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

Published online by Cambridge University Press:  09 November 2020

Sara M. Lippa*
Affiliation:
National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
Jessica Gill
Affiliation:
National Institutes of Health, National Institute of Nursing Research, Bethesda, MD, USA
Tracey A. Brickell
Affiliation:
National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA Uniformed Services University of the Health Sciences, Bethesda, MD, USA Defense and Veterans Brain Injury Center, Falls Church, VA, USA
Louis M. French
Affiliation:
National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA Uniformed Services University of the Health Sciences, Bethesda, MD, USA
Rael T. Lange
Affiliation:
National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA Defense and Veterans Brain Injury Center, Falls Church, VA, USA Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
*
*Correspondence and reprint requests to: Sara M. Lippa, Ph.D., National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Room 1121, Building 51, 8901 Wisconsin Avenue, Bethesda, MD 20814, USA. Tel.: +1 301 319 3671. Email: sara.m.lippa.civ@mail.mil

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.

Type
Brief Communication
Copyright
Copyright © INS. Published by Cambridge University Press, 2020

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