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Neuropsychological Outcome from Blast versus Non-blast: Mild Traumatic Brain Injury in U.S. Military Service Members

Published online by Cambridge University Press:  30 March 2012

Rael T. Lange*
Affiliation:
Department of Research, Defense and Veterans Brain Injury Center, North Bethesda, Maryland Department of Orthopaedics and Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland Department of Psychiatry, University of British Columbia, Vancouver, British Columbia
Sonal Pancholi
Affiliation:
Department of Research, Defense and Veterans Brain Injury Center, North Bethesda, Maryland Fort Belvoir Community Hospital, Fort Belvoir, Virginia
Tracey A. Brickell
Affiliation:
Department of Research, Defense and Veterans Brain Injury Center, North Bethesda, Maryland Department of Orthopaedics and Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland
Sara Sakura
Affiliation:
Department of Research, Defense and Veterans Brain Injury Center, North Bethesda, Maryland Department of Orthopaedics and Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland
Aditya Bhagwat
Affiliation:
Department of Research, Defense and Veterans Brain Injury Center, North Bethesda, Maryland Department of Orthopaedics and Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland United States Public Health Service, Bethesda, Maryland
Victoria Merritt
Affiliation:
Department of Psychology, Pennsylvania State University, State College, Pennsylvania
Louis M. French
Affiliation:
Department of Research, Defense and Veterans Brain Injury Center, North Bethesda, Maryland Department of Orthopaedics and Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
*
Correspondence and reprint requests to: Rael T. Lange, Defense and Veterans Brain Injury Center, 11300 Rockville Pike, Suite 1100, North Bethesda, MD 20852. E-mail: rlange@dvbic.org

Abstract

The purpose of this study was to compare the neuropsychological outcome from blast-related versus non-blast related mild traumatic brain injury (MTBI). Participants were 56 U.S. military service members who sustained an MTBI, divided into two groups based on mechanism of injury: (a) non-blast related (Non-blast; n = 21), and (b) blast plus secondary blunt trauma (Blast Plus; n = 35). All participants had sustained their injury in theatre whilst deployed during Operation Iraqi Freedom or Operation Enduring Freedom. Patients had been seen for neuropsychological evaluation at Walter Reed Army Medical Center on average 4.4 months (SD = 4.1) post-injury. Measures included 14 clinical scales from the Personality Assessment Inventory (PAI) and 12 common neurocognitive measures. For the PAI, there were no significant differences between groups on all scales (p > .05). However, medium effect sizes were found for the Depression (d = .49) and Stress (d = .47) scales (i.e., Blast Plus > Non-blast). On the neurocognitive measures, after controlling for the influence of psychological distress (i.e., Depression, Stress), there were no differences between the Non-blast and Blast Plus groups on all measures. These findings provide little evidence to suggest that blast exposure plus secondary blunt trauma results in worse cognitive or psychological recovery than blunt trauma alone. (JINS, 2012, 18, 595–605)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2012

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