Cognitive Change Associated with Self‐Reported Mild Traumatic Brain Injury Sustained During the OEF/OIF Conflicts

Abstract

Traumatic brain injury (TBI) has received much attention due to high rates of this injury in Service Members returning from the Iraq/Afghanistan conflicts. This study examined cognitive performance in Service Members tested with ANAM prior to and following deployment. The sample was divided into a control group (n = 400) reporting no TBI injury prior to or during most recent deployment, and a group who self‐reported a TBI injury (n = 502) during most recent deployment. This latter group was divided further based on self‐report of post‐concussion symptoms at post‐deployment testing. All three groups performed similarly at pre‐deployment. The group reporting TBI with active symptoms performed worst at post‐deployment and included the highest percentage of individuals showing significant decline in cognitive performance over time (30.5%). A small sample of symptomatic individuals with a non‐TBI reported injury did not demonstrate similar declines in performance, suggesting that active symptoms alone cannot account for these findings. Of those reporting a TBI injury during deployment, 70% demonstrated no significant change in cognitive performance compared with baseline. Although the exact etiology of observed declines is uncertain, findings indicate that individuals who self‐report TBI during deployment with active symptomatology at post‐deployment are at greatest risk for declines in cognitive performance. These individuals can be identified using self‐report and brief computer‐based testing. Importantly, the majority of active‐duty individuals reporting TBI during deployment do not present with lasting significant cognitive impairment, a finding consistent with the civilian literature on mild TBI.

Keywords:

• Military deployment
• Mild traumatic brain injury
• Computerized testing
• ANAM
• Military TBI

Acknowledgments

This data analysis was conducted by the Center for the Study of Human Operator Performance (C‐SHOP) at the University of Oklahoma and is made possible by a DoD Grant awarded and administered by the U.S. Army Medical Research & Materiel Command (USAMRMC) and the Telemedicine & Advanced Technology Research Center (TATRC) at Fort Detrick, MD under Contract Number W81XWH‐07‐2‐0097.

We would like to acknowledge the significant contributions of the many individuals, staff, and Service Members at the following organizations who made data collection for this analysis possible: Fort Campbell, KY; Neurocognitive Assessment Branch, Rehabilitation and Reintegration Division, US Army Office of the Surgeon General; and the Defense and Veterans Brain Injury Center.

The University of Oklahoma (OU) holds the exclusive license for the Automated Neuropsychological Assessment Metrics (ANAM). The Cognitive Science Research Center (formerly C‐SHOP) at OU is responsible for research and development of ANAM. VistaLifeSciences holds the exclusive license for ANAM commercialization. Author Friedl is a co-inventor on United States Patent 7,837,472 and has received royalties in connection with this patent. Authors Gilliland and Schlegel have standard university royalty agreements for the sale of ANAM. No other authors of this manuscript receive funds or salary support from ANAM sales.

The views, opinions, and/or findings contained in this manuscript are those of the authors/organizations and do not necessarily reflect the views of the Department of Defense and should not be construed as an official DoD/Army position, policy or decision unless so designated by other documentation. No official endorsement should be made.