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Long-term neuropsychological outcomes following mild traumatic brain injury

Published online by Cambridge University Press:  04 May 2005

RODNEY D. VANDERPLOEG
Affiliation:
Department of Mental Health and Behavioral Sciences, James A. Haley VAMC, Tampa, Florida Defense and Veterans Brain Injury Center, Tampa, Florida Department of Psychiatry and Behavioral Medicine, University of South Florida, Tampa, Florida Department of Psychology, University of South Florida, Tampa, Florida
GLENN CURTISS
Affiliation:
Department of Mental Health and Behavioral Sciences, James A. Haley VAMC, Tampa, Florida Defense and Veterans Brain Injury Center, Tampa, Florida Department of Psychiatry and Behavioral Medicine, University of South Florida, Tampa, Florida
HEATHER G. BELANGER
Affiliation:
Department of Mental Health and Behavioral Sciences, James A. Haley VAMC, Tampa, Florida Defense and Veterans Brain Injury Center, Tampa, Florida Department of Psychology, University of South Florida, Tampa, Florida Henry M. Jackson Foundation, Rockville, Maryland

Abstract

Mild traumatic brain injury (MTBI) is common, yet few studies have examined neuropsychological outcomes more than 1 year postinjury. Studies of nonreferred individuals with MTBI or studies with appropriate control groups are lacking, but necessary to draw conclusions regarding natural recovery from MTBI. We examined the long-term neuropsychological outcomes of a self-reported MTBI an average of 8 years postinjury in a nonreferred community-dwelling sample of male veterans. This was a cross-sectional cohort study derived from the Vietnam Experience Study. Three groups matched on premorbid cognitive ability were examined, those who (1) had not been injured in a MVA nor had a head injury (Normal Control; n = 3214), (2) had been injured in a motor vehicle accident (MVA) but did not have a head injury (MVA Control; n = 539), and (3) had a head injury with altered consciousness (MTBI; n = 254). A MANOVA found no group differences on a standard neuropsychological test battery of 15 measures. Across 15 measures, the average neuropsychological effect size of MTBI compared with either control group was −.03. Subtle aspects of attention and working memory also were examined by comparing groups on Paced Auditory Serial Addition Test (PASAT) continuation rate and California Verbal Learning Test (CVLT) proactive interference (PI). Compared with normal controls, the MTBI group evidenced attention problems in their lower rate of continuation to completion on the PASAT (odds ratio = 1.32, CI = 1.0–1.73) and in excessive PI (odds ratio = 1.66, CI = 1.11–2.47). Unique to the MTBI group, PASAT continuation problems were associated with left-sided visual imperceptions and excessive PI was associated with impaired tandem gait. These results show that MTBI can have adverse long-term neuropsychological outcomes on subtle aspects of complex attention and working memory. (JINS, 2005, 11, 228–236.)

Type
Research Article
Copyright
© 2005 The International Neuropsychological Society

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References

REFERENCES

Alexander, M.P. (1992). Neuropsychiatric correlates of persistent postconcussive syndrome. Journal of Head Trauma Rehabilitation, 7, 6069.Google Scholar
Alexander, M.P. (1995). Mild traumatic brain injury: Pathophysiology, natural history, and clinical management. Neurology, 45, 12531260.Google Scholar
Alves, W., Macciocchi, S.N., & Barth, J.T. (1993). Postconcussive symptoms after uncomplicated mild head injury. Journal of Head Trauma Rehabilitation, 8, 4859.Google Scholar
Benton, A.L. & Hamsher, K. (1976). Multilingual aphasia examination. Iowa City, IA: University Hospital, Department of Neurology.
Belanger, H.G., Curtiss, G., Demery, J.A., Lebowitz, B.K., & Vanderploeg, R.D. (in press). Factors moderating neuropsychological outcomes following mild traumatic brain injury: A meta-analysis. Journal of the International Neuropsychological Society.
Berg, E.A. (1941). A simple objective treatment for measuring flexibility in thinking. Journal of General Psychology, 39, 1522.Google Scholar
Binder, L.M., Rohling, M.L., & Larrabee, G.J. (1997). A review of mild head trauma, Part I: Meta-analytic review of neuropsychological studies. Journal of Clinical and Experimental Neuropsychology, 19, 421431.Google Scholar
Bowles, R.P. & Salthouse, T.A. (2003). Assessing the age-related effects of proactive interference on working memory tasks using the Rasch model. Psychology and Aging, 18, 608615.Google Scholar
Centers for Disease Control. (1988a). Health status of Vietnam veterans: I. Psychosocial characteristics. The Centers for Disease Control Vietnam Experience Study. Journal of the American Medical Association, 18, 27012707.Google Scholar
Centers for Disease Control. (1988b). Health status of Vietnam veterans: II. Physical health. The Centers for Disease Control Vietnam Experience Study. Journal of the American Medical Association, 18, 27082714.Google Scholar
Centers for Disease Control. (1989). Health status of Vietnam veterans: Vol. IV. Psychological and neuropsychological evaluation. Atlanta, GA.
Deb, S., Lyons, I., & Koutzoukis, C. (1999). Neurobehavioural symptoms one year after a head injury. British Journal of Psychiatry, 174, 360365.Google Scholar
Dikmen, S.S., Machamer, J.E., Winn, H.R., & Temkin, N.R. (1995). Neuropsychological outcome at 1-year post head injury. Neuropsychology, 9, 8090.Google Scholar
Dikmen, S., McLean, A., & Temkin, N. (1986). Neuropsychological and psychosocial consequences of minor head injury. Journal of Neurology, Neurosurgery, and Psychiatry, 49, 12271232.Google Scholar
Delis, D.C., Kramer, J.H., Kaplan, E., & Ober, B.A. (1983). California Verbal Learning Test, Research Edition. San Antonio, TX: The Psychological Corporation.
De Rosa, E. & Sullivan, E.V. (2003). Enhanced release from proactive interference in nonamnesic alcoholic individuals: Implications for impaired associative binding. Neuropsychology, 17, 469481.Google Scholar
Goodglass, H. & Kaplan, E. (1983). Boston Diagnostic Aphasia Exam. Philadelphia, Pennsylvania: Lea and Febiger.
Gronwall, D.M.A. (1977). Paced Auditory Serial-Addition Task: A measure of recovery from concussion. Perceptual and Motor Skills, 44, 367373.Google Scholar
Hartlage, L.C., Durant-Wilson, D., & Patch, P.C. (2001). Persistent neurobehavioral problems following mild traumatic brain injury. Archives of Clinical Neuropsychology, 16, 561570.Google Scholar
Heaton, R.K., Chelune, G.J., Talley, J.L., Kay, G.G., & Curtiss, G. (1993). Wisconsin Card Sorting Test Manual: Revised and Expanded. Odessa, Florida: Psychological Assessment Resources.
Heilman, K.M., Watson, R.T., & Valenstein, E. (1994). Localization of lesions in neglect and related disorders. In A. Kertesz (Ed.), Localization and neuroimaging in neuropsychology (pp. 495524). New York: Academic Press.
Henson, R.N., Shallice, T., Josephs, O., & Dolan, R.J. (2002). Functional magnetic resonance imaging of proactive interference during spoken cued recall. Neuroimage, 17, 543558.Google Scholar
Kraus, J.F. & Nourjah, P. (1988). The epidemiology of mild uncomplicated brain injury. Journal of Trauma, 28, 16371643.Google Scholar
Levin, H.S., Mattis, S., Ruff, R.M., Eisenberg, H.M., Marshall, L.F., Tabaddor, K., High, W.M., & Frankowski, R.F. (1987). Neurobehavioral outcome following minor head injury: A three-center study. Journal of Neurosurgery, 66, 234243.Google Scholar
Matthews, C.G. & Klove, H. (1964). Instruction manual for the Adult Neuropsychology Test Battery. Madison WI: University of Wisconsin Medical School.
McAllister, T.W., Saykin, A.J., Flashman, L.A., Sparling, M.B., Johnson, S.C., Guerin, S.J., Mamourian, A.C., Weaver, J.B., & Yanofsky, N. (1999). Brain activation during working memory 1 month after mild traumatic brain injury: A functional MRI study. Neurology, 53, 13001308.CrossRefGoogle Scholar
Mesulam, M.M. (1990). Large-scale neurocognitive networks and distributed processing for attention, language, and memory. Annals of Neurology, 28, 597613.Google Scholar
Montague, E., William, H., Lubin, A., & Gieseking, C. (1957). Army tests for assessment of intellectual deficit. United States Armed Forces Medical Journal, 8, 883892.Google Scholar
Nakamura, T., Meguro, K., Yamazaki, H., Okuzumi, H., Tanaka, A., Horikawa, A., Yamaguchi, K., Katsuyama, N., Nakano, M., Arai, H., & Sasaki, H. (1997). Postural and gait disturbance correlated with decreased frontal cerebral blood flow in Alzheimer disease. Alzheimer Disease and Associated Disorders, 11, 132139.Google Scholar
Powell, T.J., Collin, C., & Sutton, K. (1996). A follow-up study of patients hospitalized after minor head injury. Disability and Rehabilitation: An International Multidisciplinary Journal, 18, 231237.Google Scholar
Rey, A. (1993). Psychological examination of traumatic encephalopathy. Archives de Psychology 1941; 28, 286–340. Translated by J. Corwin & F.W. Bylsma. The Clinical Neuropsychologist, 7, 49.Google Scholar
Rimel, R.W., Giordani, B., Barth, J.T., Boll, T.J., & Jane, J.A. (1981). Disability caused by minor head injury. Neurosurgery, 9, 221228.Google Scholar
Rossor, M.N., Tyrrell, P.J., Warrington, E.K., Thompson, P.D., Marsden, C.D., & Lantos, P. (1999). Progressive frontal gait disturbance with atypical Alzheimer's disease and corticobasal degeneration. Journal of Neurology, Neurosurgery and Psychiatry, 67, 345352.Google Scholar
Rutherford, W.H., Merrett, J.D., & McDonald, J.R. (1979). Symptoms at one year following concussion from minor head injuries. Injury, 10, 225230.Google Scholar
Schretlen, D.J. & Shapiro, A.M. (2003). A quantitative review of the effects of traumatic brain injury on cognitive functioning. International Review of Psychiatry, 15, 341349Google Scholar
Smith, M.L., Leonard, G., Crane, J., & Milner, B. (1995). The effects of frontal- or temporal-lobe lesions on susceptibility to interference in spatial memory. Neuropsychologia, 33, 275285.Google Scholar
Sosin, D.M., Sniezek, J.E., & Thurman, D. (1996). Incidence of mild and moderate brain injury in the United States, 1991. Brain Injury, 10, 4754.Google Scholar
Van der Linden, M., Bruyer, R., Roland, J., & Schils, J.P. (1993). Proactive interference in patients with amnesia resulting from anterior communicating artery aneurysm. Journal of Clinical and Experimental Neuropsychology, 15, 525536.Google Scholar
Vanderploeg, R.D., Curtiss, G., Luis, C.A., Ordorica, P.I., & Salazar, A.M. (under review). Long-term morbidity and quality of life following mild head injury.
Warden, D.L., Bleiberg, J., Cameron, K.L., Ecklund, J., Walter, J., Sparling, M.B., Reeves, D., Reynolds, K.Y., & Arciero, R. (2001). Persistent prolongation of simple reaction time in sports concussion. Neurology, 57, 524526.Google Scholar
Wechsler, D. (1981). Wechsler Adult Intelligence Scale–Revised. San Antonio, TX: The Psychological Corporation.
Zakzanis, K.K., Leach, L., & Kaplan, E. (1999). Neuropsychological differential diagnosis. Exton, Pennsylvania: Swets & Zeitlinger.
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