Abnormal Neurological Exam Findings in Individuals with Mild Traumatic Brain Injury (mTBI) Versus Psychiatric and Healthy Controls

Abstract

In those with a history of mild traumatic brain injury (mTBI), cognitive and emotional disturbances are often misattributed to that preexisting injury. However, causal determinations of current symptoms cannot be conclusively determined because symptoms are often nonspecific to etiology and offer virtually no differential diagnostic value in postacute or chronic phases. This population-based study examined whether the presence of abnormalities during neurological examination would distinguish between mTBI (in the chronic phase), healthy controls, and selected psychiatric conditions. Retrospective analysis of data from 4462 community-dwelling Army veterans was conducted. Diagnostically unique groups were compared on examination of cranial nerve function and other neurological signs. Results demonstrated that individuals with mTBI were no more likely than those with a major depressive disorder, generalized anxiety disorder, posttraumatic stress disorder, or somatoform disorder to show any abnormality. Thus, like self-reported cognitive and emotional symptoms, the presence of cranial nerve or other neurological abnormalities offers no differential diagnostic value. Clinical implications and study limitations are presented.

Keywords:

• Brain injuries
• Head injuries
• Closed head injuries
• Mental disorders
• Neurologic manifestations
• Postconcussion syndrome

Acknowledgements

The research reported here was supported by the Department of Veterans Affairs, Veteran Health Administration (VHA), and the Defense and Veterans Brain Injury Center (DVBIC). Further support was provided by the James A. Haley Veterans’ Hospital. The views expressed herein are of the authors and do not necessarily reflect the views of the official policies of the Department of Veterans Affairs or the U.S. Government.