Combined PTSD, Brain Injury in Veterans Tied to Poorer Outcome

War veterans suffering from both post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) have poorer cognitive and psychological outcomes than veterans with only one of the conditions, according to new research published in the Journal of Neurotrauma.

The findings also suggest that mTBI alone may lead to ongoing, mild cognitive challenges for some patients.

Previous research has found that 12 to 16 percent of all veterans involved in the Iraqi conflict experienced mTBI and about 13 to 17 percent of veterans developed PTSD. One-third of all veterans with a TBI also suffer from PTSD.

Until now, most research has focused on the psychological and neuropsychological effects of PTSD and mild TBI as separate conditions. Recently, however, researchers at the University of Kentucky published findings from a collaborative, multisite study investigating the collective, as well as individual, effects of mTBI and PTSD on psychological and cognitive functioning.

“Most previous studies have not adequately separated out the cognitive effects due to mTBI from the cognitive effects due to PTSD,” said Dr. Walter High, an adjunct associate professor in the UK Department of Physical Medicine and Rehabilitation, Neurosurgery, and Psychology.

“Our study is relatively unique because it includes a comparison group of veterans with PTSD only. This is extremely important because the effects of mTBI and PTSD can be very similar. The inclusion of a group of veterans with both mTBI and PTSD also allowed us to look at the interactive effects of these conditions.”

The findings suggest that veterans suffering from both conditions have poorer cognitive and psychological outcomes than those diagnosed with only one of the conditions. They also found that mTBI may lead to persistent but mild cognitive challenges for some veterans.

For the study, researchers worked with veterans at the Lexington Veterans Affairs Hospital on the UK campus to conduct a series of neuropsychological tasks.

Participants were classified as mTBi only, PTSD only, or both mTBI and PTSD. The tests evaluated cognitive processing speed, IQ, verbal memory, psychological distress and more. Participants were also grouped according to general IQ, age and other characteristics.

The researchers found small reductions in information processing efficiency, attention and memory that could be attributed specifically to the mTBI.

High said the problems attributable to mTBI are small and not disabling. Veterans can overcome the mild cognitive impairment caused by mTBI with proper education about mTBI and therapies.

“The take-home message is that we need to validate to the veteran that the problems they are experiencing are real, but to reassure them that their cognitive abilities are within normal limits and they can still be successful,” High said. “There are strategies to rehabilitate and exercise their memory.”

Source: University of Kentucky