423,
< 0.001), executive functioning (R
Δ = 0.100, β = -0.317,
= 0.008), and the OTBM (R
Δ = 0.162, β = -0.405,
< 0.001). The potential impact of PTSD symptoms on cognition, over and above the impact of brain injury alone, should be considered with service members and veterans with a history of complicated mild/moderate TBI. In addition, in research comparing cognitive outcomes between patients with histories of complicated-mild, moderate, severe, and/or penetrating TBI, it will be important to account for PTSD symptoms.</description><identifier>ISSN: 0897-7151</identifier><identifier>EISSN: 1557-9042</identifier><identifier>DOI: 10.1089/neu.2021.0120</identifier><identifier>PMID: 34409857</identifier><language>eng</language><publisher>United States: Mary Ann Liebert, Inc</publisher><subject>Armed forces ; Cognition & reasoning ; Cognitive ability ; Consciousness ; Executive function ; Magnetic resonance imaging ; Medical records ; Memory ; Neuropsychology ; Post traumatic stress disorder ; Standard scores ; Traumatic brain injury ; Validity</subject><ispartof>Journal of neurotrauma, 2021-11, Vol.38 (22), p.3137-3145</ispartof><rights>Copyright Mary Ann Liebert, Inc. Nov 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c321t-815581a7d9c7dd8d7a05a68b8c044947d6cb3c11ac31338ce64e1a893a7a9c553</citedby><cites>FETCH-LOGICAL-c321t-815581a7d9c7dd8d7a05a68b8c044947d6cb3c11ac31338ce64e1a893a7a9c553</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34409857$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lippa, Sara M</creatorcontrib><creatorcontrib>French, Louis M</creatorcontrib><creatorcontrib>Brickell, Tracey A</creatorcontrib><creatorcontrib>Driscoll, Angela E</creatorcontrib><creatorcontrib>Glazer, Megan E</creatorcontrib><creatorcontrib>Tippett, Corie E</creatorcontrib><creatorcontrib>Sullivan, Jamie K</creatorcontrib><creatorcontrib>Lange, Rael T</creatorcontrib><title>Post-Traumatic Stress Disorder Symptoms Are Related to Cognition after Complicated Mild and Moderate Traumatic Brain Injury but Not Severe and Penetrating Traumatic Brain Injury</title><title>Journal of neurotrauma</title><addtitle>J Neurotrauma</addtitle><description>Although post-traumatic stress disorder (PTSD) has been associated with worse cognitive outcomes after mild traumatic brain injury (TBI), its impact has not been evaluated after more severe TBI. This study aimed to determine whether PTSD symptoms are related to cognition after complicated mild, moderate, severe, and penetrating TBI. Service members (
= 137) with a history of complicated mild/moderate TBI (
= 64) or severe/penetrating TBI (
= 73) were prospectively enrolled from United States Military Treatment Facilities. Participants completed a neuropsychological assessment one year or more post-injury. Six neuropsychological composite scores and an overall test battery mean (OTBM) were considered. Participants were excluded if there was evidence of invalid responding. Hierarchical linear regressions were conducted evaluating neuropsychological performance. The interaction between TBI severity and PTSD Checklist-Civilian version total score was significant for processing speed (β = 0.208,
= 0.034) and delayed memory (β = 0.239,
= 0.021) and trended toward significance for immediate memory (β = 0.190,
= 0.057) and the OTBM (β = 0.181,
= 0.063). For each of these composite scores, the relationship between PTSD symptoms and cognition was stronger in the complicated mild/moderate TBI group than the severe/penetrating TBI group. Within the severe/penetrating TBI group, PTSD symptoms were unrelated to cognitive performance. In contrast, within the complicated mild/moderate TBI group, PTSD symptoms were significantly related to processing speed (R
Δ = 0.077, β = -0.280,
= 0.019), immediate memory (R
Δ = 0.197, β = -0.448,
< 0.001), delayed memory (R
Δ = 0.176, β = -0.423,
< 0.001), executive functioning (R
Δ = 0.100, β = -0.317,
= 0.008), and the OTBM (R
Δ = 0.162, β = -0.405,
< 0.001). The potential impact of PTSD symptoms on cognition, over and above the impact of brain injury alone, should be considered with service members and veterans with a history of complicated mild/moderate TBI. In addition, in research comparing cognitive outcomes between patients with histories of complicated-mild, moderate, severe, and/or penetrating TBI, it will be important to account for PTSD symptoms.</description><subject>Armed forces</subject><subject>Cognition & reasoning</subject><subject>Cognitive ability</subject><subject>Consciousness</subject><subject>Executive function</subject><subject>Magnetic resonance imaging</subject><subject>Medical records</subject><subject>Memory</subject><subject>Neuropsychology</subject><subject>Post traumatic stress disorder</subject><subject>Standard scores</subject><subject>Traumatic brain injury</subject><subject>Validity</subject><issn>0897-7151</issn><issn>1557-9042</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kc1OGzEUha2KqoS0y24rS2y6meC_GXuWNPxKFFBD1yPHvkGOZuzU9lTKY_GGOECLhMTKlu93Pl35IPSVkhklqj3yMM4YYXRGKCMf0ITWtaxaItgempS5rCSt6T46SGlNCOUNk5_QPheCtKqWE_RwG1Ku7qIeB52dwYscISV84lKIFiJebIdNDkPCxxHwL-h1BotzwPNw7112wWO9yoWbh2HTO_M0_ul6i7Uvl1AU5Qm_-n9E7Ty-9OsxbvFyzPg6ZLyAv1D0u8gteMgl4_z9O6nP6ONK9wm-vJxT9Pvs9G5-UV3dnF_Oj68qwxnNlSofoaiWtjXSWmWlJrVu1FIZIkQrpG3MkhtKteGUc2WgEUC1armWujV1zafo-7N3E8OfEVLuBpcM9L32EMbUsbphinPasIIevkHXYYy-bFeoVjRKkEJOUfVMmRhSirDqNtENOm47Srpdl13pstt12e26LPy3F-u4HMD-p_-Vxx8BQFicTw</recordid><startdate>20211115</startdate><enddate>20211115</enddate><creator>Lippa, Sara M</creator><creator>French, Louis M</creator><creator>Brickell, Tracey A</creator><creator>Driscoll, Angela E</creator><creator>Glazer, Megan E</creator><creator>Tippett, Corie E</creator><creator>Sullivan, Jamie K</creator><creator>Lange, Rael T</creator><general>Mary Ann Liebert, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20211115</creationdate><title>Post-Traumatic Stress Disorder Symptoms Are Related to Cognition after Complicated Mild and Moderate Traumatic Brain Injury but Not Severe and Penetrating Traumatic Brain Injury</title><author>Lippa, Sara M ; French, Louis M ; Brickell, Tracey A ; Driscoll, Angela E ; Glazer, Megan E ; Tippett, Corie E ; Sullivan, Jamie K ; Lange, Rael T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c321t-815581a7d9c7dd8d7a05a68b8c044947d6cb3c11ac31338ce64e1a893a7a9c553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Armed forces</topic><topic>Cognition & reasoning</topic><topic>Cognitive ability</topic><topic>Consciousness</topic><topic>Executive function</topic><topic>Magnetic resonance imaging</topic><topic>Medical records</topic><topic>Memory</topic><topic>Neuropsychology</topic><topic>Post traumatic stress disorder</topic><topic>Standard scores</topic><topic>Traumatic brain injury</topic><topic>Validity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lippa, Sara M</creatorcontrib><creatorcontrib>French, Louis M</creatorcontrib><creatorcontrib>Brickell, Tracey A</creatorcontrib><creatorcontrib>Driscoll, Angela E</creatorcontrib><creatorcontrib>Glazer, Megan E</creatorcontrib><creatorcontrib>Tippett, Corie E</creatorcontrib><creatorcontrib>Sullivan, Jamie K</creatorcontrib><creatorcontrib>Lange, Rael T</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neurotrauma</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lippa, Sara M</au><au>French, Louis M</au><au>Brickell, Tracey A</au><au>Driscoll, Angela E</au><au>Glazer, Megan E</au><au>Tippett, Corie E</au><au>Sullivan, Jamie K</au><au>Lange, Rael T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Post-Traumatic Stress Disorder Symptoms Are Related to Cognition after Complicated Mild and Moderate Traumatic Brain Injury but Not Severe and Penetrating Traumatic Brain Injury</atitle><jtitle>Journal of neurotrauma</jtitle><addtitle>J Neurotrauma</addtitle><date>2021-11-15</date><risdate>2021</risdate><volume>38</volume><issue>22</issue><spage>3137</spage><epage>3145</epage><pages>3137-3145</pages><issn>0897-7151</issn><eissn>1557-9042</eissn><abstract>Although post-traumatic stress disorder (PTSD) has been associated with worse cognitive outcomes after mild traumatic brain injury (TBI), its impact has not been evaluated after more severe TBI. This study aimed to determine whether PTSD symptoms are related to cognition after complicated mild, moderate, severe, and penetrating TBI. Service members (
= 137) with a history of complicated mild/moderate TBI (
= 64) or severe/penetrating TBI (
= 73) were prospectively enrolled from United States Military Treatment Facilities. Participants completed a neuropsychological assessment one year or more post-injury. Six neuropsychological composite scores and an overall test battery mean (OTBM) were considered. Participants were excluded if there was evidence of invalid responding. Hierarchical linear regressions were conducted evaluating neuropsychological performance. The interaction between TBI severity and PTSD Checklist-Civilian version total score was significant for processing speed (β = 0.208,
= 0.034) and delayed memory (β = 0.239,
= 0.021) and trended toward significance for immediate memory (β = 0.190,
= 0.057) and the OTBM (β = 0.181,
= 0.063). For each of these composite scores, the relationship between PTSD symptoms and cognition was stronger in the complicated mild/moderate TBI group than the severe/penetrating TBI group. Within the severe/penetrating TBI group, PTSD symptoms were unrelated to cognitive performance. In contrast, within the complicated mild/moderate TBI group, PTSD symptoms were significantly related to processing speed (R
Δ = 0.077, β = -0.280,
= 0.019), immediate memory (R
Δ = 0.197, β = -0.448,
< 0.001), delayed memory (R
Δ = 0.176, β = -0.423,
< 0.001), executive functioning (R
Δ = 0.100, β = -0.317,
= 0.008), and the OTBM (R
Δ = 0.162, β = -0.405,
< 0.001). The potential impact of PTSD symptoms on cognition, over and above the impact of brain injury alone, should be considered with service members and veterans with a history of complicated mild/moderate TBI. In addition, in research comparing cognitive outcomes between patients with histories of complicated-mild, moderate, severe, and/or penetrating TBI, it will be important to account for PTSD symptoms.</abstract><cop>United States</cop><pub>Mary Ann Liebert, Inc</pub><pmid>34409857</pmid><doi>10.1089/neu.2021.0120</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0897-7151 |
| ispartof | Journal of neurotrauma, 2021-11, Vol.38 (22), p.3137-3145 |
| issn | 0897-7151 1557-9042 |
| language | eng |
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| source | Alma/SFX Local Collection |
| subjects | Armed forces Cognition & reasoning Cognitive ability Consciousness Executive function Magnetic resonance imaging Medical records Memory Neuropsychology Post traumatic stress disorder Standard scores Traumatic brain injury Validity |
| title | Post-Traumatic Stress Disorder Symptoms Are Related to Cognition after Complicated Mild and Moderate Traumatic Brain Injury but Not Severe and Penetrating Traumatic Brain Injury |
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