Marion, Donald W; Curley, Kenneth C; Schwab, Karen; Hicks, Ramona R; M, T B I Diagnostics Workgroup
Proceedings of the military mTBI Diagnostics Workshop, St. Pete Beach, August 2010 Journal Article
In: Journal of Neurotrauma, vol. 28, pp. 517–526, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Marion2011,
title = {Proceedings of the military mTBI Diagnostics Workshop, St. Pete Beach, August 2010},
author = {Marion, Donald W and Curley, Kenneth C and Schwab, Karen and Hicks, Ramona R and M, T B I Diagnostics Workgroup},
year = {2011},
date = {2011-01-01},
journal = {Journal of Neurotrauma},
volume = {28},
pages = {517--526},
address = {The Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center, Washington, DC 20307, USA. Donald.Marion@us.army.mil},
abstract = {Approximately 28,000 service members (SMs) sustain a traumatic brain injury (TBI) each year in the U.S. military. The majority of the injuries result either in a brief or no loss of consciousness, and are classified as a mild TBI (mTBI or concussion). Current evaluation guidelines of SMs suspected of having a mTBI rely heavily on self-reports. However, there is concern that SMs typically minimize or do not report their symptoms of mTBI for fear that doing so will result in being removed from the battlefield. Because mTBI often results in headaches, cognitive dysfunction, attention difficulties, and balance problems, returning to the battlefield before resolution of their symptoms can be dangerous for the SM and for their unit. Sustaining a second concussion before resolution of a previous mTBI also may make long-term neuronal injury more likely. The mTBI Diagnostics Workshop was designed as a forum where civilian and military experts from a variety of TBI-related clinical and basic science disciplines could meet to define the diagnostic tools, alone or in combination, that were most likely to result in an acute, objective diagnosis of mTBI. The premise of the meeting was that a small number of well-focused research projects conducted over the next 2-3 years could be done to validate the optimal test, or more likely combination of tests, that would be practical and reliable for the acute diagnosis of mTBI within 2-3 h of injury in theater. The recommendations of the Workshop are provided in this report.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Nelson, Nathaniel W; Hoelzle, James B; McGuire, Kathryn A; Ferrier-Auerbach, Amanda G; Charlesworth, Molly J; Sponheim, Scott R
Neuropsychological evaluation of blast-related concussion: illustrating the challenges and complexities through OEF/OIF case studies Journal Article
In: Brain Injury, vol. 25, pp. 511–525, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Nelson2011a,
title = {Neuropsychological evaluation of blast-related concussion: illustrating the challenges and complexities through OEF/OIF case studies},
author = {Nelson, Nathaniel W and Hoelzle, James B and McGuire, Kathryn A and Ferrier-Auerbach, Amanda G and Charlesworth, Molly J and Sponheim, Scott R},
year = {2011},
date = {2011-01-01},
journal = {Brain Injury},
volume = {25},
pages = {511--525},
address = {University of St. Thomas, Graduate School of Professional Psychology, LaSalle Ave., Minneapolis, MN 55403, USA. nels0600@stthomas.edu},
abstract = {BACKGROUND/OBJECTIVE: Soldiers of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF) sustain blast-related mild traumatic brain injury (concussion) with alarming regularity. This study discusses factors in addition to concussion, such as co-morbid psychological difficulty (e.g. post-traumatic stress) and symptom validity concerns that may complicate neuropsychological evaluation in the late stage of concussive injury. CASE REPORT: The study presents the complexities that accompany neuropsychological evaluation of blast concussion through discussion of three case reports of OEF/OIF personnel. DISCUSSION: The authors emphasize uniform assessment of blast concussion, the importance of determining concussion severity according to acute-injury characteristics and elaborate upon non-concussion-related factors that may impact course of cognitive limitation. The authors conclude with a discussion of the need for future research examining the impact of blast concussion (particularly recurrent concussion) and neuropsychological performance.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Ling, Geoffrey S F; Ecklund, James M
Traumatic brain injury in modern war Journal Article
In: Current Opinion in Anaesthesiology, vol. 24, pp. 124–130, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Ling2011,
title = {Traumatic brain injury in modern war},
author = {Ling, Geoffrey S F and Ecklund, James M},
year = {2011},
date = {2011-01-01},
journal = {Current Opinion in Anaesthesiology},
volume = {24},
pages = {124--130},
address = {Department of Neurology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, Maryland, USA. gling@usuhs.mil},
abstract = {PURPOSE OF REVIEW: To review the emerging literature on traumatic brain injury (TBI) caused by explosive blast. RECENT FINDINGS: Efforts are underway to understand how explosive blast injures brain, what is the clinical presentation and how best to manage it. A major way blast injures brain is from detonation pressure waves coupling to a victim's head leading to brain deformation. The effect of other explosion-related elements is unknown. Because scientific insights take time to develop but injuries are occurring now, the military adopts existing civilian standard of care practices developed for similar diseases, such as the Guidelines for the Management of Severe Traumatic Brain Injury developed mainly for closed head TBI. When these do not exist, the military creates them, such as the Veterans Administration and Department of Defense Clinical Practice Guidelines for Concussion/Mild TBI. Another treatment advance is the creation of the first large system-wide approach to diagnosis and clinical management of TBI, which begins at the site of injury and extends through both the military and the Veterans' Administration medical care systems. SUMMARY: Explosive blast TBI is being addressed at all levels - basic research through clinical care. New clinical practice guidelines are being used in a standardized system-wide approach.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Cooper, Douglas B; Kennedy, Jan E; Cullen, Maren A; Critchfield, Edan; Amador, Ricardo R; Bowles, Amy O
Association between combat stress and post-concussive symptom reporting in OEF/OIF service members with mild traumatic brain injuries Journal Article
In: Brain Injury, vol. 25, pp. 1–7, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Cooper2011,
title = {Association between combat stress and post-concussive symptom reporting in OEF/OIF service members with mild traumatic brain injuries},
author = {Cooper, Douglas B and Kennedy, Jan E and Cullen, Maren A and Critchfield, Edan and Amador, Ricardo R and Bowles, Amy O},
year = {2011},
date = {2011-01-01},
journal = {Brain Injury},
volume = {25},
pages = {1--7},
address = {Department of Orthopedics \& Rehabilitation, Brooke Army Medical Center, Ft. Sam Houston, TX, USA. douglas.cooper2@amedd.army.mil},
abstract = {OBJECTIVE: The relationship between combat stress and post-concussive symptoms in service members with mild traumatic brain injuries (mTBI) is poorly understood. It was hypothesized that the co-occurrence of combat stress would have a significant effect on the severity of post-concussive complaints, specifically on emotional and cognitive symptoms. METHODS: Four hundred and seventy-two combat-deployed service members with mTBI completed self-report inventories of post-traumatic stress and post-concussive symptoms. Two groups were formed based on post-traumatic stress symptoms (High Combat Stress and Low Combat Stress). RESULTS: A 3-8-fold increase in post-concussive symptoms was observed when comparing the High and Low Combat Stress Groups. Elevations in post-concussive symptom reporting were not limited to emotional and/or cognitive symptoms, but rather were inclusive of all measured post-concussive symptoms. CONCLUSIONS: The findings of the present study suggest that non-brain injury-related factors, such as high-levels of combat stress, may impact post-concussive symptom reporting in this population, further confounding the accuracy of the post-concussion syndrome (PCS) diagnosis. Considerable caution should be exercised in making the diagnosis of PCS in concussed service members with co-occurring combat-stress disorders.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Watts, Dorraine D; Gibbons, Susanne; Kurzweil, Dina
Mild traumatic brain injury: a survey of perceived knowledge and learning preferences of military and civilian nurses Journal Article
In: Journal of Neuroscience Nursing, vol. 43, pp. 122–129, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Watts2011,
title = {Mild traumatic brain injury: a survey of perceived knowledge and learning preferences of military and civilian nurses},
author = {Watts, Dorraine D and Gibbons, Susanne and Kurzweil, Dina},
year = {2011},
date = {2011-01-01},
journal = {Journal of Neuroscience Nursing},
volume = {43},
pages = {122--129},
address = {Susanne Gibbons, PhD C-ANP C-GNP, is an assistant professor at the Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD. Dina Kurzweil, MS MA PhD(c), is a deputy director at the Education and Technology Innovation},
abstract = {ABSTRACT: Early case recognition and intervention by nurses for patients with mild traumatic brain injury (mTBI) can significantly improve outcomes for civilian and military patients. The "Concussion/mTBI Learning Needs Assessment for Registered Nurses Survey" was developed to evaluate bedside nurses' knowledge related to the assessment and care of patients with mTBI as well as their preferences for learning in order to develop a targeted curriculum. An anonymous, self-administered, Web-based survey was available from February to August 2009. A series of invitational e-mails were sent to nurses at a convenience sample of civilian, federal, and military institutions. A total of 1,224 nurses meeting the inclusion criteria of being bedside care providers and nonadvanced practice responded and were included in the analysis (civilian},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Armistead-Jehle, P; Hansen, C L
In: Archives of Clinical Neuropsychology, vol. 26, pp. 592–601, 2011, ISSN: 0887-6177.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Armistead-Jehle2011,
title = {Comparison of the Repeatable Battery for the Assessment of Neuropsychological Status Effort Index and Stand-Alone Symptom Validity Tests in a Military Sample},
author = {Armistead-Jehle, P and Hansen, C L},
doi = {10.1093/arclin/acr049},
issn = {0887-6177},
year = {2011},
date = {2011-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {26},
pages = {592--601},
abstract = {The current study sought to report the base rates of Symptom Validity Test (SVT) failure in an active duty military sample as well as to compare the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Effort Index (EI) to stand-alone measures of symptom validity. SVT failure varied from previous studies and even among different subgroups in the current sample, ranging from 8% to 30%. The RBANS EI demonstrated modest sensitivity in the detection of suboptimal effort when compared with stand-alone SVTs. Although the index appears to add some utility to the detection of suboptimal effort, sole use of the EI as a measure of symptom validity could conceivably result in an unnecessarily high rate of false negatives.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Hisley, D M; Gurganus, J C; Drysdale, A W
Experimental methodology using digital image correlation to assess ballistic helmet blunt trauma Journal Article
In: Journal of Applied Mechanics-Transactions of the Asme, vol. 78, 2011, ISSN: 0021-8936.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Hisley2011,
title = {Experimental methodology using digital image correlation to assess ballistic helmet blunt trauma},
author = {Hisley, D M and Gurganus, J C and Drysdale, A W},
doi = {051022 10.1115/1.4004332},
issn = {0021-8936},
year = {2011},
date = {2011-01-01},
journal = {Journal of Applied Mechanics-Transactions of the Asme},
volume = {78},
abstract = {As modern helmets have become quite capable of defeating the penetration capabilities of ballistic threats, Soldiers may experience head injuries due to blunt trauma caused by helmet back face deformation (BFD). Possible resulting injuries include skull fracture, hematoma, concussion, contusion, diffuse axonal injury, etc. Some of these injuries have been associated with traumatic brain injury. In order to assess potential injury mechanisms prior to fielding new helmets, we have developed a means to experimentally replicate and measure helmet BFD that can be correlated to injury criteria. In this study, helmet performance test methodology is developed using a digital image correlation (DIC) technique. DIC provides the capability to measure dynamic displacements, thereby providing the ability to calculate deformation, velocity, and acceleration rates. We have shown that digital image correlation is an experimentation technique that accurately captures BFD area and rate of deformation for impacts against combat helmets. We used the DIC data to calculate a new metric; the available energy that could potentially impact a Soldier's head. Our study shows that DIC data upholds the hypothesis that helmet BFD mechanically loads the skull similar to a direct impact from a less-than-lethal projectile or blunt object impact. The available energy obtained from DIC measurements was used to calculate the blunt criterion (BC) for helmet standoff distances of 12.7 mm (0.5 in) and 19.1 mm (0.75 in), which in turn can provide a prediction of the probability of abbreviated injury scale (AIS) levels and, in particular, skull fracture. DIC can be used to provide dynamic helmet performance data that will allow increased understanding of BFD and quantitative assessment and validation of helmet performance results. Knowledge of the conditions leading to head trauma obtained through DIC experimentation should enable the selection of new energy-absorbing materials for helmets; thus, allowing new helmet design candidate performances to be objectively evaluated. Test data and characterization of helmet response could then be used to achieve improved warfighter survivability. [DOI: 10.1115/1.4004332]},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Otis, J D; McGlinchey, R; Vasterling, J J; Kerns, R D
Complicating factors associated with mild traumatic brain injury: Impact on pain and posttraumatic stress disorder treatment Journal Article
In: Journal of Clinical Psychology in Medical Settings, vol. 18, pp. 145–154, 2011, ISSN: 1068-9583.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Otis2011,
title = {Complicating factors associated with mild traumatic brain injury: Impact on pain and posttraumatic stress disorder treatment},
author = {Otis, J D and McGlinchey, R and Vasterling, J J and Kerns, R D},
doi = {10.1007/s10880-011-9239-2},
issn = {1068-9583},
year = {2011},
date = {2011-01-01},
journal = {Journal of Clinical Psychology in Medical Settings},
volume = {18},
pages = {145--154},
abstract = {The nature of combat in Iraq and Afghanistan has resulted in high rates of comorbidity among chronic pain, posttraumatic stress disorder (PTSD), and mild traumatic brain injury (mTBI) in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). Although separate evidence-based psychological treatments have been developed for chronic pain and PTSD, far less is known about how to approach treatment when these conditions co-occur, and especially when they co-occur with mTBI. To provide the best care possible for OEF/OIF Veterans, clinicians need to have a clearer understanding of how to identify these conditions, ways in which these conditions may interact with one another, and ways in which existing evidence-based treatments can be modified to meet the needs of individuals with mTBI. The purpose of the present paper is to review the comorbidity of pain, PTSD, and mTBI in OEF/OIF Veterans, and provide recommendations to clinicians who provide care to Veterans with these conditions. First, we will begin with an overview of the presentation, symptomatology, and treatment of chronic pain and PTSD. The challenges associated with mTBI in OEF/OIF Veterans will be reported and data will be presented on the comorbidity among all three of these conditions in OEF/OIF Veterans. Second, we will present recommendations for providing psychological treatment for chronic pain and PTSD when comorbid with mTBI. Finally, the paper concludes with a discussion of the need for a multidisciplinary treatment approach, as well as a call for continued research to further refine existing treatments for these conditions.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Cullen, D K; Xu, Y A; Reneer, D V; Browne, K D; Geddes, J W; Yang, S; Smith, D H
Color changing photonic crystals detect blast exposure Journal Article
In: Neuroimage, vol. 54, pp. S37–S44, 2011, ISSN: 1053-8119.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Cullen2011,
title = {Color changing photonic crystals detect blast exposure},
author = {Cullen, D K and Xu, Y A and Reneer, D V and Browne, K D and Geddes, J W and Yang, S and Smith, D H},
doi = {10.1016/j.neuroimage.2010.10.076},
issn = {1053-8119},
year = {2011},
date = {2011-01-01},
journal = {Neuroimage},
volume = {54},
pages = {S37--S44},
abstract = {Blast-induced traumatic brain injury (bTBI) is the "signaturewound" of the current wars in Iraq and Afghanistan. However, with no objective information of relative blast exposure, warfighters with bTBI may not receive appropriate medical care and are at risk of being returned to the battlefield. Accordingly, we have created a colorimetric blast injury dosimeter (BID) that exploits material failure of photonic crystals to detect blast exposure. Appearing like a colored sticker, the BID is fabricated in photosensitive polymers via multi-beam interference lithography. Although very stable in the presence of heat, cold or physical impact, sculpted micro -and nano-structures of the BID are physically altered in a precise manner by blast exposure, resulting in color changes that correspond with blast intensity. This approach offers a lightweight, power-free sensor that can be readily interpreted by the naked eye. Importantly, with future refinement this technology may be deployed to identify soldiers exposed to blast at levels suggested to be supra-threshold for non-impact blast-induced mild TBI.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Luethcke, Cynthia A; Bryan, Craig J; Morrow, Chad E; Isler, William C
Comparison of concussive symptoms, cognitive performance, and psychological symptoms between acute blast-versus nonblast-induced mild traumatic brain injury Journal Article
In: Journal of the International Neuropsychological Society, vol. 17, pp. 36–45, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Luethcke2011,
title = {Comparison of concussive symptoms, cognitive performance, and psychological symptoms between acute blast-versus nonblast-induced mild traumatic brain injury},
author = {Luethcke, Cynthia A and Bryan, Craig J and Morrow, Chad E and Isler, William C},
year = {2011},
date = {2011-01-01},
journal = {Journal of the International Neuropsychological Society},
volume = {17},
pages = {36--45},
address = {Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA.},
abstract = {Blast-related head injuries are one of the most prevalent injuries among military personnel deployed in service of Operation Iraqi Freedom. Although several studies have evaluated symptoms after blast injury in military personnel, few studies compared them to nonblast injuries or measured symptoms within the acute stage after traumatic brain injury (TBI). Knowledge of acute symptoms will help deployed clinicians make important decisions regarding recommendations for treatment and return to duty. Furthermore, differences more apparent during the acute stage might suggest important predictors of the long-term trajectory of recovery. This study evaluated concussive, psychological, and cognitive symptoms in military personnel and civilian contractors (N = 82) diagnosed with mild TBI (mTBI) at a combat support hospital in Iraq. Participants completed a clinical interview, the Automated Neuropsychological Assessment Metric (ANAM), PTSD Checklist-Military Version (PCL-M), Behavioral Health Measure (BHM), and Insomnia Severity Index (ISI) within 72 hr of injury. Results suggest that there are few differences in concussive symptoms, psychological symptoms, and neurocognitive performance between blast and nonblast mTBIs, although clinically significant impairment in cognitive reaction time for both blast and nonblast groups is observed. Reductions in ANAM accuracy were related to duration of loss of consciousness, not injury mechanism.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Chen, Yun; Huang, Wei
Non-impact, blast-induced mild TBI and PTSD: concepts and caveats Journal Article
In: Brain Injury, vol. 25, pp. 641–650, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Chen2011,
title = {Non-impact, blast-induced mild TBI and PTSD: concepts and caveats},
author = {Chen, Yun and Huang, Wei},
year = {2011},
date = {2011-01-01},
journal = {Brain Injury},
volume = {25},
pages = {641--650},
address = {Tripler Army Medical Center, Honolulu, HI, USA. yun.chen@us.army.mil},
abstract = {PRIMARY OBJECTIVE: A volumetric blood surge (rapid physical movement/displacement of blood) is hypothesized to cause the non-impact, mild TBI and battlefield PTSD induced by a blast over-pressure wave. RESEARCH DESIGN: Systematic review of the literature. METHODS AND PROCEDURES: Articles relating to the fields of blast injury, brain injury and relevant disorders were searched between the years 1968-2010 for keywords such as 'brain injury', 'post-traumatic stress disorder' and 'blast pressure wave'. Articles found through journal and Internet databases were cross-referenced. MAIN OUTCOMES AND RESULTS: The blood surge, which is driven by elevated overall pressure in the ventral body cavity after exposure of the torso to blast wave, may move through blood vessels to the low-pressure cranial cavity from the high-pressure ventral body cavity. It dramatically increases cerebral perfusion pressure and causes damage to both tiny cerebral blood vessels and the BBB. CONCLUSIONS: Three factors may be critical to the induction of blast-induced brain injuries: (1) the difference in pressure between the ventral body cavity and cranial cavity; (2) blood that acts as a transmission medium to propagate a pressure wave to the brain; and (3) the vulnerability of cerebral blood vessels and the BBB to a sudden fluctuation in perfusion pressure.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Polusny, Melissa A; Kehle, Shannon M; Nelson, Nathaniel W; Erbes, Christopher R; Arbisi, Paul A; Thuras, Paul
Longitudinal effects of mild traumatic brain injury and posttraumatic stress disorder comorbidity on postdeployment outcomes in national guard soldiers deployed to Iraq Journal Article
In: Archives of General Psychiatry, vol. 68, pp. 79–89, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Polusny2011,
title = {Longitudinal effects of mild traumatic brain injury and posttraumatic stress disorder comorbidity on postdeployment outcomes in national guard soldiers deployed to Iraq},
author = {Polusny, Melissa A and Kehle, Shannon M and Nelson, Nathaniel W and Erbes, Christopher R and Arbisi, Paul A and Thuras, Paul},
year = {2011},
date = {2011-01-01},
journal = {Archives of General Psychiatry},
volume = {68},
pages = {79--89},
address = {University of Minnesota Medical School, Minneapolis, USA. melissa.polusny@va.gov},
abstract = {CONTEXT: Troops deployed to Iraq and Afghanistan are at high risk for exposure to combat events resulting in mild traumatic brain injury (MTBI) or concussion and posttraumatic stress disorder (PTSD). The longer-term impact of combat-related concussion/MTBI and comorbid PTSD on troops' health and well-being is unknown. OBJECTIVE: To assess longitudinal associations between concussion/MTBI and PTSD symptoms reported in theater and longer-term psychosocial outcomes in combat-deployed National Guard soldiers. DESIGN: Longitudinal cohort study. Participants were surveyed in Iraq 1 month before returning home (time 1) and 1 year later (time 2). Self-reports of concussion/MTBI and PTSD were assessed at times 1 and 2. Based on time 1 concussion/MTBI status (defined as an injury during deployment with loss of consciousness or altered mental status) and time 2 postdeployment probable PTSD status, soldiers were compared on a range of time 2 psychosocial outcomes. PARTICIPANTS: Nine hundred fifty-three US National Guard soldiers. SETTING: The time 1 sample was assessed during redeployment transition briefings held at military installations in the Iraq combat theater. The time 2 sample was assessed using mailed surveys sent to the homes of US National Guard service members. MAIN OUTCOME MEASURES: Postconcussive, depression, and physical symptoms; alcohol use; social functioning; and quality of life assessed at time 2 using valid clinical instruments. RESULTS: The rate of self-reported concussion/MTBI during deployment was 9.2% at time 1 and 22.0% at time 2. Soldiers with a history of concussion/MTBI were more likely than those without to report postdeployment postconcussive symptoms and poorer psychosocial outcomes. However, after adjusting for PTSD symptoms, concussion/MTBI was not associated with postdeployment symptoms or outcomes. Time 1 PTSD symptoms more strongly predicted postdeployment symptoms and outcomes than did concussion/MTBI history. CONCLUSIONS: Although combat-related PTSD was strongly associated with postconcussive symptoms and psychosocial outcomes 1 year after soldiers returned from Iraq, there was little evidence of a long-term negative impact of concussion/MTBI history on these outcomes after accounting for PTSD. These findings and the 2-fold increase in reports of deployment-related concussion/MTBI history have important implications for screening and treatment.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Peskind, Elaine R; Petrie, Eric C; Cross, Donna J; Pagulayan, Kathleen; McCraw, Kathleen; Hoff, David; Hart, Kim; Yu, Chang-En; Raskind, Murray A; Cook, David G; Minoshima, Satoshi
Cerebrocerebellar hypometabolism associated with repetitive blast exposure mild traumatic brain injury in 12 Iraq war Veterans with persistent post-concussive symptoms Journal Article
In: Neuroimage, vol. 54 Suppl 1, pp. S76–82, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Peskind2011,
title = {Cerebrocerebellar hypometabolism associated with repetitive blast exposure mild traumatic brain injury in 12 Iraq war Veterans with persistent post-concussive symptoms},
author = {Peskind, Elaine R and Petrie, Eric C and Cross, Donna J and Pagulayan, Kathleen and McCraw, Kathleen and Hoff, David and Hart, Kim and Yu, Chang-En and Raskind, Murray A and Cook, David G and Minoshima, Satoshi},
year = {2011},
date = {2011-01-01},
journal = {Neuroimage},
volume = {54 Suppl 1},
pages = {S76--82},
address = {Northwest Network Mental Illness, Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA. peskind@uw.edu},
abstract = {Disagreement exists regarding the extent to which persistent post-concussive symptoms (PCS) reported by Iraq combat Veterans with repeated episodes of mild traumatic brain injury (mTBI) from explosive blasts represent structural or functional brain damage or an epiphenomenon of comorbid depression or posttraumatic stress disorder (PTSD). Objective assessment of brain function in this population may clarify the issue. To this end, twelve Iraq war Veterans (32.0 +/- 8.5 [mean +/- standard deviation (SD)] years of age) reporting one or more blast exposures meeting American Congress of Rehabilitation Medicine criteria for mTBI and persistent PCS and 12 cognitively normal community volunteers (53.0 +/- 4.6 years of age) without history of head trauma underwent brain fluorodeoxyglucose positron emission tomography (FDG-PET) and neuropsychological assessments and completed PCS and psychiatric symptom rating scales. Compared to controls, Veterans with mTBI (with or without PTSD) exhibited decreased cerebral metabolic rate of glucose in the cerebellum, vermis, pons, and medial temporal lobe. They also exhibited subtle impairments in verbal fluency, cognitive processing speed, attention, and working memory, similar to those reported in the literature for patients with cerebellar lesions. These FDG-PET imaging findings suggest that regional brain hypometabolism may constitute a neurobiological substrate for chronic PCS in Iraq combat Veterans with repetitive blast-trauma mTBI. Given the potential public health implications of these findings, further investigation of brain function in these Veterans appears warranted.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Wilk, J; Herrell, R; Hoge, C
Mild traumatic brain injury (concussion), post-traumatic stress disorder, and depression in US soldiers involved in combat deployments: Association with post-deployment symptoms Journal Article
In: Archives of Clinical Neuropsychology, vol. 26, pp. 524, 2011, ISSN: 0887-6177.
BibTeX | Tags: Military Military LB - Military
@article{Wilk2011,
title = {Mild traumatic brain injury (concussion), post-traumatic stress disorder, and depression in US soldiers involved in combat deployments: Association with post-deployment symptoms},
author = {Wilk, J and Herrell, R and Hoge, C},
issn = {0887-6177},
year = {2011},
date = {2011-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {26},
pages = {524},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Young, R S K; Scott, K R
Combat vs. non-combat related traumatic brain injury (TBI) in US service members in Iraq: Performance on neurological cxamination and the MACE (Military Acute Concussion Examination) Journal Article
In: Neurology, vol. 76, pp. A159–A159, 2011, ISSN: 0028-3878.
BibTeX | Tags: Military Military LB - Military
@article{Young2011,
title = {Combat vs. non-combat related traumatic brain injury (TBI) in US service members in Iraq: Performance on neurological cxamination and the MACE (Military Acute Concussion Examination)},
author = {Young, R S K and Scott, K R},
issn = {0028-3878},
year = {2011},
date = {2011-01-01},
journal = {Neurology},
volume = {76},
pages = {A159--A159},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Risdall, Jane E; Menon, David K
Traumatic brain injury Journal Article
In: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, vol. 366, pp. 241–250, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Risdall2011,
title = {Traumatic brain injury},
author = {Risdall, Jane E and Menon, David K},
year = {2011},
date = {2011-01-01},
journal = {Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences},
volume = {366},
pages = {241--250},
address = {Surgeon Commander, Royal Navy, UK.},
abstract = {There is an increasing incidence of military traumatic brain injury (TBI), and similar injuries are seen in civilians in war zones or terrorist incidents. Indeed, blast-induced mild TBI has been referred to as the signature injury of the conflicts in Iraq and Afghanistan. Assessment involves schemes that are common in civilian practice but, in common with civilian TBI, takes little account of information available from modern imaging (particularly diffusion tensor magnetic resonance imaging) and emerging biomarkers. The efficient logistics of clinical care delivery in the field may have a role in optimizing outcome. Clinical care has much in common with civilian TBI, but intracranial pressure monitoring is not always available, and protocols need to be modified to take account of this. In addition, severe early oedema has led to increasing use of decompressive craniectomy, and blast TBI may be associated with a higher incidence of vasospasm and pseudoaneurysm formation. Visual and/or auditory deficits are common, and there is a significant risk of post-traumatic epilepsy. TBI is rarely an isolated finding in this setting, and persistent post-concussive symptoms are commonly associated with post-traumatic stress disorder and chronic pain, a constellation of findings that has been called the polytrauma clinical triad.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Alvarez, M; Kennedy, J; Amador, R; Cullen, M
Military Acute Concussion Evaluation Score and Its Relevance to Post-Concussive Symptoms in mTBI Service Members Journal Article
In: Neurology, vol. 76, pp. A165–A165, 2011, ISSN: 0028-3878.
BibTeX | Tags: Military Military LB - Military
@article{Alvarez2011,
title = {Military Acute Concussion Evaluation Score and Its Relevance to Post-Concussive Symptoms in mTBI Service Members},
author = {Alvarez, M and Kennedy, J and Amador, R and Cullen, M},
issn = {0028-3878},
year = {2011},
date = {2011-01-01},
journal = {Neurology},
volume = {76},
pages = {A165--A165},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Melamed, B G; Castro, C
Observations and insights about Strengthening Our Soldiers (SOS) Journal Article
In: Journal of Clinical Psychology in Medical Settings, vol. 18, pp. 210–223, 2011, ISSN: 1068-9583.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Melamed2011,
title = {Observations and insights about Strengthening Our Soldiers (SOS)},
author = {Melamed, B G and Castro, C},
doi = {10.1007/s10880-011-9253-4},
issn = {1068-9583},
year = {2011},
date = {2011-01-01},
journal = {Journal of Clinical Psychology in Medical Settings},
volume = {18},
pages = {210--223},
abstract = {The Special Issue (June 2011) of the Journal of Clinical Psychology in Medical Settings titled Strengthening Our Soldiers (SOS) and Their Families: Contemporary Psychological Advances Applied to Wartime Problems revealed the following important concerns: 1) Who is at risk for psychological sequelae during and following service in the U.S. military? 2) How to deliver the best treatment for our soldiers and veterans with PTSD, Traumatic Brain Injury and Pain? 3) How to train the trainers? and 4) What are the current priorities for service delivery, research and funding? Assessment strategies and tools are provided to assist in identification of suicidal ideation and behaviors, alcohol abuse in spouses, posttraumatic stress disorders, depression, brain injuries and post-concussion syndrome, as well as positive growth experiences. Empirically validated Cognitive Processing and Prolonged Exposure treatments are described as are the empirical results already in evidence in our military populations. The innovative use of Virtual Reality and Telehealth applications is demonstrated in both army and naval settings for preparing and reducing trauma in affected soldiers. The Functional and Occupational Rehabilitation Treatment (FORT) Program and its role in returning function to injured soldiers with musculoskeletal pain and motion restrictions, while also leading to reductions of anxiety, depression and use of medical services, is described. A critique about providing service-research for children's reactions to their parent's deployments and family functioning during separation and reintegration is provided. The need for theoretical-empirical approaches to understanding pain-behavior, anxiety dysregulation as it impacts the brain function and structure is provided by experts in pain, neuropsychology, brain circuitry and anxiety management of multiple traumas. This final paper in SOS provides commentary on SOS and describes possible future implications of current psychological knowledge related to military personnel and their families.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Brenner, Lisa A; Ignacio, Rosalinda V; Blow, Frederic C
Suicide and traumatic brain injury among individuals seeking Veterans Health Administration services Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 26, pp. 257–264, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Brenner2011,
title = {Suicide and traumatic brain injury among individuals seeking Veterans Health Administration services},
author = {Brenner, Lisa A and Ignacio, Rosalinda V and Blow, Frederic C},
year = {2011},
date = {2011-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {26},
pages = {257--264},
address = {VISN 19 Mental Illness Research Education and Clinical Center (MIRECC), Denver, Colorado 80220, USA. Lisa.Brenner@va.gov},
abstract = {OBJECTIVE: To examine associations between history of traumatic brain injury (TBI) diagnosis and death by suicide among individuals receiving care within the Veterans Health Administration (VHA). METHOD: Individuals who received care between fiscal years 2001 to 2006 were included in analyses. Cox proportional hazards survival models for time to suicide, with time-dependent covariates, were utilized. Covariance sandwich estimators were used to adjust for the clustered nature of the data, with patients nested within VHA facilities. Analyses included all patients with a history of TBI (n = 49626) plus a 5% random sample of patients without TBI (n = 389053). Of those with a history of TBI, 105 died by suicide. Models were adjusted for demographic and psychiatric covariates. RESULTS: Veterans with a history of TBI were 1.55 (95% confidence interval [CI], 1.24-1.92) times more likely to die by suicide than those without a history of TBI. Analyses by TBI severity were also conducted, and they suggested that in comparison to those without an injury history, those with (1) concussion/cranial fracture were 1.98 times more likely (95% CI, 1.39-2.82) to die by suicide and (2) cerebral contusion/traumatic intracranial hemorrhage were 1.34 times more likely (95% CI, 1.09-1.64) to die by suicide. This increased risk was not explained by the presence of psychiatric disorders or demographic factors. CONCLUSIONS: Among VHA users, those with a diagnosis of TBI were at greater risk for suicide than those without this diagnosis. Further research is indicated to identify evidence-based means of assessment and treatment for those with TBI and suicidal behavior.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Weinberger, Sharon
Bombs' hidden impact: the brain war Journal Article
In: Nature, vol. 477, pp. 390–393, 2011.
BibTeX | Tags: Military Military LB - Military
@article{Weinberger2011,
title = {Bombs' hidden impact: the brain war},
author = {Weinberger, Sharon},
year = {2011},
date = {2011-01-01},
journal = {Nature},
volume = {477},
pages = {390--393},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Romesser, Jennifer; Shen, Shuying; Reblin, Maija; Kircher, John; Allen, Steven; Roberts, Toni; Marchand, William R
A preliminary study of the effect of a diagnosis of concussion on PTSD symptoms and other psychiatric variables at the time of treatment seeking among veterans Journal Article
In: Military Medicine, vol. 176, pp. 246–252, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Romesser2011,
title = {A preliminary study of the effect of a diagnosis of concussion on PTSD symptoms and other psychiatric variables at the time of treatment seeking among veterans},
author = {Romesser, Jennifer and Shen, Shuying and Reblin, Maija and Kircher, John and Allen, Steven and Roberts, Toni and Marchand, William R},
year = {2011},
date = {2011-01-01},
journal = {Military Medicine},
volume = {176},
pages = {246--252},
address = {The George E. Wahlen Veterans Affairs Medical Center, 500 Foothill, Salt Lake City, UT 84148, USA.},
abstract = {The aim of this study was to assess whether a diagnosis of concussion given at a Veterans Healthcare Administration secondary traumatic brain injury assessment impacted either posttraumatic stress disorder (PTSD) symptomatology or other variables at the time veterans sought treatment for PTSD. This retrospective study compared 61 male veterans with a history of military-related concussion and military-related PTSD to 83 male veterans with military-related PTSD but without a diagnosis of military-related concussion. There were no significant between-group differences in PTSD symptomatology. However, the cohort with a history of military concussion endorsed decreased ability to cope with PTSD symptoms, increased problems with physical health, and more pain complaints. If replicated, these results may guide the design of more effective interventions for veterans who receive diagnoses of PTSD and concussion.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Rigg, John L; Mooney, Scott R
Concussions and the military: Issues specific to service members Journal Article
In: PM & R, vol. 3, pp. S380–S386, 2011, ISSN: 1934-1482.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Rigg2011,
title = {Concussions and the military: Issues specific to service members},
author = {Rigg, John L and Mooney, Scott R},
doi = {10.1016/j.pmrj.2011.08.005},
issn = {1934-1482},
year = {2011},
date = {2011-01-01},
journal = {PM \& R},
volume = {3},
pages = {S380--S386},
abstract = {Since October 2001, more than 1.6 million American military service members have deployed to Iraq and Afghanistan in the Global War on Terrorism. It is estimated that between 5% and 35% of them have sustained a concussion, also called mild traumatic brain injury (mTBI), during their deployment. Up to 80% of the concussions experienced in theater are secondary to blast exposures. The unique circumstances and consequences of sustaining a concussion in combat demands a unique understanding and treatment plan. The current literature was reviewed and revealed a paucity of pathophysiological explanations on the nature of the injury and informed treatment plans. However, through observation and experience, a theoretical but scientifically plausible model for why and how blast injuries experienced in combat give rise to the symptoms that affect day-to-day function of service members who have been concussed has been developed. We also are able to offer treatment strategies based on our evaluation of the current literature and experience to help palliate postconcussive symptoms. The purpose of this review is to elucidate common physical, cognitive, emotional, and situational challenges, and possible solutions for this special population of patients who will be transitioning into the civilian sector and interfacing with health professionals. There is a need for further investigation and testing of these strategies.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Akin, Faith W; Murnane, Owen D
Head injury and blast exposure: vestibular consequences Journal Article
In: Otolaryngologic Clinics of North America, vol. 44, pp. 323–334, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Akin2011,
title = {Head injury and blast exposure: vestibular consequences},
author = {Akin, Faith W and Murnane, Owen D},
year = {2011},
date = {2011-01-01},
journal = {Otolaryngologic Clinics of North America},
volume = {44},
pages = {323--334},
address = {Vestibular/Balance Laboratory, Audiology Service, Veterans Affairs Medical Center, Mountain Home, TN 37684, USA. faith.akin@va.gov},
abstract = {Young adults are more likely to suffer blast injury and traumatic brain injury (TBI) than other age groups. This article reviews the literature on the vestibular[NON-BREAKING SPACE]consequences of blast exposure and TBI and concussion. In addition, the vestibular test findings obtained from 31 veterans with a history of blast exposure and/or mild TBI are presented. The authors discuss loss of horizontal semicircular canal function and postural instability related to head injury. Preliminary data suggest the novel theory that otolith organs are uniquely vulnerable to head injury and blast exposure.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Ryan, P B; Lee-Wilk, T; Kok, B C; Wilk, J E
Interdisciplinary rehabilitation of mild TBI and PTSD: A case report Journal Article
In: Brain Injury, vol. 25, pp. 1019–1025, 2011, ISSN: 0269-9052.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Ryan2011,
title = {Interdisciplinary rehabilitation of mild TBI and PTSD: A case report},
author = {Ryan, P B and Lee-Wilk, T and Kok, B C and Wilk, J E},
doi = {10.3109/02699052.2011.597044},
issn = {0269-9052},
year = {2011},
date = {2011-01-01},
journal = {Brain Injury},
volume = {25},
pages = {1019--1025},
abstract = {Background: Prevalence of mild traumatic brain injury (mTBI) or concussion on the battlefield in Iraq/Afghanistan has resulted in its designation as a 'signature injury'. Civilian studies have shown that negative expectations for recovery may lead to worse outcomes. While there is concern that concussion screening procedures in the Veteran's Affairs Healthcare System and the Department of Defence could fuel negative expectations, leading to negative iatrogenic effects, it has been difficult to document this in clinical settings. The aim of this report is to describe the case of a veteran with comorbid mTBI/PTSD with persistent symptoms of unknown aetiology and the effects of provider communications on the patient's recovery. Methods: Case report of a veteran with reported mTBI, including provider communications, neuropsychological test results and report of functioning after changes in provider messages. Results: Two-years post-mTBI, the patient attributed cognitive difficulties to his brain injury, but neuropsychological assessment found that his cognitive profile was consistent with psychological rather than neurological dysfunction. After providers systematically emphasized expectations of recovery, the patient's daily functioning improved. Conclusions: This case illustrates difficulties in mass screening for and treating mTBI. Recommendations for improvement include clinician training in effectively communicating positive expectations of recovery after concussion.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Nelson, Nathaniel W; Hoelzle, James B; McGuire, Kathryn A; Sim, Anita H; Goldman, Daniel J; Ferrier-Auerbach, Amanda G; Charlesworth, Molly J; Arbisi, Paul A; Sponheim, Scott R
Self-report of psychological function among OEF/OIF personnel who also report combat-related concussion Journal Article
In: Clinical Neuropsychologist, vol. 25, pp. 716–740, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Nelson2011c,
title = {Self-report of psychological function among OEF/OIF personnel who also report combat-related concussion},
author = {Nelson, Nathaniel W and Hoelzle, James B and McGuire, Kathryn A and Sim, Anita H and Goldman, Daniel J and Ferrier-Auerbach, Amanda G and Charlesworth, Molly J and Arbisi, Paul A and Sponheim, Scott R},
year = {2011},
date = {2011-01-01},
journal = {Clinical Neuropsychologist},
volume = {25},
pages = {716--740},
address = {Graduate School of Professional Psychology, University of St. Thomas, Minneapolis, MN 55403, USA. nels0600@stthomas.edu},
abstract = {MMPI-2 RF profiles of 128 U.S. soldiers and veterans with history of concussion were examined. Participants evaluated in forensic (n[THIN SPACE]=[THIN SPACE]42) and clinical (n[THIN SPACE]=[THIN SPACE]43) settings showed significantly higher validity and clinical elevations relative to a research group (n[THIN SPACE]=[THIN SPACE]43). In the full sample, a multivariate GLM identified main effects for disability claim status and Axis I diagnosis across numerous MMPI-2 RF scales. Participants with co-morbid PTSD and concussion showed significant Restructured Clinical and Specific Problem scale elevations relative to those without Axis I diagnosis. Participants with PTSD and active disability claims were especially prone to elevate on FBS/FBS-r and RBS. Implications for neuropsychologists who routinely administer the MMPI-2/RF in the context of combat-related concussion are discussed.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Bryan, Craig J; Hernandez, Ann M
Predictors of post-traumatic headache severity among deployed military personnel Journal Article
In: Headache, vol. 51, pp. 945–953, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Bryan2011,
title = {Predictors of post-traumatic headache severity among deployed military personnel},
author = {Bryan, Craig J and Hernandez, Ann M},
year = {2011},
date = {2011-01-01},
journal = {Headache},
volume = {51},
pages = {945--953},
address = {Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.},
abstract = {OBJECTIVE: The current study used a cross-sectional observational design to evaluate the relationship between psychological, physiological, and contextual factors and headache severity among 133 deployed military personnel and 4 civilian contractors diagnosed with mild traumatic brain injury (mTBI) referred to a combat support hospital in Iraq. BACKGROUND: Although TBI and headache sequelae have been documented for military combatants, little is known about factors associated with headache severity. METHODS: Military personnel (n = 157) and civilian (n = 4) contractors referred to a combat support hospital in Iraq underwent a standardized intake evaluation which included computerized neurocognitive testing, psychological and physical health questionnaires, a clinical interview, and a physical examination by a physician. RESULTS: Results of zero-inflated Poisson regression modeling suggest that insomnia is associated with increased likelihood for endorsement of any headache, but loss of consciousness, post-traumatic stress disorder symptoms, and slowed reaction time only are predictive of headache severity. Among the subset of patients presenting to the combat support hospital within 7 days of mTBI (n = 101), number of TBI symptoms demonstrated a non-significant trend toward increased likelihood of headache endorsement of any kind, with loss of consciousness, post-traumatic stress disorder, and slowed reaction time demonstrating significant relationships with headache severity. CONCLUSION: Knowledge of predictors of post-concussive headache onset and severity may assist clinicians in making important decisions regarding treatment recommendations for veterans with mTBI.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Coldren, Rodney L; Russell, Michael L; Kelly, Mark P; Parish, Robert V; Dretsch, Michael
Re: Automated neuropsychological assessment metrics (ANAM) Journal Article
In: Military Medicine, vol. 176, pp. iv, 2011.
BibTeX | Tags: Military Military LB - Military
@article{Coldren2011,
title = {Re: Automated neuropsychological assessment metrics (ANAM)},
author = {Coldren, Rodney L and Russell, Michael L and Kelly, Mark P and Parish, Robert V and Dretsch, Michael},
year = {2011},
date = {2011-01-01},
journal = {Military Medicine},
volume = {176},
pages = {iv},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Nelson, N W; Hoelzle, J B; Doane, B M; McGuire, K A; Ferrier-Auerbach, A G; Charlesworth, M J; Polusny, M A; Arbisi, P A; Lamberty, G J; Sponheim, S R
Neuropsychological outcomes of United States veterans with report of remote blast concussion and concurrent psychological distress Journal Article
In: Clinical Neuropsychologist, vol. 25, pp. 553–554, 2011, ISSN: 1385-4046.
BibTeX | Tags: Military Military LB - Military
@article{Nelson2011b,
title = {Neuropsychological outcomes of United States veterans with report of remote blast concussion and concurrent psychological distress},
author = {Nelson, N W and Hoelzle, J B and Doane, B M and McGuire, K A and Ferrier-Auerbach, A G and Charlesworth, M J and Polusny, M A and Arbisi, P A and Lamberty, G J and Sponheim, S R},
issn = {1385-4046},
year = {2011},
date = {2011-01-01},
journal = {Clinical Neuropsychologist},
volume = {25},
pages = {553--554},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Erickson, Jay C
Treatment outcomes of chronic post-traumatic headaches after mild head trauma in US soldiers: an observational study Journal Article
In: Headache, vol. 51, pp. 932–944, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Erickson2011,
title = {Treatment outcomes of chronic post-traumatic headaches after mild head trauma in US soldiers: an observational study},
author = {Erickson, Jay C},
year = {2011},
date = {2011-01-01},
journal = {Headache},
volume = {51},
pages = {932--944},
address = {Neurology Service, Madigan Army Medical Center, Tacoma, WA, USA. jay.erickson@us.army.mil},
abstract = {BACKGROUND: he effectiveness of medical therapies for chronic post-traumatic headaches (PTHs) attributable to mild head trauma in military troops has not been established. OBJECTIVE: To determine the treatment outcomes of acute and prophylactic medical therapies prescribed for chronic PTHs after mild head trauma in US Army soldiers. METHODS: A retrospective cohort study was conducted with 100 soldiers undergoing treatment for chronic PTH at a single US Army neurology clinic. Headache frequency and Migraine Disability Assessment (MIDAS) scores were determined at the initial clinic visit and then again by phone 3 months after starting headache prophylactic medication. Response rates of headache abortive medications were also determined. Treatment outcomes were compared between subjects with blast-related PTH and non-blast PTH. RESULTS: Ninety-nine of 100 subjects were male. Seventy-seven of 100 subjects had blast PTH and 23/100 subjects had non-blast PTH. Headache characteristics were similar for blast PTH and non-blast PTH with 96% and 95%, respectively, resembling migraine. Headache frequency among all PTH subjects decreased from 17.1 days/month at baseline to 14.5 days/month at follow-up (P = .009). Headache frequency decreased by 41% among non-blast PTH compared to 9% among blast PTH. Fifty-seven percent of non-blast PTH subjects had a 50% or greater decline in headache frequency compared to 29% of blast PTH subjects (P =.023). A significant decline in headache frequency occurred in subjects treated with topiramate (n = 29, -23%},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Snell, Frances I; Halter, Margaret Jordan
A signature wound of war: mild traumatic brain injury Journal Article
In: Journal of Psychosocial Nursing & Mental Health Services, vol. 48, pp. 22–28, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Snell2010,
title = {A signature wound of war: mild traumatic brain injury},
author = {Snell, Frances I and Halter, Margaret Jordan},
year = {2010},
date = {2010-01-01},
journal = {Journal of Psychosocial Nursing \& Mental Health Services},
volume = {48},
pages = {22--28},
address = {Louis Stokes Cleveland VA Medical Center, Akron Community-Based Outpatient Clinic, Akron, OH 44319, USA. Frances.Snell@va.gov},
abstract = {Improvised explosive devices are the weapons of choice for the insurgent enemy in Iraq and Afghanistan. More soldiers are surviving these blast injuries due to improved torso protection yet are sustaining head and neck wounds in numbers that exceed those from previous wars. Although moderate and severe traumatic head injuries are easily identified and aggressively treated, mild traumatic brain injuries (m-TBIs), or concussions, had previously been deemed inconsequential and often overlooked. Recently, however, the U.S. Department of Defense and Veterans Health Administration have placed emphasis on identifying service members at risk for m-TBI because a select number continue to have disabling symptoms that can negatively affect quality of life. Research regarding the effects and treatment of blasts injury are gaining momentum, but further work needs to be accomplished. This article provides a three-question screening tool that can be used to identify these at-risk veterans.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Caplan, L J; Ivins, B; Poole, J H; Vanderploeg, R D; Jaffee, M S; Schwab, K
The structure of postconcussive symptoms in 3 US military samples Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 25, pp. 447–458, 2010, ISSN: 0885-9701.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Caplan2010,
title = {The structure of postconcussive symptoms in 3 US military samples},
author = {Caplan, L J and Ivins, B and Poole, J H and Vanderploeg, R D and Jaffee, M S and Schwab, K},
doi = {10.1097/HTR.0b013e3181d5bdbd},
issn = {0885-9701},
year = {2010},
date = {2010-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {25},
pages = {447--458},
abstract = {Objective: To evaluate alternative models of symptom clusters for the 22-item Neurobehavioral Symptom Inventory. Participants: Three military samples, including 2 nonclinical samples (n = 2420},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Meyer, Kimberly S; Marion, Donald W; Coronel, Helen; Jaffee, Michael S
Combat-related traumatic brain injury and its implications to military healthcare Journal Article
In: Psychiatric Clinics of North America, vol. 33, pp. 783–796, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Meyer2010,
title = {Combat-related traumatic brain injury and its implications to military healthcare},
author = {Meyer, Kimberly S and Marion, Donald W and Coronel, Helen and Jaffee, Michael S},
year = {2010},
date = {2010-01-01},
journal = {Psychiatric Clinics of North America},
volume = {33},
pages = {783--796},
address = {Defense and Veterans Brain Injury Center, PO Box 59181, Washington, DC 20012, USA. kimberly.meyer1@us.army.mil},
abstract = {Traumatic brain injury (TBI) is a known injury in today's combat arena. Improved screening and surveillance methods have diagnosed TBI with increasing frequency. Current treatment plans are based largely on information gleaned from sports injuries. However, these management paradigms fail to address the effect of physiologic stress (fatigue, dehydration) and psychological stress at the time of injury as well as the number of previous concussions that may affect recovery from combat-related TBI. This article presents current evaluation and management of combat-related injury and discusses other psychological conditions that may coexist with TBI.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Brenner, L A; Terrio, H; Homaifar, B Y; Gutierrez, P M; Staves, P J; Harwood, J E F; Reeves, D; Adler, L E; Ivins, B J; Helmick, K; Warden, D
Neuropsychological test performance in soldiers with blast-related mild TBI Journal Article
In: Neuropsychology, vol. 24, pp. 160–167, 2010, ISSN: 0894-4105.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Brenner2010,
title = {Neuropsychological test performance in soldiers with blast-related mild TBI},
author = {Brenner, L A and Terrio, H and Homaifar, B Y and Gutierrez, P M and Staves, P J and Harwood, J E F and Reeves, D and Adler, L E and Ivins, B J and Helmick, K and Warden, D},
doi = {10.1037/a0017966},
issn = {0894-4105},
year = {2010},
date = {2010-01-01},
journal = {Neuropsychology},
volume = {24},
pages = {160--167},
abstract = {This exploratory study was conducted to increase understanding of neuropsychological test performance in those with blast-related mild traumatic brain injury (mTBI). The two variables of interest for their impact oil test performance were presence of mTBI symptoms and history of posttraumatic stress disorder (PTSD). Forty-five soldiers postblast mTBI, 27 with enduring mTBI symptoms and 18 without, completed a series of neuropsychological tests. Seventeen of the 45 met criteria for PTSD. The Paced Auditory Serial Addition Test (Frencham, Fox, \& Mayberry. 2005; Spreen \& Strauss, 1998) was the primary Outcome Measure. Two-sided. 2-sample t tests were used to compare scores between groups of interest. Presence of mTBI symptoms did not impact test performance. In addition, no significant differences between soldiers with and without PTSD were identified. Standard neuropsychological assessment may not increase understanding about impairment associated with mTBI symptoms. Further research in this area is indicated.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Wilk, Joshua E; Thomas, Jeffrey L; McGurk, Dennis M; Riviere, Lyndon A; Castro, Carl A; Hoge, Charles W
Mild traumatic brain injury (concussion) during combat: lack of association of blast mechanism with persistent postconcussive symptoms Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 25, pp. 9–14, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Wilk2010,
title = {Mild traumatic brain injury (concussion) during combat: lack of association of blast mechanism with persistent postconcussive symptoms},
author = {Wilk, Joshua E and Thomas, Jeffrey L and McGurk, Dennis M and Riviere, Lyndon A and Castro, Carl A and Hoge, Charles W},
year = {2010},
date = {2010-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {25},
pages = {9--14},
address = {Division of Psychiatry and Neuroscience, Walter Reed Army Institute of Research, US Army Medical Research and Materiel Command, Silver Spring, Maryland 20910, USA. joshua.wilk@amedd.army.mil},
abstract = {OBJECTIVE: To determine whether screening for a blast mechanism of concussion identifies individuals at higher risk of persistent postconcussive symptoms (PCS). SETTING: United States Army post. PARTICIPANTS: 3952 US Army infantry soldiers were administered anonymous surveys 3 to 6 months after returning from a yearlong deployment to Iraq. MAIN OUTCOME MEASURES: Self-reported concussion (defined as an injury that resulted in being "dazed, confused, or 'seeing stars'"; "not remembering the injury"; or "losing consciousness [knocked out]): Patient Health Questionnaire 15-item scale for physical symptoms and PCS; Posttraumatic Stress Disorder Checklist; and Patient Health Questionnaire depression module. RESULTS: Of the 587 soldiers (14.9% of the total sample) who met criteria for concussion, 201 (34.2%) reported loss of consciousness, and 373 (63.5%) reported only an alteration of consciousness without loss of consciousness; 424 (72.2%) reported a blast mechanism, and 150 (25.6%) reported a nonblast mechanism. Among soldiers who lost consciousness, blast mechanism was significantly associated with headaches and tinnitus 3 to 6 months postdeployment compared with a nonblast mechanism. However, among the larger group of soldiers reporting concussions without loss of consciousness, blast was not associated with adverse health outcomes. CONCLUSIONS: Blast mechanism of concussion was inconsistently associated with PCS, depending on the definition of concussion utilized. A self-reported history of blast mechanism was not associated with persistent PCS for the majority of US soldiers with concussions.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Nyein, Michelle K; Jason, Amanda M; Yu, Li; Pita, Claudio M; Joannopoulos, John D; Moore, David F; Radovitzky, Raul A
In silico investigation of intracranial blast mitigation with relevance to military traumatic brain injury.[Erratum appears in Proc Natl Acad Sci U S A. 2011 Jan 4;108(1):433] Journal Article
In: Proceedings of the National Academy of Sciences of the United States of America, vol. 107, pp. 20703–20708, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Nyein2010,
title = {In silico investigation of intracranial blast mitigation with relevance to military traumatic brain injury.[Erratum appears in Proc Natl Acad Sci U S A. 2011 Jan 4;108(1):433]},
author = {Nyein, Michelle K and Jason, Amanda M and Yu, Li and Pita, Claudio M and Joannopoulos, John D and Moore, David F and Radovitzky, Raul A},
year = {2010},
date = {2010-01-01},
journal = {Proceedings of the National Academy of Sciences of the United States of America},
volume = {107},
pages = {20703--20708},
address = {Department of Aeronautics and Astronautics, Institute for Soldier Nanotechnologies, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.},
abstract = {Blast-induced traumatic brain injury is the most prevalent military injury in Iraq and Afghanistan, yet little is known about the mechanical effects of blasts on the human head, and still less is known about how personal protective equipment affects the brain's response to blasts. In this study we investigated the effect of the Advanced Combat Helmet (ACH) and a conceptual face shield on the propagation of stress waves within the brain tissue following blast events. We used a sophisticated computational framework for simulating coupled fluid-solid dynamic interactions and a three-dimensional biofidelic finite element model of the human head and intracranial contents combined with a detailed model of the ACH and a conceptual face shield. Simulations were conducted in which the unhelmeted head, head with helmet, and head with helmet and face shield were exposed to a frontal blast wave with incident overpressure of 10[NON-BREAKING SPACE]atm. Direct transmission of stress waves into the intracranial cavity was observed in the unprotected head and head with helmet simulations. Compared to the unhelmeted head, the head with helmet experienced slight mitigation of intracranial stresses. This suggests that the existing ACH does not significantly contribute to mitigating blast effects, but does not worsen them either. By contrast, the helmet and face shield combination impeded direct transmission of stress waves to the face, resulting in a delay in the transmission of stresses to the intracranial cavity and lower intracranial stresses. This suggests a possible strategy for mitigating blast waves often associated with military concussion.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Lippa, S M; Pastorek, N J; Benge, J F; Thornton, G M
Postconcussive symptoms after blast and nonblast-related mild traumatic brain injuries in Afghanistan and Iraq war veterans Journal Article
In: Journal of the International Neuropsychological Society, vol. 16, pp. 856–866, 2010, ISSN: 1355-6177.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Lippa2010,
title = {Postconcussive symptoms after blast and nonblast-related mild traumatic brain injuries in Afghanistan and Iraq war veterans},
author = {Lippa, S M and Pastorek, N J and Benge, J F and Thornton, G M},
doi = {10.1017/s1355617710000743},
issn = {1355-6177},
year = {2010},
date = {2010-01-01},
journal = {Journal of the International Neuropsychological Society},
volume = {16},
pages = {856--866},
abstract = {Blast injury is common in current warfare, but little is known about the effects of blast-related mild traumatic brain injury (mTBI). Profile analyses were conducted investigating differences in self-reported postconcussive (PC) symptoms in 339 veteran outpatients with mTBI histories reporting current symptoms based on mechanism of injury (blast only, nonblast only, or both blast and nonblast), number of blast injuries, and distance from the blast. Veterans with any blast-related mTBI history were younger and reported higher posttraumatic stress symptoms than veterans with nonblast-related mTBI histories, with a marginally significant difference in posttraumatic stress symptom report between veterans reporting blast-related mTBI only and those reporting nonblast-related mTBI. The groups did not differ in terms of PC symptom severity or PC symptom cluster profiles. Among veterans with blast-related mTBI histories, PC symptom report did not vary by number of blast-related mTBIs or proximity to blast. Overall, posttraumatic stress symptoms accounted for a substantial portion of variance in PC symptom report. In veteran outpatients with remote mTBI histories who have enduring symptom complaints related to the mTBI, mechanism of injury did not clearly contribute to differential PC symptom severity or PC symptom cluster profile. Proximal rather than distal factors may be important intervention targets in returning symptomatic veterans with mTBI histories. (JINS, 2010, 16, 856-866.)},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Svetlov, Stanislav I; Prima, Victor; Kirk, Daniel R; Gutierrez, Hector; Curley, Kenneth C; Hayes, Ronald L; Wang, Kevin K W
Morphologic and biochemical characterization of brain injury in a model of controlled blast overpressure exposure Journal Article
In: Journal of Trauma, vol. 69, pp. 795–804, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Svetlov2010,
title = {Morphologic and biochemical characterization of brain injury in a model of controlled blast overpressure exposure},
author = {Svetlov, Stanislav I and Prima, Victor and Kirk, Daniel R and Gutierrez, Hector and Curley, Kenneth C and Hayes, Ronald L and Wang, Kevin K W},
year = {2010},
date = {2010-01-01},
journal = {Journal of Trauma},
volume = {69},
pages = {795--804},
address = {Center of Innovative Research, Banyan Biomarkers, Inc, Alachua, Florida 32615, USA. ssvetlov@banyanbio.com},
abstract = {OBJECTIVES: Existing experimental approaches for studies of blast impact in small animals are insufficient and lacking consistency. Here, we present a comprehensive model, with repeatable blast signatures of controlled duration, peak pressure, and transmitted impulse, accurately reproducing blast impact in laboratory animals. MATERIALS: Rat survival, brain pathomorphology, and levels of putative biomarkers of brain injury glial fibrillary acid protein (GFAP), neuron-specific enolase, and ubiquitin C-terminal hydrolase (UCH)-L1 were examined in brain, cerebrospinal fluid (CSF), and blood after 10 msec of 358 kPa peak overpressure blast exposure. RESULTS: The high-speed imaging demonstrated a strong head acceleration/jolting accompanied by typical intracranial hematomas and brain swelling. Microscopic injury was revealed by prominent silver staining in deep brain areas, including the nucleus subthalamicus zone, suggesting both diffused and focal neurodegeneration. GFAP and 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNPase), markers of astroglia and oligodendroglia, accumulated substantially in the hippocampus 24 hours after blast and persisted for 30 days postblast. However, GFAP content in the blood significantly increased 24 hours after injury, followed by a decline and subsequent accumulation in CSF in a time-dependent fashion. A similar profile is shown for UCH-L1 increase in blood, whereas increased CSF levels of UCH-L1 persisted throughout 14 days after blast and varied significantly in individual rats. Neuron-specific enolase levels in blood were significantly elevated within 24 hours and 48 hours postblast. CONCLUSIONS: The proposed model of controlled nonpenetrating blast in rats demonstrates the critical pathologic and biochemical signatures of blast brain injury that may be triggered by cerebrovascular responses, including blood-brain barrier disruption, glia responses, and neuroglial alterations.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Bradley, E; Lockwood, C; Hull, A; Poole, J
Neuropsychological performance in veterans following concussion due to blast versus non-blast injuries Journal Article
In: Archives of Clinical Neuropsychology, vol. 25, pp. 569, 2010, ISSN: 0887-6177.
BibTeX | Tags: Military Military LB - Military
@article{Bradley2010,
title = {Neuropsychological performance in veterans following concussion due to blast versus non-blast injuries},
author = {Bradley, E and Lockwood, C and Hull, A and Poole, J},
issn = {0887-6177},
year = {2010},
date = {2010-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {25},
pages = {569},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Burgess, Paula; Sullivent, Ernest E; Sasser, Scott M; Wald, Marlena M; Ossmann, Eric; Kapil, Vikas
Managing traumatic brain injury secondary to explosions Journal Article
In: Journal of Emergencies, Trauma, and Shock, vol. 3, pp. 164–172, 2010.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Burgess2010,
title = {Managing traumatic brain injury secondary to explosions},
author = {Burgess, Paula and Sullivent, Ernest E and Sasser, Scott M and Wald, Marlena M and Ossmann, Eric and Kapil, Vikas},
doi = {DOI: 10.4103/0974-2700.62120},
year = {2010},
date = {2010-01-01},
journal = {Journal of Emergencies, Trauma, and Shock},
volume = {3},
pages = {164--172},
abstract = {Explosions and bombings are the most common deliberate cause of disasters with large numbers of casualties. Despite this fact, disaster medical response training has traditionally focused on the management of injuries following natural disasters and terrorist attacks with biological, chemical, and nuclear agents. The following article is a clinical primer for physicians regarding traumatic brain injury (TBI) caused by explosions and bombings. The history, physics, and treatment of TBI are outlined.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Lew, H L; Amick, M M; Kraft, M; Stein, M B; Cifu, D X
Potential driving issues in combat returnees Journal Article
In: Neurorehabilitation, vol. 26, pp. 271–278, 2010, ISSN: 1053-8135.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Lew2010a,
title = {Potential driving issues in combat returnees},
author = {Lew, H L and Amick, M M and Kraft, M and Stein, M B and Cifu, D X},
doi = {10.3233/nre-2010-0562},
issn = {1053-8135},
year = {2010},
date = {2010-01-01},
journal = {Neurorehabilitation},
volume = {26},
pages = {271--278},
abstract = {The driving abilities of service members returning from Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) have not been well reported and are an important aspect of their return to normal life. This article reviews the unique risk factors for unsafe driving in this cohort. In particular, the cognitive and psychological symptoms of mild traumatic brain injury and postraumatic stress disorder, two of the most common diagnoses affecting these returning warriors, are specified, and their possible association with impaired driving is examined. The potential negative impact of the "battlemind driving tactics" (i.e., evasive driving skills) acquired by these service members as part of their military tours is also highlighted. The article concludes with comments about the functional consequences of impaired driving in this population, including limits to participation in rehabilitation and community reintegration, as well as recognition of the need for further research in this area.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Brenner, Lisa A; Ivins, Brian J; Schwab, Karen; Warden, Deborah; Nelson, Lonnie A; Jaffee, Michael; Terrio, Heidi
Traumatic brain injury, posttraumatic stress disorder, and postconcussive symptom reporting among troops returning from Iraq Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 25, pp. 307–312, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Brenner2010a,
title = {Traumatic brain injury, posttraumatic stress disorder, and postconcussive symptom reporting among troops returning from Iraq},
author = {Brenner, Lisa A and Ivins, Brian J and Schwab, Karen and Warden, Deborah and Nelson, Lonnie A and Jaffee, Michael and Terrio, Heidi},
year = {2010},
date = {2010-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {25},
pages = {307--312},
address = {VA VISN 19 Mental Illness Research Education and Clinical Center, Denver, Colorado, USA. lisa.brenner@va.gov},
abstract = {OBJECTIVES: Analyze the contribution of mild traumatic brain injury (mTBI) and/or posttraumatic stress disorder (PTSD) to the endorsement of postconcussive (PC) symptoms during Post Deployment Health Assessment. Determine whether a combination of mTBI and PTSD was more strongly associated with symptoms than either condition alone. METHODS: Cross-sectional study design where both the exposure, mTBI and/or PTSD, and the outcomes of interest, PC symptoms, were ascertained after return from deployment. Subjects were injured soldiers (n = 1247) from one Fort Carson Brigade Combat Team (n = 3973). MAIN OUTCOME MEASURES: Positive history of PC symptoms. RESULTS: PTSD and mTBI together were more strongly associated with having PC symptoms (adjusted prevalence ratio 6.27; 95% CI: 4.13-9.43) than either mTBI alone (adjusted prevalence ratio = 4.03; 95% CI: 2.67-6.07) or PTSD alone (adjusted prevalence ratio = 2.74; 95% CI: 1.58-4.74) after adjusting for age, gender, education, rank, and Military Occupational Specialty. CONCLUSIONS: In soldiers with histories of physical injury, mTBI and PTSD were independently associated with PC symptom reporting. Those with both conditions were at greater risk for PC symptoms than those with either PTSD, mTBI, or neither. Findings support the importance of continued screening for both conditions with the aim of early identification and intervention.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Coldren, Rodney L; Kelly, Mark P; Parish, Robert V; Dretsch, Michael; Russell, Michael L
Evaluation of the Military Acute Concussion Evaluation for use in combat operations more than 12 hours after injury Journal Article
In: Military Medicine, vol. 175, pp. 477–481, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Coldren2010,
title = {Evaluation of the Military Acute Concussion Evaluation for use in combat operations more than 12 hours after injury},
author = {Coldren, Rodney L and Kelly, Mark P and Parish, Robert V and Dretsch, Michael and Russell, Michael L},
year = {2010},
date = {2010-01-01},
journal = {Military Medicine},
volume = {175},
pages = {477--481},
address = {Uniformed Services University of the Health Sciences, Department of Preventive Medicine and Biometrics, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.},
abstract = {The diagnosis and management of concussion can be difficult in a combat environment, especially in the absence of loss of consciousness or post-traumatic amnesia. As no validated test exists to diagnose or grade neurocognitive impairment from a concussion, the military currently employs the Military Acute Concussion Evaluation (MACE) in Iraq. This is a two-part test, which incorporates the standardized assessment of concussion (SAC) as its objective score, although it has not been shown to be valid unless administered shortly after injury. A research team deployed to Iraq between January and April 2009 to examine the validity of several tests of neurocognitive function following a concussion, including the MACE. When administered more than 12 hours after the concussive injury, the MACE lacked sufficient sensitivity and specificity to be clinically useful.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Caldroney, Ralph D; Radike, James
Experience with mild traumatic brain injuries and postconcussion syndrome at Kandahar, Afghanistan Journal Article
In: US Army Medical Department Journal, pp. 22–30, 2010.
BibTeX | Tags: Military Military LB - Military
@article{Caldroney2010,
title = {Experience with mild traumatic brain injuries and postconcussion syndrome at Kandahar, Afghanistan},
author = {Caldroney, Ralph D and Radike, James},
year = {2010},
date = {2010-01-01},
journal = {US Army Medical Department Journal},
pages = {22--30},
address = {135th Expeditionary Sustainment Command, Kandahar Air Field, Afghanistan.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Kozminski, Matthew
Combat-related posttraumatic headache: diagnosis, mechanisms of injury, and challenges to treatment Journal Article
In: Journal of the American Osteopathic Association, vol. 110, pp. 514–519, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Kozminski2010,
title = {Combat-related posttraumatic headache: diagnosis, mechanisms of injury, and challenges to treatment},
author = {Kozminski, Matthew},
year = {2010},
date = {2010-01-01},
journal = {Journal of the American Osteopathic Association},
volume = {110},
pages = {514--519},
address = {Neurology Clinic, Darnall Army Medical Center, 36000 Darnall Loop, Fort Hood, TX 76544, USA. mpkst17@yahoo.com},
abstract = {CONTEXT: Studies have revealed the rates of posttraumatic stress disorder (PTSD) and concussion among US soldiers returning from combat, but only one study has focused on the subpopulation of soldiers with headache. OBJECTIVES: To determine the rate of PTSD among US soldiers with comorbid chronic posttraumatic headache attributed to head injury, to identify common mechanisms of head injury, and to identify the common challenges a healthcare provider must face when treating US soldiers with chronic posttraumatic headache attributed to head injury. METHODS: Between July 2007 and December 2008, the author examined 42 US Army soldiers with complaint of chronic headache. In March 2009, the author retrospectively reviewed the outpatient records for diagnoses, mechanisms of injury, and challenges to treatment. RESULTS: The rate of concussion, defined by the Defense and Veterans Brain Injury Center Working Group on the Acute Management of Mild Traumatic Brain Injury in Military Operational Settings, was 95%. The rate of PTSD, as determined either with the PTSD Checklist or by confirming a prior diagnosis by another healthcare provider, was 97.9%. Both rates are remarkably higher than rates reported in the literature. The most common mechanisms of injury were proximity to blast (18 [45.2%]) and direct target of blast (15 [35.7%]). The most common treatment challenges were overuse of headache-abortive medications (10 [23.8%]) and poor patient followup (7 [16.7%]). CONCLUSION: Physicians should be aware that the rates of PTSD and concussion for US soldiers, most often linked to involvement in or proximity to a blast, are higher for soldiers complaining of chronic headache. Physicians should also be aware of the potential for overuse of medications in this patient population.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Rosenfeld, Jeffrey V; Ford, Nick L
Bomb blast, mild traumatic brain injury and psychiatric morbidity: a review Journal Article
In: Injury, vol. 41, pp. 437–443, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Rosenfeld2010,
title = {Bomb blast, mild traumatic brain injury and psychiatric morbidity: a review},
author = {Rosenfeld, Jeffrey V and Ford, Nick L},
year = {2010},
date = {2010-01-01},
journal = {Injury},
volume = {41},
pages = {437--443},
address = {Department of Surgery, Monash University, Australia. j.rosenfeld@alfred.org.au},
abstract = {Traumatic brain injury (TBI) arising from blast exposure during war is common, and frequently complicated by psychiatric morbidity. There is controversy as to whether mild TBI from blast is different from other causes of mild TBI. Anxiety and affective disorders such as Post-traumatic Stress Disorder (PTSD) and depression are common accompaniments of blast injury with a significant overlap in the diagnostic features of PTSD with post-concussive syndrome (PCS). This review focuses on this overlap and the effects of mild TBI due to bomb blast. Mild TBI may have been over diagnosed by late retrospective review of returned servicemen and women using imprecise criteria. There is therefore a requirement for clear and careful documentation by health professionals of a TBI due to bomb blast shortly after the event so that the diagnosis of TBI can be made with confidence. There is a need for the early recognition of symptoms of PCS, PTSD and depression and early multi-disciplinary interventions focussed on expected return to duties. There also needs to be a continued emphasis on the de-stigmatization of psychological conditions in military personnel returning from deployment.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Hettich, Thomas; Whitfield, Ethan; Kratz, Kris; Frament, Colin
Case report: use of the Immediate Post Concussion Assessment and Cognitive Testing (ImPACT) to assist with return to duty determination of special operations soldiers who sustained mild traumatic brain injury Journal Article
In: Journal of Special Operations Medicine, vol. 10, pp. 48–55, 2010.
BibTeX | Tags: Military Military LB - Military
@article{Hettich2010,
title = {Case report: use of the Immediate Post Concussion Assessment and Cognitive Testing (ImPACT) to assist with return to duty determination of special operations soldiers who sustained mild traumatic brain injury},
author = {Hettich, Thomas and Whitfield, Ethan and Kratz, Kris and Frament, Colin},
year = {2010},
date = {2010-01-01},
journal = {Journal of Special Operations Medicine},
volume = {10},
pages = {48--55},
address = {Usasoc, usa.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Theeler, Brett J; Flynn, Frederick G; Erickson, Jay C
Headaches after concussion in US soldiers returning from Iraq or Afghanistan Journal Article
In: Headache, vol. 50, pp. 1262–1272, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Theeler2010,
title = {Headaches after concussion in US soldiers returning from Iraq or Afghanistan},
author = {Theeler, Brett J and Flynn, Frederick G and Erickson, Jay C},
year = {2010},
date = {2010-01-01},
journal = {Headache},
volume = {50},
pages = {1262--1272},
address = {William Beaumont Army Medical Center, Department of Medicine, Neurology Service, Medical Corps, United States Army, Fort Bliss, TX 79920-5001, USA.},
abstract = {OBJECTIVES: To determine the prevalence, characteristics, impact, and treatment patterns of headaches after concussion in US Army soldiers returning from a deployment to Iraq or Afghanistan. METHODS: A cross-sectional study was conducted with a cohort of soldiers undergoing postdeployment evaluation during a 5-month period at the Madigan Traumatic Brain Injury Program at Ft. Lewis, WA. All soldiers screening positive for a deployment-related concussion were given a 13-item headache questionnaire. RESULTS: A total of 1033 (19.6%) of 5270 returning soldiers met criteria for a deployment-related concussion. Among those with a concussion, 957 (97.8%) reported having headaches during the final 3 months of deployment. Posttraumatic headaches, defined as headaches beginning within 1 week after a concussion, were present in 361 (37%) soldiers. In total, 58% of posttraumatic headaches were classified as migraine. Posttraumatic headaches had a higher attack frequency than nontraumatic headaches, averaging 10 days per month. Chronic daily headache was present in 27% of soldiers with posttraumatic headache compared with 14% of soldiers with nontraumatic headache. Posttraumatic headaches interfered with duty performance in 37% of cases and caused more sick call visits compared with nontraumatic headache. In total, 78% of soldiers with posttraumatic headache used abortive medications, predominantly over-the-counter analgesics, and most perceived medication as effective. CONCLUSIONS: More than 1 in 3 returning military troops who have sustained a deployment-related concussion have headaches that meet criteria for posttraumatic headache. Migraine is the predominant headache phenotype precipitated by a concussion during military deployment. Compared with headaches not directly attributable to head trauma, posttraumatic headaches are associated with a higher frequency of headache attacks and an increased prevalence of chronic daily headache.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Nelson, Nathaniel W; Hoelzle, James B; McGuire, Kathryn A; Ferrier-Auerbach, Amanda G; Charlesworth, Molly J; Sponheim, Scott R
Evaluation context impacts neuropsychological performance of OEF/OIF veterans with reported combat-related concussion Journal Article
In: Archives of Clinical Neuropsychology, vol. 25, pp. 713–723, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Nelson2010,
title = {Evaluation context impacts neuropsychological performance of OEF/OIF veterans with reported combat-related concussion},
author = {Nelson, Nathaniel W and Hoelzle, James B and McGuire, Kathryn A and Ferrier-Auerbach, Amanda G and Charlesworth, Molly J and Sponheim, Scott R},
year = {2010},
date = {2010-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {25},
pages = {713--723},
address = {Minneapolis VA Medical Center, MN, USA. nels5363@umn.edu},
abstract = {Although soldiers of Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) encounter combat-related concussion at an unprecedented rate, relatively few studies have examined how evaluation context, insufficient effort, and concussion history impact neuropsychological performances in the years following injury. The current study explores these issues in a sample of 119 U.S. veterans (OEF/OIF forensic concussion},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Lew, H L; Weihing, J; Myers, P J; Pogoda, T K; Goodrich, G L
Dual sensory impairment (DSI) in traumatic brain injury (TBI) - An emerging interdisciplinary challenge Journal Article
In: Neurorehabilitation, vol. 26, pp. 213–222, 2010, ISSN: 1053-8135.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Lew2010,
title = {Dual sensory impairment (DSI) in traumatic brain injury (TBI) - An emerging interdisciplinary challenge},
author = {Lew, H L and Weihing, J and Myers, P J and Pogoda, T K and Goodrich, G L},
doi = {10.3233/nre-2010-0557},
issn = {1053-8135},
year = {2010},
date = {2010-01-01},
journal = {Neurorehabilitation},
volume = {26},
pages = {213--222},
abstract = {The present review characterizes dual sensory impairment (DSI) as co-existing auditory and visual deficits in TBI that can be peripherally or centrally based. Current research investigating DSI in the military population, along with applicable research which focuses on unimodal deficits, is considered. Due to the heterogenous nature of TBI lesions, an important challenge that the clinician faces is ruling out the influence of multiple sensory deficits and/or the influence of cognitive processes on diagnosis and rehabilitation of the patient. Treatment options for DSI involve remediation of the sensory deficits via existing sensory aids or training exercises.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Felber, Eric S
Combat-related posttraumatic headache: diagnosis, mechanisms of injury, and challenges to treatment Journal Article
In: Journal of the American Osteopathic Association, vol. 110, pp. 737–738, 2010.
BibTeX | Tags: Military Military LB - Military
@article{Felber2010,
title = {Combat-related posttraumatic headache: diagnosis, mechanisms of injury, and challenges to treatment},
author = {Felber, Eric S},
year = {2010},
date = {2010-01-01},
journal = {Journal of the American Osteopathic Association},
volume = {110},
pages = {737--738},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Alvarez, M; Kennedy, J; Amador, R; Cullen, M
Military Acute Concussion Evaluation Score and Its Relevance to Post-Concussive Symptoms in mTBI Service Members Journal Article
In: Neurology, vol. 76, pp. A165–A165, 2011, ISSN: 0028-3878.
@article{Alvarez2011,
title = {Military Acute Concussion Evaluation Score and Its Relevance to Post-Concussive Symptoms in mTBI Service Members},
author = {Alvarez, M and Kennedy, J and Amador, R and Cullen, M},
issn = {0028-3878},
year = {2011},
date = {2011-01-01},
journal = {Neurology},
volume = {76},
pages = {A165--A165},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Erickson, Jay C
Treatment outcomes of chronic post-traumatic headaches after mild head trauma in US soldiers: an observational study Journal Article
In: Headache, vol. 51, pp. 932–944, 2011.
@article{Erickson2011,
title = {Treatment outcomes of chronic post-traumatic headaches after mild head trauma in US soldiers: an observational study},
author = {Erickson, Jay C},
year = {2011},
date = {2011-01-01},
journal = {Headache},
volume = {51},
pages = {932--944},
address = {Neurology Service, Madigan Army Medical Center, Tacoma, WA, USA. jay.erickson@us.army.mil},
abstract = {BACKGROUND: he effectiveness of medical therapies for chronic post-traumatic headaches (PTHs) attributable to mild head trauma in military troops has not been established. OBJECTIVE: To determine the treatment outcomes of acute and prophylactic medical therapies prescribed for chronic PTHs after mild head trauma in US Army soldiers. METHODS: A retrospective cohort study was conducted with 100 soldiers undergoing treatment for chronic PTH at a single US Army neurology clinic. Headache frequency and Migraine Disability Assessment (MIDAS) scores were determined at the initial clinic visit and then again by phone 3 months after starting headache prophylactic medication. Response rates of headache abortive medications were also determined. Treatment outcomes were compared between subjects with blast-related PTH and non-blast PTH. RESULTS: Ninety-nine of 100 subjects were male. Seventy-seven of 100 subjects had blast PTH and 23/100 subjects had non-blast PTH. Headache characteristics were similar for blast PTH and non-blast PTH with 96% and 95%, respectively, resembling migraine. Headache frequency among all PTH subjects decreased from 17.1 days/month at baseline to 14.5 days/month at follow-up (P = .009). Headache frequency decreased by 41% among non-blast PTH compared to 9% among blast PTH. Fifty-seven percent of non-blast PTH subjects had a 50% or greater decline in headache frequency compared to 29% of blast PTH subjects (P =.023). A significant decline in headache frequency occurred in subjects treated with topiramate (n = 29, -23%},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Nelson, N W; Hoelzle, J B; Doane, B M; McGuire, K A; Ferrier-Auerbach, A G; Charlesworth, M J; Polusny, M A; Arbisi, P A; Lamberty, G J; Sponheim, S R
Neuropsychological outcomes of United States veterans with report of remote blast concussion and concurrent psychological distress Journal Article
In: Clinical Neuropsychologist, vol. 25, pp. 553–554, 2011, ISSN: 1385-4046.
@article{Nelson2011b,
title = {Neuropsychological outcomes of United States veterans with report of remote blast concussion and concurrent psychological distress},
author = {Nelson, N W and Hoelzle, J B and Doane, B M and McGuire, K A and Ferrier-Auerbach, A G and Charlesworth, M J and Polusny, M A and Arbisi, P A and Lamberty, G J and Sponheim, S R},
issn = {1385-4046},
year = {2011},
date = {2011-01-01},
journal = {Clinical Neuropsychologist},
volume = {25},
pages = {553--554},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Coldren, Rodney L; Russell, Michael L; Kelly, Mark P; Parish, Robert V; Dretsch, Michael
Re: Automated neuropsychological assessment metrics (ANAM) Journal Article
In: Military Medicine, vol. 176, pp. iv, 2011.
@article{Coldren2011,
title = {Re: Automated neuropsychological assessment metrics (ANAM)},
author = {Coldren, Rodney L and Russell, Michael L and Kelly, Mark P and Parish, Robert V and Dretsch, Michael},
year = {2011},
date = {2011-01-01},
journal = {Military Medicine},
volume = {176},
pages = {iv},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bryan, Craig J; Hernandez, Ann M
Predictors of post-traumatic headache severity among deployed military personnel Journal Article
In: Headache, vol. 51, pp. 945–953, 2011.
@article{Bryan2011,
title = {Predictors of post-traumatic headache severity among deployed military personnel},
author = {Bryan, Craig J and Hernandez, Ann M},
year = {2011},
date = {2011-01-01},
journal = {Headache},
volume = {51},
pages = {945--953},
address = {Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.},
abstract = {OBJECTIVE: The current study used a cross-sectional observational design to evaluate the relationship between psychological, physiological, and contextual factors and headache severity among 133 deployed military personnel and 4 civilian contractors diagnosed with mild traumatic brain injury (mTBI) referred to a combat support hospital in Iraq. BACKGROUND: Although TBI and headache sequelae have been documented for military combatants, little is known about factors associated with headache severity. METHODS: Military personnel (n = 157) and civilian (n = 4) contractors referred to a combat support hospital in Iraq underwent a standardized intake evaluation which included computerized neurocognitive testing, psychological and physical health questionnaires, a clinical interview, and a physical examination by a physician. RESULTS: Results of zero-inflated Poisson regression modeling suggest that insomnia is associated with increased likelihood for endorsement of any headache, but loss of consciousness, post-traumatic stress disorder symptoms, and slowed reaction time only are predictive of headache severity. Among the subset of patients presenting to the combat support hospital within 7 days of mTBI (n = 101), number of TBI symptoms demonstrated a non-significant trend toward increased likelihood of headache endorsement of any kind, with loss of consciousness, post-traumatic stress disorder, and slowed reaction time demonstrating significant relationships with headache severity. CONCLUSION: Knowledge of predictors of post-concussive headache onset and severity may assist clinicians in making important decisions regarding treatment recommendations for veterans with mTBI.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Nelson, Nathaniel W; Hoelzle, James B; McGuire, Kathryn A; Sim, Anita H; Goldman, Daniel J; Ferrier-Auerbach, Amanda G; Charlesworth, Molly J; Arbisi, Paul A; Sponheim, Scott R
Self-report of psychological function among OEF/OIF personnel who also report combat-related concussion Journal Article
In: Clinical Neuropsychologist, vol. 25, pp. 716–740, 2011.
@article{Nelson2011c,
title = {Self-report of psychological function among OEF/OIF personnel who also report combat-related concussion},
author = {Nelson, Nathaniel W and Hoelzle, James B and McGuire, Kathryn A and Sim, Anita H and Goldman, Daniel J and Ferrier-Auerbach, Amanda G and Charlesworth, Molly J and Arbisi, Paul A and Sponheim, Scott R},
year = {2011},
date = {2011-01-01},
journal = {Clinical Neuropsychologist},
volume = {25},
pages = {716--740},
address = {Graduate School of Professional Psychology, University of St. Thomas, Minneapolis, MN 55403, USA. nels0600@stthomas.edu},
abstract = {MMPI-2 RF profiles of 128 U.S. soldiers and veterans with history of concussion were examined. Participants evaluated in forensic (n[THIN SPACE]=[THIN SPACE]42) and clinical (n[THIN SPACE]=[THIN SPACE]43) settings showed significantly higher validity and clinical elevations relative to a research group (n[THIN SPACE]=[THIN SPACE]43). In the full sample, a multivariate GLM identified main effects for disability claim status and Axis I diagnosis across numerous MMPI-2 RF scales. Participants with co-morbid PTSD and concussion showed significant Restructured Clinical and Specific Problem scale elevations relative to those without Axis I diagnosis. Participants with PTSD and active disability claims were especially prone to elevate on FBS/FBS-r and RBS. Implications for neuropsychologists who routinely administer the MMPI-2/RF in the context of combat-related concussion are discussed.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Ryan, P B; Lee-Wilk, T; Kok, B C; Wilk, J E
Interdisciplinary rehabilitation of mild TBI and PTSD: A case report Journal Article
In: Brain Injury, vol. 25, pp. 1019–1025, 2011, ISSN: 0269-9052.
@article{Ryan2011,
title = {Interdisciplinary rehabilitation of mild TBI and PTSD: A case report},
author = {Ryan, P B and Lee-Wilk, T and Kok, B C and Wilk, J E},
doi = {10.3109/02699052.2011.597044},
issn = {0269-9052},
year = {2011},
date = {2011-01-01},
journal = {Brain Injury},
volume = {25},
pages = {1019--1025},
abstract = {Background: Prevalence of mild traumatic brain injury (mTBI) or concussion on the battlefield in Iraq/Afghanistan has resulted in its designation as a 'signature injury'. Civilian studies have shown that negative expectations for recovery may lead to worse outcomes. While there is concern that concussion screening procedures in the Veteran's Affairs Healthcare System and the Department of Defence could fuel negative expectations, leading to negative iatrogenic effects, it has been difficult to document this in clinical settings. The aim of this report is to describe the case of a veteran with comorbid mTBI/PTSD with persistent symptoms of unknown aetiology and the effects of provider communications on the patient's recovery. Methods: Case report of a veteran with reported mTBI, including provider communications, neuropsychological test results and report of functioning after changes in provider messages. Results: Two-years post-mTBI, the patient attributed cognitive difficulties to his brain injury, but neuropsychological assessment found that his cognitive profile was consistent with psychological rather than neurological dysfunction. After providers systematically emphasized expectations of recovery, the patient's daily functioning improved. Conclusions: This case illustrates difficulties in mass screening for and treating mTBI. Recommendations for improvement include clinician training in effectively communicating positive expectations of recovery after concussion.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Akin, Faith W; Murnane, Owen D
Head injury and blast exposure: vestibular consequences Journal Article
In: Otolaryngologic Clinics of North America, vol. 44, pp. 323–334, 2011.
@article{Akin2011,
title = {Head injury and blast exposure: vestibular consequences},
author = {Akin, Faith W and Murnane, Owen D},
year = {2011},
date = {2011-01-01},
journal = {Otolaryngologic Clinics of North America},
volume = {44},
pages = {323--334},
address = {Vestibular/Balance Laboratory, Audiology Service, Veterans Affairs Medical Center, Mountain Home, TN 37684, USA. faith.akin@va.gov},
abstract = {Young adults are more likely to suffer blast injury and traumatic brain injury (TBI) than other age groups. This article reviews the literature on the vestibular[NON-BREAKING SPACE]consequences of blast exposure and TBI and concussion. In addition, the vestibular test findings obtained from 31 veterans with a history of blast exposure and/or mild TBI are presented. The authors discuss loss of horizontal semicircular canal function and postural instability related to head injury. Preliminary data suggest the novel theory that otolith organs are uniquely vulnerable to head injury and blast exposure.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Rigg, John L; Mooney, Scott R
Concussions and the military: Issues specific to service members Journal Article
In: PM & R, vol. 3, pp. S380–S386, 2011, ISSN: 1934-1482.
@article{Rigg2011,
title = {Concussions and the military: Issues specific to service members},
author = {Rigg, John L and Mooney, Scott R},
doi = {10.1016/j.pmrj.2011.08.005},
issn = {1934-1482},
year = {2011},
date = {2011-01-01},
journal = {PM \& R},
volume = {3},
pages = {S380--S386},
abstract = {Since October 2001, more than 1.6 million American military service members have deployed to Iraq and Afghanistan in the Global War on Terrorism. It is estimated that between 5% and 35% of them have sustained a concussion, also called mild traumatic brain injury (mTBI), during their deployment. Up to 80% of the concussions experienced in theater are secondary to blast exposures. The unique circumstances and consequences of sustaining a concussion in combat demands a unique understanding and treatment plan. The current literature was reviewed and revealed a paucity of pathophysiological explanations on the nature of the injury and informed treatment plans. However, through observation and experience, a theoretical but scientifically plausible model for why and how blast injuries experienced in combat give rise to the symptoms that affect day-to-day function of service members who have been concussed has been developed. We also are able to offer treatment strategies based on our evaluation of the current literature and experience to help palliate postconcussive symptoms. The purpose of this review is to elucidate common physical, cognitive, emotional, and situational challenges, and possible solutions for this special population of patients who will be transitioning into the civilian sector and interfacing with health professionals. There is a need for further investigation and testing of these strategies.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Romesser, Jennifer; Shen, Shuying; Reblin, Maija; Kircher, John; Allen, Steven; Roberts, Toni; Marchand, William R
A preliminary study of the effect of a diagnosis of concussion on PTSD symptoms and other psychiatric variables at the time of treatment seeking among veterans Journal Article
In: Military Medicine, vol. 176, pp. 246–252, 2011.
@article{Romesser2011,
title = {A preliminary study of the effect of a diagnosis of concussion on PTSD symptoms and other psychiatric variables at the time of treatment seeking among veterans},
author = {Romesser, Jennifer and Shen, Shuying and Reblin, Maija and Kircher, John and Allen, Steven and Roberts, Toni and Marchand, William R},
year = {2011},
date = {2011-01-01},
journal = {Military Medicine},
volume = {176},
pages = {246--252},
address = {The George E. Wahlen Veterans Affairs Medical Center, 500 Foothill, Salt Lake City, UT 84148, USA.},
abstract = {The aim of this study was to assess whether a diagnosis of concussion given at a Veterans Healthcare Administration secondary traumatic brain injury assessment impacted either posttraumatic stress disorder (PTSD) symptomatology or other variables at the time veterans sought treatment for PTSD. This retrospective study compared 61 male veterans with a history of military-related concussion and military-related PTSD to 83 male veterans with military-related PTSD but without a diagnosis of military-related concussion. There were no significant between-group differences in PTSD symptomatology. However, the cohort with a history of military concussion endorsed decreased ability to cope with PTSD symptoms, increased problems with physical health, and more pain complaints. If replicated, these results may guide the design of more effective interventions for veterans who receive diagnoses of PTSD and concussion.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Weinberger, Sharon
Bombs' hidden impact: the brain war Journal Article
In: Nature, vol. 477, pp. 390–393, 2011.
@article{Weinberger2011,
title = {Bombs' hidden impact: the brain war},
author = {Weinberger, Sharon},
year = {2011},
date = {2011-01-01},
journal = {Nature},
volume = {477},
pages = {390--393},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Brenner, Lisa A; Ignacio, Rosalinda V; Blow, Frederic C
Suicide and traumatic brain injury among individuals seeking Veterans Health Administration services Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 26, pp. 257–264, 2011.
@article{Brenner2011,
title = {Suicide and traumatic brain injury among individuals seeking Veterans Health Administration services},
author = {Brenner, Lisa A and Ignacio, Rosalinda V and Blow, Frederic C},
year = {2011},
date = {2011-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {26},
pages = {257--264},
address = {VISN 19 Mental Illness Research Education and Clinical Center (MIRECC), Denver, Colorado 80220, USA. Lisa.Brenner@va.gov},
abstract = {OBJECTIVE: To examine associations between history of traumatic brain injury (TBI) diagnosis and death by suicide among individuals receiving care within the Veterans Health Administration (VHA). METHOD: Individuals who received care between fiscal years 2001 to 2006 were included in analyses. Cox proportional hazards survival models for time to suicide, with time-dependent covariates, were utilized. Covariance sandwich estimators were used to adjust for the clustered nature of the data, with patients nested within VHA facilities. Analyses included all patients with a history of TBI (n = 49626) plus a 5% random sample of patients without TBI (n = 389053). Of those with a history of TBI, 105 died by suicide. Models were adjusted for demographic and psychiatric covariates. RESULTS: Veterans with a history of TBI were 1.55 (95% confidence interval [CI], 1.24-1.92) times more likely to die by suicide than those without a history of TBI. Analyses by TBI severity were also conducted, and they suggested that in comparison to those without an injury history, those with (1) concussion/cranial fracture were 1.98 times more likely (95% CI, 1.39-2.82) to die by suicide and (2) cerebral contusion/traumatic intracranial hemorrhage were 1.34 times more likely (95% CI, 1.09-1.64) to die by suicide. This increased risk was not explained by the presence of psychiatric disorders or demographic factors. CONCLUSIONS: Among VHA users, those with a diagnosis of TBI were at greater risk for suicide than those without this diagnosis. Further research is indicated to identify evidence-based means of assessment and treatment for those with TBI and suicidal behavior.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Melamed, B G; Castro, C
Observations and insights about Strengthening Our Soldiers (SOS) Journal Article
In: Journal of Clinical Psychology in Medical Settings, vol. 18, pp. 210–223, 2011, ISSN: 1068-9583.
@article{Melamed2011,
title = {Observations and insights about Strengthening Our Soldiers (SOS)},
author = {Melamed, B G and Castro, C},
doi = {10.1007/s10880-011-9253-4},
issn = {1068-9583},
year = {2011},
date = {2011-01-01},
journal = {Journal of Clinical Psychology in Medical Settings},
volume = {18},
pages = {210--223},
abstract = {The Special Issue (June 2011) of the Journal of Clinical Psychology in Medical Settings titled Strengthening Our Soldiers (SOS) and Their Families: Contemporary Psychological Advances Applied to Wartime Problems revealed the following important concerns: 1) Who is at risk for psychological sequelae during and following service in the U.S. military? 2) How to deliver the best treatment for our soldiers and veterans with PTSD, Traumatic Brain Injury and Pain? 3) How to train the trainers? and 4) What are the current priorities for service delivery, research and funding? Assessment strategies and tools are provided to assist in identification of suicidal ideation and behaviors, alcohol abuse in spouses, posttraumatic stress disorders, depression, brain injuries and post-concussion syndrome, as well as positive growth experiences. Empirically validated Cognitive Processing and Prolonged Exposure treatments are described as are the empirical results already in evidence in our military populations. The innovative use of Virtual Reality and Telehealth applications is demonstrated in both army and naval settings for preparing and reducing trauma in affected soldiers. The Functional and Occupational Rehabilitation Treatment (FORT) Program and its role in returning function to injured soldiers with musculoskeletal pain and motion restrictions, while also leading to reductions of anxiety, depression and use of medical services, is described. A critique about providing service-research for children's reactions to their parent's deployments and family functioning during separation and reintegration is provided. The need for theoretical-empirical approaches to understanding pain-behavior, anxiety dysregulation as it impacts the brain function and structure is provided by experts in pain, neuropsychology, brain circuitry and anxiety management of multiple traumas. This final paper in SOS provides commentary on SOS and describes possible future implications of current psychological knowledge related to military personnel and their families.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Risdall, Jane E; Menon, David K
Traumatic brain injury Journal Article
In: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, vol. 366, pp. 241–250, 2011.
@article{Risdall2011,
title = {Traumatic brain injury},
author = {Risdall, Jane E and Menon, David K},
year = {2011},
date = {2011-01-01},
journal = {Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences},
volume = {366},
pages = {241--250},
address = {Surgeon Commander, Royal Navy, UK.},
abstract = {There is an increasing incidence of military traumatic brain injury (TBI), and similar injuries are seen in civilians in war zones or terrorist incidents. Indeed, blast-induced mild TBI has been referred to as the signature injury of the conflicts in Iraq and Afghanistan. Assessment involves schemes that are common in civilian practice but, in common with civilian TBI, takes little account of information available from modern imaging (particularly diffusion tensor magnetic resonance imaging) and emerging biomarkers. The efficient logistics of clinical care delivery in the field may have a role in optimizing outcome. Clinical care has much in common with civilian TBI, but intracranial pressure monitoring is not always available, and protocols need to be modified to take account of this. In addition, severe early oedema has led to increasing use of decompressive craniectomy, and blast TBI may be associated with a higher incidence of vasospasm and pseudoaneurysm formation. Visual and/or auditory deficits are common, and there is a significant risk of post-traumatic epilepsy. TBI is rarely an isolated finding in this setting, and persistent post-concussive symptoms are commonly associated with post-traumatic stress disorder and chronic pain, a constellation of findings that has been called the polytrauma clinical triad.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Young, R S K; Scott, K R
Combat vs. non-combat related traumatic brain injury (TBI) in US service members in Iraq: Performance on neurological cxamination and the MACE (Military Acute Concussion Examination) Journal Article
In: Neurology, vol. 76, pp. A159–A159, 2011, ISSN: 0028-3878.
@article{Young2011,
title = {Combat vs. non-combat related traumatic brain injury (TBI) in US service members in Iraq: Performance on neurological cxamination and the MACE (Military Acute Concussion Examination)},
author = {Young, R S K and Scott, K R},
issn = {0028-3878},
year = {2011},
date = {2011-01-01},
journal = {Neurology},
volume = {76},
pages = {A159--A159},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Wilk, J; Herrell, R; Hoge, C
Mild traumatic brain injury (concussion), post-traumatic stress disorder, and depression in US soldiers involved in combat deployments: Association with post-deployment symptoms Journal Article
In: Archives of Clinical Neuropsychology, vol. 26, pp. 524, 2011, ISSN: 0887-6177.
@article{Wilk2011,
title = {Mild traumatic brain injury (concussion), post-traumatic stress disorder, and depression in US soldiers involved in combat deployments: Association with post-deployment symptoms},
author = {Wilk, J and Herrell, R and Hoge, C},
issn = {0887-6177},
year = {2011},
date = {2011-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {26},
pages = {524},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hisley, D M; Gurganus, J C; Drysdale, A W
Experimental methodology using digital image correlation to assess ballistic helmet blunt trauma Journal Article
In: Journal of Applied Mechanics-Transactions of the Asme, vol. 78, 2011, ISSN: 0021-8936.
@article{Hisley2011,
title = {Experimental methodology using digital image correlation to assess ballistic helmet blunt trauma},
author = {Hisley, D M and Gurganus, J C and Drysdale, A W},
doi = {051022 10.1115/1.4004332},
issn = {0021-8936},
year = {2011},
date = {2011-01-01},
journal = {Journal of Applied Mechanics-Transactions of the Asme},
volume = {78},
abstract = {As modern helmets have become quite capable of defeating the penetration capabilities of ballistic threats, Soldiers may experience head injuries due to blunt trauma caused by helmet back face deformation (BFD). Possible resulting injuries include skull fracture, hematoma, concussion, contusion, diffuse axonal injury, etc. Some of these injuries have been associated with traumatic brain injury. In order to assess potential injury mechanisms prior to fielding new helmets, we have developed a means to experimentally replicate and measure helmet BFD that can be correlated to injury criteria. In this study, helmet performance test methodology is developed using a digital image correlation (DIC) technique. DIC provides the capability to measure dynamic displacements, thereby providing the ability to calculate deformation, velocity, and acceleration rates. We have shown that digital image correlation is an experimentation technique that accurately captures BFD area and rate of deformation for impacts against combat helmets. We used the DIC data to calculate a new metric; the available energy that could potentially impact a Soldier's head. Our study shows that DIC data upholds the hypothesis that helmet BFD mechanically loads the skull similar to a direct impact from a less-than-lethal projectile or blunt object impact. The available energy obtained from DIC measurements was used to calculate the blunt criterion (BC) for helmet standoff distances of 12.7 mm (0.5 in) and 19.1 mm (0.75 in), which in turn can provide a prediction of the probability of abbreviated injury scale (AIS) levels and, in particular, skull fracture. DIC can be used to provide dynamic helmet performance data that will allow increased understanding of BFD and quantitative assessment and validation of helmet performance results. Knowledge of the conditions leading to head trauma obtained through DIC experimentation should enable the selection of new energy-absorbing materials for helmets; thus, allowing new helmet design candidate performances to be objectively evaluated. Test data and characterization of helmet response could then be used to achieve improved warfighter survivability. [DOI: 10.1115/1.4004332]},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Watts, Dorraine D; Gibbons, Susanne; Kurzweil, Dina
Mild traumatic brain injury: a survey of perceived knowledge and learning preferences of military and civilian nurses Journal Article
In: Journal of Neuroscience Nursing, vol. 43, pp. 122–129, 2011.
@article{Watts2011,
title = {Mild traumatic brain injury: a survey of perceived knowledge and learning preferences of military and civilian nurses},
author = {Watts, Dorraine D and Gibbons, Susanne and Kurzweil, Dina},
year = {2011},
date = {2011-01-01},
journal = {Journal of Neuroscience Nursing},
volume = {43},
pages = {122--129},
address = {Susanne Gibbons, PhD C-ANP C-GNP, is an assistant professor at the Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD. Dina Kurzweil, MS MA PhD(c), is a deputy director at the Education and Technology Innovation},
abstract = {ABSTRACT: Early case recognition and intervention by nurses for patients with mild traumatic brain injury (mTBI) can significantly improve outcomes for civilian and military patients. The "Concussion/mTBI Learning Needs Assessment for Registered Nurses Survey" was developed to evaluate bedside nurses' knowledge related to the assessment and care of patients with mTBI as well as their preferences for learning in order to develop a targeted curriculum. An anonymous, self-administered, Web-based survey was available from February to August 2009. A series of invitational e-mails were sent to nurses at a convenience sample of civilian, federal, and military institutions. A total of 1,224 nurses meeting the inclusion criteria of being bedside care providers and nonadvanced practice responded and were included in the analysis (civilian},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Armistead-Jehle, P; Hansen, C L
In: Archives of Clinical Neuropsychology, vol. 26, pp. 592–601, 2011, ISSN: 0887-6177.
@article{Armistead-Jehle2011,
title = {Comparison of the Repeatable Battery for the Assessment of Neuropsychological Status Effort Index and Stand-Alone Symptom Validity Tests in a Military Sample},
author = {Armistead-Jehle, P and Hansen, C L},
doi = {10.1093/arclin/acr049},
issn = {0887-6177},
year = {2011},
date = {2011-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {26},
pages = {592--601},
abstract = {The current study sought to report the base rates of Symptom Validity Test (SVT) failure in an active duty military sample as well as to compare the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Effort Index (EI) to stand-alone measures of symptom validity. SVT failure varied from previous studies and even among different subgroups in the current sample, ranging from 8% to 30%. The RBANS EI demonstrated modest sensitivity in the detection of suboptimal effort when compared with stand-alone SVTs. Although the index appears to add some utility to the detection of suboptimal effort, sole use of the EI as a measure of symptom validity could conceivably result in an unnecessarily high rate of false negatives.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cooper, Douglas B; Kennedy, Jan E; Cullen, Maren A; Critchfield, Edan; Amador, Ricardo R; Bowles, Amy O
Association between combat stress and post-concussive symptom reporting in OEF/OIF service members with mild traumatic brain injuries Journal Article
In: Brain Injury, vol. 25, pp. 1–7, 2011.
@article{Cooper2011,
title = {Association between combat stress and post-concussive symptom reporting in OEF/OIF service members with mild traumatic brain injuries},
author = {Cooper, Douglas B and Kennedy, Jan E and Cullen, Maren A and Critchfield, Edan and Amador, Ricardo R and Bowles, Amy O},
year = {2011},
date = {2011-01-01},
journal = {Brain Injury},
volume = {25},
pages = {1--7},
address = {Department of Orthopedics \& Rehabilitation, Brooke Army Medical Center, Ft. Sam Houston, TX, USA. douglas.cooper2@amedd.army.mil},
abstract = {OBJECTIVE: The relationship between combat stress and post-concussive symptoms in service members with mild traumatic brain injuries (mTBI) is poorly understood. It was hypothesized that the co-occurrence of combat stress would have a significant effect on the severity of post-concussive complaints, specifically on emotional and cognitive symptoms. METHODS: Four hundred and seventy-two combat-deployed service members with mTBI completed self-report inventories of post-traumatic stress and post-concussive symptoms. Two groups were formed based on post-traumatic stress symptoms (High Combat Stress and Low Combat Stress). RESULTS: A 3-8-fold increase in post-concussive symptoms was observed when comparing the High and Low Combat Stress Groups. Elevations in post-concussive symptom reporting were not limited to emotional and/or cognitive symptoms, but rather were inclusive of all measured post-concussive symptoms. CONCLUSIONS: The findings of the present study suggest that non-brain injury-related factors, such as high-levels of combat stress, may impact post-concussive symptom reporting in this population, further confounding the accuracy of the post-concussion syndrome (PCS) diagnosis. Considerable caution should be exercised in making the diagnosis of PCS in concussed service members with co-occurring combat-stress disorders.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Marion, Donald W; Curley, Kenneth C; Schwab, Karen; Hicks, Ramona R; M, T B I Diagnostics Workgroup
Proceedings of the military mTBI Diagnostics Workshop, St. Pete Beach, August 2010 Journal Article
In: Journal of Neurotrauma, vol. 28, pp. 517–526, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Marion2011,
title = {Proceedings of the military mTBI Diagnostics Workshop, St. Pete Beach, August 2010},
author = {Marion, Donald W and Curley, Kenneth C and Schwab, Karen and Hicks, Ramona R and M, T B I Diagnostics Workgroup},
year = {2011},
date = {2011-01-01},
journal = {Journal of Neurotrauma},
volume = {28},
pages = {517--526},
address = {The Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center, Washington, DC 20307, USA. Donald.Marion@us.army.mil},
abstract = {Approximately 28,000 service members (SMs) sustain a traumatic brain injury (TBI) each year in the U.S. military. The majority of the injuries result either in a brief or no loss of consciousness, and are classified as a mild TBI (mTBI or concussion). Current evaluation guidelines of SMs suspected of having a mTBI rely heavily on self-reports. However, there is concern that SMs typically minimize or do not report their symptoms of mTBI for fear that doing so will result in being removed from the battlefield. Because mTBI often results in headaches, cognitive dysfunction, attention difficulties, and balance problems, returning to the battlefield before resolution of their symptoms can be dangerous for the SM and for their unit. Sustaining a second concussion before resolution of a previous mTBI also may make long-term neuronal injury more likely. The mTBI Diagnostics Workshop was designed as a forum where civilian and military experts from a variety of TBI-related clinical and basic science disciplines could meet to define the diagnostic tools, alone or in combination, that were most likely to result in an acute, objective diagnosis of mTBI. The premise of the meeting was that a small number of well-focused research projects conducted over the next 2-3 years could be done to validate the optimal test, or more likely combination of tests, that would be practical and reliable for the acute diagnosis of mTBI within 2-3 h of injury in theater. The recommendations of the Workshop are provided in this report.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Nelson, Nathaniel W; Hoelzle, James B; McGuire, Kathryn A; Ferrier-Auerbach, Amanda G; Charlesworth, Molly J; Sponheim, Scott R
Neuropsychological evaluation of blast-related concussion: illustrating the challenges and complexities through OEF/OIF case studies Journal Article
In: Brain Injury, vol. 25, pp. 511–525, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Nelson2011a,
title = {Neuropsychological evaluation of blast-related concussion: illustrating the challenges and complexities through OEF/OIF case studies},
author = {Nelson, Nathaniel W and Hoelzle, James B and McGuire, Kathryn A and Ferrier-Auerbach, Amanda G and Charlesworth, Molly J and Sponheim, Scott R},
year = {2011},
date = {2011-01-01},
journal = {Brain Injury},
volume = {25},
pages = {511--525},
address = {University of St. Thomas, Graduate School of Professional Psychology, LaSalle Ave., Minneapolis, MN 55403, USA. nels0600@stthomas.edu},
abstract = {BACKGROUND/OBJECTIVE: Soldiers of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF) sustain blast-related mild traumatic brain injury (concussion) with alarming regularity. This study discusses factors in addition to concussion, such as co-morbid psychological difficulty (e.g. post-traumatic stress) and symptom validity concerns that may complicate neuropsychological evaluation in the late stage of concussive injury. CASE REPORT: The study presents the complexities that accompany neuropsychological evaluation of blast concussion through discussion of three case reports of OEF/OIF personnel. DISCUSSION: The authors emphasize uniform assessment of blast concussion, the importance of determining concussion severity according to acute-injury characteristics and elaborate upon non-concussion-related factors that may impact course of cognitive limitation. The authors conclude with a discussion of the need for future research examining the impact of blast concussion (particularly recurrent concussion) and neuropsychological performance.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Ling, Geoffrey S F; Ecklund, James M
Traumatic brain injury in modern war Journal Article
In: Current Opinion in Anaesthesiology, vol. 24, pp. 124–130, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Ling2011,
title = {Traumatic brain injury in modern war},
author = {Ling, Geoffrey S F and Ecklund, James M},
year = {2011},
date = {2011-01-01},
journal = {Current Opinion in Anaesthesiology},
volume = {24},
pages = {124--130},
address = {Department of Neurology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, Maryland, USA. gling@usuhs.mil},
abstract = {PURPOSE OF REVIEW: To review the emerging literature on traumatic brain injury (TBI) caused by explosive blast. RECENT FINDINGS: Efforts are underway to understand how explosive blast injures brain, what is the clinical presentation and how best to manage it. A major way blast injures brain is from detonation pressure waves coupling to a victim's head leading to brain deformation. The effect of other explosion-related elements is unknown. Because scientific insights take time to develop but injuries are occurring now, the military adopts existing civilian standard of care practices developed for similar diseases, such as the Guidelines for the Management of Severe Traumatic Brain Injury developed mainly for closed head TBI. When these do not exist, the military creates them, such as the Veterans Administration and Department of Defense Clinical Practice Guidelines for Concussion/Mild TBI. Another treatment advance is the creation of the first large system-wide approach to diagnosis and clinical management of TBI, which begins at the site of injury and extends through both the military and the Veterans' Administration medical care systems. SUMMARY: Explosive blast TBI is being addressed at all levels - basic research through clinical care. New clinical practice guidelines are being used in a standardized system-wide approach.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Cooper, Douglas B; Kennedy, Jan E; Cullen, Maren A; Critchfield, Edan; Amador, Ricardo R; Bowles, Amy O
Association between combat stress and post-concussive symptom reporting in OEF/OIF service members with mild traumatic brain injuries Journal Article
In: Brain Injury, vol. 25, pp. 1–7, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Cooper2011,
title = {Association between combat stress and post-concussive symptom reporting in OEF/OIF service members with mild traumatic brain injuries},
author = {Cooper, Douglas B and Kennedy, Jan E and Cullen, Maren A and Critchfield, Edan and Amador, Ricardo R and Bowles, Amy O},
year = {2011},
date = {2011-01-01},
journal = {Brain Injury},
volume = {25},
pages = {1--7},
address = {Department of Orthopedics \& Rehabilitation, Brooke Army Medical Center, Ft. Sam Houston, TX, USA. douglas.cooper2@amedd.army.mil},
abstract = {OBJECTIVE: The relationship between combat stress and post-concussive symptoms in service members with mild traumatic brain injuries (mTBI) is poorly understood. It was hypothesized that the co-occurrence of combat stress would have a significant effect on the severity of post-concussive complaints, specifically on emotional and cognitive symptoms. METHODS: Four hundred and seventy-two combat-deployed service members with mTBI completed self-report inventories of post-traumatic stress and post-concussive symptoms. Two groups were formed based on post-traumatic stress symptoms (High Combat Stress and Low Combat Stress). RESULTS: A 3-8-fold increase in post-concussive symptoms was observed when comparing the High and Low Combat Stress Groups. Elevations in post-concussive symptom reporting were not limited to emotional and/or cognitive symptoms, but rather were inclusive of all measured post-concussive symptoms. CONCLUSIONS: The findings of the present study suggest that non-brain injury-related factors, such as high-levels of combat stress, may impact post-concussive symptom reporting in this population, further confounding the accuracy of the post-concussion syndrome (PCS) diagnosis. Considerable caution should be exercised in making the diagnosis of PCS in concussed service members with co-occurring combat-stress disorders.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Watts, Dorraine D; Gibbons, Susanne; Kurzweil, Dina
Mild traumatic brain injury: a survey of perceived knowledge and learning preferences of military and civilian nurses Journal Article
In: Journal of Neuroscience Nursing, vol. 43, pp. 122–129, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Watts2011,
title = {Mild traumatic brain injury: a survey of perceived knowledge and learning preferences of military and civilian nurses},
author = {Watts, Dorraine D and Gibbons, Susanne and Kurzweil, Dina},
year = {2011},
date = {2011-01-01},
journal = {Journal of Neuroscience Nursing},
volume = {43},
pages = {122--129},
address = {Susanne Gibbons, PhD C-ANP C-GNP, is an assistant professor at the Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD. Dina Kurzweil, MS MA PhD(c), is a deputy director at the Education and Technology Innovation},
abstract = {ABSTRACT: Early case recognition and intervention by nurses for patients with mild traumatic brain injury (mTBI) can significantly improve outcomes for civilian and military patients. The "Concussion/mTBI Learning Needs Assessment for Registered Nurses Survey" was developed to evaluate bedside nurses' knowledge related to the assessment and care of patients with mTBI as well as their preferences for learning in order to develop a targeted curriculum. An anonymous, self-administered, Web-based survey was available from February to August 2009. A series of invitational e-mails were sent to nurses at a convenience sample of civilian, federal, and military institutions. A total of 1,224 nurses meeting the inclusion criteria of being bedside care providers and nonadvanced practice responded and were included in the analysis (civilian},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Armistead-Jehle, P; Hansen, C L
In: Archives of Clinical Neuropsychology, vol. 26, pp. 592–601, 2011, ISSN: 0887-6177.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Armistead-Jehle2011,
title = {Comparison of the Repeatable Battery for the Assessment of Neuropsychological Status Effort Index and Stand-Alone Symptom Validity Tests in a Military Sample},
author = {Armistead-Jehle, P and Hansen, C L},
doi = {10.1093/arclin/acr049},
issn = {0887-6177},
year = {2011},
date = {2011-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {26},
pages = {592--601},
abstract = {The current study sought to report the base rates of Symptom Validity Test (SVT) failure in an active duty military sample as well as to compare the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Effort Index (EI) to stand-alone measures of symptom validity. SVT failure varied from previous studies and even among different subgroups in the current sample, ranging from 8% to 30%. The RBANS EI demonstrated modest sensitivity in the detection of suboptimal effort when compared with stand-alone SVTs. Although the index appears to add some utility to the detection of suboptimal effort, sole use of the EI as a measure of symptom validity could conceivably result in an unnecessarily high rate of false negatives.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Hisley, D M; Gurganus, J C; Drysdale, A W
Experimental methodology using digital image correlation to assess ballistic helmet blunt trauma Journal Article
In: Journal of Applied Mechanics-Transactions of the Asme, vol. 78, 2011, ISSN: 0021-8936.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Hisley2011,
title = {Experimental methodology using digital image correlation to assess ballistic helmet blunt trauma},
author = {Hisley, D M and Gurganus, J C and Drysdale, A W},
doi = {051022 10.1115/1.4004332},
issn = {0021-8936},
year = {2011},
date = {2011-01-01},
journal = {Journal of Applied Mechanics-Transactions of the Asme},
volume = {78},
abstract = {As modern helmets have become quite capable of defeating the penetration capabilities of ballistic threats, Soldiers may experience head injuries due to blunt trauma caused by helmet back face deformation (BFD). Possible resulting injuries include skull fracture, hematoma, concussion, contusion, diffuse axonal injury, etc. Some of these injuries have been associated with traumatic brain injury. In order to assess potential injury mechanisms prior to fielding new helmets, we have developed a means to experimentally replicate and measure helmet BFD that can be correlated to injury criteria. In this study, helmet performance test methodology is developed using a digital image correlation (DIC) technique. DIC provides the capability to measure dynamic displacements, thereby providing the ability to calculate deformation, velocity, and acceleration rates. We have shown that digital image correlation is an experimentation technique that accurately captures BFD area and rate of deformation for impacts against combat helmets. We used the DIC data to calculate a new metric; the available energy that could potentially impact a Soldier's head. Our study shows that DIC data upholds the hypothesis that helmet BFD mechanically loads the skull similar to a direct impact from a less-than-lethal projectile or blunt object impact. The available energy obtained from DIC measurements was used to calculate the blunt criterion (BC) for helmet standoff distances of 12.7 mm (0.5 in) and 19.1 mm (0.75 in), which in turn can provide a prediction of the probability of abbreviated injury scale (AIS) levels and, in particular, skull fracture. DIC can be used to provide dynamic helmet performance data that will allow increased understanding of BFD and quantitative assessment and validation of helmet performance results. Knowledge of the conditions leading to head trauma obtained through DIC experimentation should enable the selection of new energy-absorbing materials for helmets; thus, allowing new helmet design candidate performances to be objectively evaluated. Test data and characterization of helmet response could then be used to achieve improved warfighter survivability. [DOI: 10.1115/1.4004332]},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Otis, J D; McGlinchey, R; Vasterling, J J; Kerns, R D
Complicating factors associated with mild traumatic brain injury: Impact on pain and posttraumatic stress disorder treatment Journal Article
In: Journal of Clinical Psychology in Medical Settings, vol. 18, pp. 145–154, 2011, ISSN: 1068-9583.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Otis2011,
title = {Complicating factors associated with mild traumatic brain injury: Impact on pain and posttraumatic stress disorder treatment},
author = {Otis, J D and McGlinchey, R and Vasterling, J J and Kerns, R D},
doi = {10.1007/s10880-011-9239-2},
issn = {1068-9583},
year = {2011},
date = {2011-01-01},
journal = {Journal of Clinical Psychology in Medical Settings},
volume = {18},
pages = {145--154},
abstract = {The nature of combat in Iraq and Afghanistan has resulted in high rates of comorbidity among chronic pain, posttraumatic stress disorder (PTSD), and mild traumatic brain injury (mTBI) in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). Although separate evidence-based psychological treatments have been developed for chronic pain and PTSD, far less is known about how to approach treatment when these conditions co-occur, and especially when they co-occur with mTBI. To provide the best care possible for OEF/OIF Veterans, clinicians need to have a clearer understanding of how to identify these conditions, ways in which these conditions may interact with one another, and ways in which existing evidence-based treatments can be modified to meet the needs of individuals with mTBI. The purpose of the present paper is to review the comorbidity of pain, PTSD, and mTBI in OEF/OIF Veterans, and provide recommendations to clinicians who provide care to Veterans with these conditions. First, we will begin with an overview of the presentation, symptomatology, and treatment of chronic pain and PTSD. The challenges associated with mTBI in OEF/OIF Veterans will be reported and data will be presented on the comorbidity among all three of these conditions in OEF/OIF Veterans. Second, we will present recommendations for providing psychological treatment for chronic pain and PTSD when comorbid with mTBI. Finally, the paper concludes with a discussion of the need for a multidisciplinary treatment approach, as well as a call for continued research to further refine existing treatments for these conditions.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Cullen, D K; Xu, Y A; Reneer, D V; Browne, K D; Geddes, J W; Yang, S; Smith, D H
Color changing photonic crystals detect blast exposure Journal Article
In: Neuroimage, vol. 54, pp. S37–S44, 2011, ISSN: 1053-8119.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Cullen2011,
title = {Color changing photonic crystals detect blast exposure},
author = {Cullen, D K and Xu, Y A and Reneer, D V and Browne, K D and Geddes, J W and Yang, S and Smith, D H},
doi = {10.1016/j.neuroimage.2010.10.076},
issn = {1053-8119},
year = {2011},
date = {2011-01-01},
journal = {Neuroimage},
volume = {54},
pages = {S37--S44},
abstract = {Blast-induced traumatic brain injury (bTBI) is the "signaturewound" of the current wars in Iraq and Afghanistan. However, with no objective information of relative blast exposure, warfighters with bTBI may not receive appropriate medical care and are at risk of being returned to the battlefield. Accordingly, we have created a colorimetric blast injury dosimeter (BID) that exploits material failure of photonic crystals to detect blast exposure. Appearing like a colored sticker, the BID is fabricated in photosensitive polymers via multi-beam interference lithography. Although very stable in the presence of heat, cold or physical impact, sculpted micro -and nano-structures of the BID are physically altered in a precise manner by blast exposure, resulting in color changes that correspond with blast intensity. This approach offers a lightweight, power-free sensor that can be readily interpreted by the naked eye. Importantly, with future refinement this technology may be deployed to identify soldiers exposed to blast at levels suggested to be supra-threshold for non-impact blast-induced mild TBI.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Luethcke, Cynthia A; Bryan, Craig J; Morrow, Chad E; Isler, William C
Comparison of concussive symptoms, cognitive performance, and psychological symptoms between acute blast-versus nonblast-induced mild traumatic brain injury Journal Article
In: Journal of the International Neuropsychological Society, vol. 17, pp. 36–45, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Luethcke2011,
title = {Comparison of concussive symptoms, cognitive performance, and psychological symptoms between acute blast-versus nonblast-induced mild traumatic brain injury},
author = {Luethcke, Cynthia A and Bryan, Craig J and Morrow, Chad E and Isler, William C},
year = {2011},
date = {2011-01-01},
journal = {Journal of the International Neuropsychological Society},
volume = {17},
pages = {36--45},
address = {Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA.},
abstract = {Blast-related head injuries are one of the most prevalent injuries among military personnel deployed in service of Operation Iraqi Freedom. Although several studies have evaluated symptoms after blast injury in military personnel, few studies compared them to nonblast injuries or measured symptoms within the acute stage after traumatic brain injury (TBI). Knowledge of acute symptoms will help deployed clinicians make important decisions regarding recommendations for treatment and return to duty. Furthermore, differences more apparent during the acute stage might suggest important predictors of the long-term trajectory of recovery. This study evaluated concussive, psychological, and cognitive symptoms in military personnel and civilian contractors (N = 82) diagnosed with mild TBI (mTBI) at a combat support hospital in Iraq. Participants completed a clinical interview, the Automated Neuropsychological Assessment Metric (ANAM), PTSD Checklist-Military Version (PCL-M), Behavioral Health Measure (BHM), and Insomnia Severity Index (ISI) within 72 hr of injury. Results suggest that there are few differences in concussive symptoms, psychological symptoms, and neurocognitive performance between blast and nonblast mTBIs, although clinically significant impairment in cognitive reaction time for both blast and nonblast groups is observed. Reductions in ANAM accuracy were related to duration of loss of consciousness, not injury mechanism.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Chen, Yun; Huang, Wei
Non-impact, blast-induced mild TBI and PTSD: concepts and caveats Journal Article
In: Brain Injury, vol. 25, pp. 641–650, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Chen2011,
title = {Non-impact, blast-induced mild TBI and PTSD: concepts and caveats},
author = {Chen, Yun and Huang, Wei},
year = {2011},
date = {2011-01-01},
journal = {Brain Injury},
volume = {25},
pages = {641--650},
address = {Tripler Army Medical Center, Honolulu, HI, USA. yun.chen@us.army.mil},
abstract = {PRIMARY OBJECTIVE: A volumetric blood surge (rapid physical movement/displacement of blood) is hypothesized to cause the non-impact, mild TBI and battlefield PTSD induced by a blast over-pressure wave. RESEARCH DESIGN: Systematic review of the literature. METHODS AND PROCEDURES: Articles relating to the fields of blast injury, brain injury and relevant disorders were searched between the years 1968-2010 for keywords such as 'brain injury', 'post-traumatic stress disorder' and 'blast pressure wave'. Articles found through journal and Internet databases were cross-referenced. MAIN OUTCOMES AND RESULTS: The blood surge, which is driven by elevated overall pressure in the ventral body cavity after exposure of the torso to blast wave, may move through blood vessels to the low-pressure cranial cavity from the high-pressure ventral body cavity. It dramatically increases cerebral perfusion pressure and causes damage to both tiny cerebral blood vessels and the BBB. CONCLUSIONS: Three factors may be critical to the induction of blast-induced brain injuries: (1) the difference in pressure between the ventral body cavity and cranial cavity; (2) blood that acts as a transmission medium to propagate a pressure wave to the brain; and (3) the vulnerability of cerebral blood vessels and the BBB to a sudden fluctuation in perfusion pressure.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Polusny, Melissa A; Kehle, Shannon M; Nelson, Nathaniel W; Erbes, Christopher R; Arbisi, Paul A; Thuras, Paul
Longitudinal effects of mild traumatic brain injury and posttraumatic stress disorder comorbidity on postdeployment outcomes in national guard soldiers deployed to Iraq Journal Article
In: Archives of General Psychiatry, vol. 68, pp. 79–89, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Polusny2011,
title = {Longitudinal effects of mild traumatic brain injury and posttraumatic stress disorder comorbidity on postdeployment outcomes in national guard soldiers deployed to Iraq},
author = {Polusny, Melissa A and Kehle, Shannon M and Nelson, Nathaniel W and Erbes, Christopher R and Arbisi, Paul A and Thuras, Paul},
year = {2011},
date = {2011-01-01},
journal = {Archives of General Psychiatry},
volume = {68},
pages = {79--89},
address = {University of Minnesota Medical School, Minneapolis, USA. melissa.polusny@va.gov},
abstract = {CONTEXT: Troops deployed to Iraq and Afghanistan are at high risk for exposure to combat events resulting in mild traumatic brain injury (MTBI) or concussion and posttraumatic stress disorder (PTSD). The longer-term impact of combat-related concussion/MTBI and comorbid PTSD on troops' health and well-being is unknown. OBJECTIVE: To assess longitudinal associations between concussion/MTBI and PTSD symptoms reported in theater and longer-term psychosocial outcomes in combat-deployed National Guard soldiers. DESIGN: Longitudinal cohort study. Participants were surveyed in Iraq 1 month before returning home (time 1) and 1 year later (time 2). Self-reports of concussion/MTBI and PTSD were assessed at times 1 and 2. Based on time 1 concussion/MTBI status (defined as an injury during deployment with loss of consciousness or altered mental status) and time 2 postdeployment probable PTSD status, soldiers were compared on a range of time 2 psychosocial outcomes. PARTICIPANTS: Nine hundred fifty-three US National Guard soldiers. SETTING: The time 1 sample was assessed during redeployment transition briefings held at military installations in the Iraq combat theater. The time 2 sample was assessed using mailed surveys sent to the homes of US National Guard service members. MAIN OUTCOME MEASURES: Postconcussive, depression, and physical symptoms; alcohol use; social functioning; and quality of life assessed at time 2 using valid clinical instruments. RESULTS: The rate of self-reported concussion/MTBI during deployment was 9.2% at time 1 and 22.0% at time 2. Soldiers with a history of concussion/MTBI were more likely than those without to report postdeployment postconcussive symptoms and poorer psychosocial outcomes. However, after adjusting for PTSD symptoms, concussion/MTBI was not associated with postdeployment symptoms or outcomes. Time 1 PTSD symptoms more strongly predicted postdeployment symptoms and outcomes than did concussion/MTBI history. CONCLUSIONS: Although combat-related PTSD was strongly associated with postconcussive symptoms and psychosocial outcomes 1 year after soldiers returned from Iraq, there was little evidence of a long-term negative impact of concussion/MTBI history on these outcomes after accounting for PTSD. These findings and the 2-fold increase in reports of deployment-related concussion/MTBI history have important implications for screening and treatment.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Peskind, Elaine R; Petrie, Eric C; Cross, Donna J; Pagulayan, Kathleen; McCraw, Kathleen; Hoff, David; Hart, Kim; Yu, Chang-En; Raskind, Murray A; Cook, David G; Minoshima, Satoshi
Cerebrocerebellar hypometabolism associated with repetitive blast exposure mild traumatic brain injury in 12 Iraq war Veterans with persistent post-concussive symptoms Journal Article
In: Neuroimage, vol. 54 Suppl 1, pp. S76–82, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Peskind2011,
title = {Cerebrocerebellar hypometabolism associated with repetitive blast exposure mild traumatic brain injury in 12 Iraq war Veterans with persistent post-concussive symptoms},
author = {Peskind, Elaine R and Petrie, Eric C and Cross, Donna J and Pagulayan, Kathleen and McCraw, Kathleen and Hoff, David and Hart, Kim and Yu, Chang-En and Raskind, Murray A and Cook, David G and Minoshima, Satoshi},
year = {2011},
date = {2011-01-01},
journal = {Neuroimage},
volume = {54 Suppl 1},
pages = {S76--82},
address = {Northwest Network Mental Illness, Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA. peskind@uw.edu},
abstract = {Disagreement exists regarding the extent to which persistent post-concussive symptoms (PCS) reported by Iraq combat Veterans with repeated episodes of mild traumatic brain injury (mTBI) from explosive blasts represent structural or functional brain damage or an epiphenomenon of comorbid depression or posttraumatic stress disorder (PTSD). Objective assessment of brain function in this population may clarify the issue. To this end, twelve Iraq war Veterans (32.0 +/- 8.5 [mean +/- standard deviation (SD)] years of age) reporting one or more blast exposures meeting American Congress of Rehabilitation Medicine criteria for mTBI and persistent PCS and 12 cognitively normal community volunteers (53.0 +/- 4.6 years of age) without history of head trauma underwent brain fluorodeoxyglucose positron emission tomography (FDG-PET) and neuropsychological assessments and completed PCS and psychiatric symptom rating scales. Compared to controls, Veterans with mTBI (with or without PTSD) exhibited decreased cerebral metabolic rate of glucose in the cerebellum, vermis, pons, and medial temporal lobe. They also exhibited subtle impairments in verbal fluency, cognitive processing speed, attention, and working memory, similar to those reported in the literature for patients with cerebellar lesions. These FDG-PET imaging findings suggest that regional brain hypometabolism may constitute a neurobiological substrate for chronic PCS in Iraq combat Veterans with repetitive blast-trauma mTBI. Given the potential public health implications of these findings, further investigation of brain function in these Veterans appears warranted.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Wilk, J; Herrell, R; Hoge, C
Mild traumatic brain injury (concussion), post-traumatic stress disorder, and depression in US soldiers involved in combat deployments: Association with post-deployment symptoms Journal Article
In: Archives of Clinical Neuropsychology, vol. 26, pp. 524, 2011, ISSN: 0887-6177.
BibTeX | Tags: Military Military LB - Military
@article{Wilk2011,
title = {Mild traumatic brain injury (concussion), post-traumatic stress disorder, and depression in US soldiers involved in combat deployments: Association with post-deployment symptoms},
author = {Wilk, J and Herrell, R and Hoge, C},
issn = {0887-6177},
year = {2011},
date = {2011-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {26},
pages = {524},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Young, R S K; Scott, K R
Combat vs. non-combat related traumatic brain injury (TBI) in US service members in Iraq: Performance on neurological cxamination and the MACE (Military Acute Concussion Examination) Journal Article
In: Neurology, vol. 76, pp. A159–A159, 2011, ISSN: 0028-3878.
BibTeX | Tags: Military Military LB - Military
@article{Young2011,
title = {Combat vs. non-combat related traumatic brain injury (TBI) in US service members in Iraq: Performance on neurological cxamination and the MACE (Military Acute Concussion Examination)},
author = {Young, R S K and Scott, K R},
issn = {0028-3878},
year = {2011},
date = {2011-01-01},
journal = {Neurology},
volume = {76},
pages = {A159--A159},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Risdall, Jane E; Menon, David K
Traumatic brain injury Journal Article
In: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, vol. 366, pp. 241–250, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Risdall2011,
title = {Traumatic brain injury},
author = {Risdall, Jane E and Menon, David K},
year = {2011},
date = {2011-01-01},
journal = {Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences},
volume = {366},
pages = {241--250},
address = {Surgeon Commander, Royal Navy, UK.},
abstract = {There is an increasing incidence of military traumatic brain injury (TBI), and similar injuries are seen in civilians in war zones or terrorist incidents. Indeed, blast-induced mild TBI has been referred to as the signature injury of the conflicts in Iraq and Afghanistan. Assessment involves schemes that are common in civilian practice but, in common with civilian TBI, takes little account of information available from modern imaging (particularly diffusion tensor magnetic resonance imaging) and emerging biomarkers. The efficient logistics of clinical care delivery in the field may have a role in optimizing outcome. Clinical care has much in common with civilian TBI, but intracranial pressure monitoring is not always available, and protocols need to be modified to take account of this. In addition, severe early oedema has led to increasing use of decompressive craniectomy, and blast TBI may be associated with a higher incidence of vasospasm and pseudoaneurysm formation. Visual and/or auditory deficits are common, and there is a significant risk of post-traumatic epilepsy. TBI is rarely an isolated finding in this setting, and persistent post-concussive symptoms are commonly associated with post-traumatic stress disorder and chronic pain, a constellation of findings that has been called the polytrauma clinical triad.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Alvarez, M; Kennedy, J; Amador, R; Cullen, M
Military Acute Concussion Evaluation Score and Its Relevance to Post-Concussive Symptoms in mTBI Service Members Journal Article
In: Neurology, vol. 76, pp. A165–A165, 2011, ISSN: 0028-3878.
BibTeX | Tags: Military Military LB - Military
@article{Alvarez2011,
title = {Military Acute Concussion Evaluation Score and Its Relevance to Post-Concussive Symptoms in mTBI Service Members},
author = {Alvarez, M and Kennedy, J and Amador, R and Cullen, M},
issn = {0028-3878},
year = {2011},
date = {2011-01-01},
journal = {Neurology},
volume = {76},
pages = {A165--A165},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Melamed, B G; Castro, C
Observations and insights about Strengthening Our Soldiers (SOS) Journal Article
In: Journal of Clinical Psychology in Medical Settings, vol. 18, pp. 210–223, 2011, ISSN: 1068-9583.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Melamed2011,
title = {Observations and insights about Strengthening Our Soldiers (SOS)},
author = {Melamed, B G and Castro, C},
doi = {10.1007/s10880-011-9253-4},
issn = {1068-9583},
year = {2011},
date = {2011-01-01},
journal = {Journal of Clinical Psychology in Medical Settings},
volume = {18},
pages = {210--223},
abstract = {The Special Issue (June 2011) of the Journal of Clinical Psychology in Medical Settings titled Strengthening Our Soldiers (SOS) and Their Families: Contemporary Psychological Advances Applied to Wartime Problems revealed the following important concerns: 1) Who is at risk for psychological sequelae during and following service in the U.S. military? 2) How to deliver the best treatment for our soldiers and veterans with PTSD, Traumatic Brain Injury and Pain? 3) How to train the trainers? and 4) What are the current priorities for service delivery, research and funding? Assessment strategies and tools are provided to assist in identification of suicidal ideation and behaviors, alcohol abuse in spouses, posttraumatic stress disorders, depression, brain injuries and post-concussion syndrome, as well as positive growth experiences. Empirically validated Cognitive Processing and Prolonged Exposure treatments are described as are the empirical results already in evidence in our military populations. The innovative use of Virtual Reality and Telehealth applications is demonstrated in both army and naval settings for preparing and reducing trauma in affected soldiers. The Functional and Occupational Rehabilitation Treatment (FORT) Program and its role in returning function to injured soldiers with musculoskeletal pain and motion restrictions, while also leading to reductions of anxiety, depression and use of medical services, is described. A critique about providing service-research for children's reactions to their parent's deployments and family functioning during separation and reintegration is provided. The need for theoretical-empirical approaches to understanding pain-behavior, anxiety dysregulation as it impacts the brain function and structure is provided by experts in pain, neuropsychology, brain circuitry and anxiety management of multiple traumas. This final paper in SOS provides commentary on SOS and describes possible future implications of current psychological knowledge related to military personnel and their families.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Brenner, Lisa A; Ignacio, Rosalinda V; Blow, Frederic C
Suicide and traumatic brain injury among individuals seeking Veterans Health Administration services Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 26, pp. 257–264, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Brenner2011,
title = {Suicide and traumatic brain injury among individuals seeking Veterans Health Administration services},
author = {Brenner, Lisa A and Ignacio, Rosalinda V and Blow, Frederic C},
year = {2011},
date = {2011-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {26},
pages = {257--264},
address = {VISN 19 Mental Illness Research Education and Clinical Center (MIRECC), Denver, Colorado 80220, USA. Lisa.Brenner@va.gov},
abstract = {OBJECTIVE: To examine associations between history of traumatic brain injury (TBI) diagnosis and death by suicide among individuals receiving care within the Veterans Health Administration (VHA). METHOD: Individuals who received care between fiscal years 2001 to 2006 were included in analyses. Cox proportional hazards survival models for time to suicide, with time-dependent covariates, were utilized. Covariance sandwich estimators were used to adjust for the clustered nature of the data, with patients nested within VHA facilities. Analyses included all patients with a history of TBI (n = 49626) plus a 5% random sample of patients without TBI (n = 389053). Of those with a history of TBI, 105 died by suicide. Models were adjusted for demographic and psychiatric covariates. RESULTS: Veterans with a history of TBI were 1.55 (95% confidence interval [CI], 1.24-1.92) times more likely to die by suicide than those without a history of TBI. Analyses by TBI severity were also conducted, and they suggested that in comparison to those without an injury history, those with (1) concussion/cranial fracture were 1.98 times more likely (95% CI, 1.39-2.82) to die by suicide and (2) cerebral contusion/traumatic intracranial hemorrhage were 1.34 times more likely (95% CI, 1.09-1.64) to die by suicide. This increased risk was not explained by the presence of psychiatric disorders or demographic factors. CONCLUSIONS: Among VHA users, those with a diagnosis of TBI were at greater risk for suicide than those without this diagnosis. Further research is indicated to identify evidence-based means of assessment and treatment for those with TBI and suicidal behavior.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Weinberger, Sharon
Bombs' hidden impact: the brain war Journal Article
In: Nature, vol. 477, pp. 390–393, 2011.
BibTeX | Tags: Military Military LB - Military
@article{Weinberger2011,
title = {Bombs' hidden impact: the brain war},
author = {Weinberger, Sharon},
year = {2011},
date = {2011-01-01},
journal = {Nature},
volume = {477},
pages = {390--393},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Romesser, Jennifer; Shen, Shuying; Reblin, Maija; Kircher, John; Allen, Steven; Roberts, Toni; Marchand, William R
A preliminary study of the effect of a diagnosis of concussion on PTSD symptoms and other psychiatric variables at the time of treatment seeking among veterans Journal Article
In: Military Medicine, vol. 176, pp. 246–252, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Romesser2011,
title = {A preliminary study of the effect of a diagnosis of concussion on PTSD symptoms and other psychiatric variables at the time of treatment seeking among veterans},
author = {Romesser, Jennifer and Shen, Shuying and Reblin, Maija and Kircher, John and Allen, Steven and Roberts, Toni and Marchand, William R},
year = {2011},
date = {2011-01-01},
journal = {Military Medicine},
volume = {176},
pages = {246--252},
address = {The George E. Wahlen Veterans Affairs Medical Center, 500 Foothill, Salt Lake City, UT 84148, USA.},
abstract = {The aim of this study was to assess whether a diagnosis of concussion given at a Veterans Healthcare Administration secondary traumatic brain injury assessment impacted either posttraumatic stress disorder (PTSD) symptomatology or other variables at the time veterans sought treatment for PTSD. This retrospective study compared 61 male veterans with a history of military-related concussion and military-related PTSD to 83 male veterans with military-related PTSD but without a diagnosis of military-related concussion. There were no significant between-group differences in PTSD symptomatology. However, the cohort with a history of military concussion endorsed decreased ability to cope with PTSD symptoms, increased problems with physical health, and more pain complaints. If replicated, these results may guide the design of more effective interventions for veterans who receive diagnoses of PTSD and concussion.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Rigg, John L; Mooney, Scott R
Concussions and the military: Issues specific to service members Journal Article
In: PM & R, vol. 3, pp. S380–S386, 2011, ISSN: 1934-1482.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Rigg2011,
title = {Concussions and the military: Issues specific to service members},
author = {Rigg, John L and Mooney, Scott R},
doi = {10.1016/j.pmrj.2011.08.005},
issn = {1934-1482},
year = {2011},
date = {2011-01-01},
journal = {PM \& R},
volume = {3},
pages = {S380--S386},
abstract = {Since October 2001, more than 1.6 million American military service members have deployed to Iraq and Afghanistan in the Global War on Terrorism. It is estimated that between 5% and 35% of them have sustained a concussion, also called mild traumatic brain injury (mTBI), during their deployment. Up to 80% of the concussions experienced in theater are secondary to blast exposures. The unique circumstances and consequences of sustaining a concussion in combat demands a unique understanding and treatment plan. The current literature was reviewed and revealed a paucity of pathophysiological explanations on the nature of the injury and informed treatment plans. However, through observation and experience, a theoretical but scientifically plausible model for why and how blast injuries experienced in combat give rise to the symptoms that affect day-to-day function of service members who have been concussed has been developed. We also are able to offer treatment strategies based on our evaluation of the current literature and experience to help palliate postconcussive symptoms. The purpose of this review is to elucidate common physical, cognitive, emotional, and situational challenges, and possible solutions for this special population of patients who will be transitioning into the civilian sector and interfacing with health professionals. There is a need for further investigation and testing of these strategies.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Akin, Faith W; Murnane, Owen D
Head injury and blast exposure: vestibular consequences Journal Article
In: Otolaryngologic Clinics of North America, vol. 44, pp. 323–334, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Akin2011,
title = {Head injury and blast exposure: vestibular consequences},
author = {Akin, Faith W and Murnane, Owen D},
year = {2011},
date = {2011-01-01},
journal = {Otolaryngologic Clinics of North America},
volume = {44},
pages = {323--334},
address = {Vestibular/Balance Laboratory, Audiology Service, Veterans Affairs Medical Center, Mountain Home, TN 37684, USA. faith.akin@va.gov},
abstract = {Young adults are more likely to suffer blast injury and traumatic brain injury (TBI) than other age groups. This article reviews the literature on the vestibular[NON-BREAKING SPACE]consequences of blast exposure and TBI and concussion. In addition, the vestibular test findings obtained from 31 veterans with a history of blast exposure and/or mild TBI are presented. The authors discuss loss of horizontal semicircular canal function and postural instability related to head injury. Preliminary data suggest the novel theory that otolith organs are uniquely vulnerable to head injury and blast exposure.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Ryan, P B; Lee-Wilk, T; Kok, B C; Wilk, J E
Interdisciplinary rehabilitation of mild TBI and PTSD: A case report Journal Article
In: Brain Injury, vol. 25, pp. 1019–1025, 2011, ISSN: 0269-9052.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Ryan2011,
title = {Interdisciplinary rehabilitation of mild TBI and PTSD: A case report},
author = {Ryan, P B and Lee-Wilk, T and Kok, B C and Wilk, J E},
doi = {10.3109/02699052.2011.597044},
issn = {0269-9052},
year = {2011},
date = {2011-01-01},
journal = {Brain Injury},
volume = {25},
pages = {1019--1025},
abstract = {Background: Prevalence of mild traumatic brain injury (mTBI) or concussion on the battlefield in Iraq/Afghanistan has resulted in its designation as a 'signature injury'. Civilian studies have shown that negative expectations for recovery may lead to worse outcomes. While there is concern that concussion screening procedures in the Veteran's Affairs Healthcare System and the Department of Defence could fuel negative expectations, leading to negative iatrogenic effects, it has been difficult to document this in clinical settings. The aim of this report is to describe the case of a veteran with comorbid mTBI/PTSD with persistent symptoms of unknown aetiology and the effects of provider communications on the patient's recovery. Methods: Case report of a veteran with reported mTBI, including provider communications, neuropsychological test results and report of functioning after changes in provider messages. Results: Two-years post-mTBI, the patient attributed cognitive difficulties to his brain injury, but neuropsychological assessment found that his cognitive profile was consistent with psychological rather than neurological dysfunction. After providers systematically emphasized expectations of recovery, the patient's daily functioning improved. Conclusions: This case illustrates difficulties in mass screening for and treating mTBI. Recommendations for improvement include clinician training in effectively communicating positive expectations of recovery after concussion.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Nelson, Nathaniel W; Hoelzle, James B; McGuire, Kathryn A; Sim, Anita H; Goldman, Daniel J; Ferrier-Auerbach, Amanda G; Charlesworth, Molly J; Arbisi, Paul A; Sponheim, Scott R
Self-report of psychological function among OEF/OIF personnel who also report combat-related concussion Journal Article
In: Clinical Neuropsychologist, vol. 25, pp. 716–740, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Nelson2011c,
title = {Self-report of psychological function among OEF/OIF personnel who also report combat-related concussion},
author = {Nelson, Nathaniel W and Hoelzle, James B and McGuire, Kathryn A and Sim, Anita H and Goldman, Daniel J and Ferrier-Auerbach, Amanda G and Charlesworth, Molly J and Arbisi, Paul A and Sponheim, Scott R},
year = {2011},
date = {2011-01-01},
journal = {Clinical Neuropsychologist},
volume = {25},
pages = {716--740},
address = {Graduate School of Professional Psychology, University of St. Thomas, Minneapolis, MN 55403, USA. nels0600@stthomas.edu},
abstract = {MMPI-2 RF profiles of 128 U.S. soldiers and veterans with history of concussion were examined. Participants evaluated in forensic (n[THIN SPACE]=[THIN SPACE]42) and clinical (n[THIN SPACE]=[THIN SPACE]43) settings showed significantly higher validity and clinical elevations relative to a research group (n[THIN SPACE]=[THIN SPACE]43). In the full sample, a multivariate GLM identified main effects for disability claim status and Axis I diagnosis across numerous MMPI-2 RF scales. Participants with co-morbid PTSD and concussion showed significant Restructured Clinical and Specific Problem scale elevations relative to those without Axis I diagnosis. Participants with PTSD and active disability claims were especially prone to elevate on FBS/FBS-r and RBS. Implications for neuropsychologists who routinely administer the MMPI-2/RF in the context of combat-related concussion are discussed.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Bryan, Craig J; Hernandez, Ann M
Predictors of post-traumatic headache severity among deployed military personnel Journal Article
In: Headache, vol. 51, pp. 945–953, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Bryan2011,
title = {Predictors of post-traumatic headache severity among deployed military personnel},
author = {Bryan, Craig J and Hernandez, Ann M},
year = {2011},
date = {2011-01-01},
journal = {Headache},
volume = {51},
pages = {945--953},
address = {Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.},
abstract = {OBJECTIVE: The current study used a cross-sectional observational design to evaluate the relationship between psychological, physiological, and contextual factors and headache severity among 133 deployed military personnel and 4 civilian contractors diagnosed with mild traumatic brain injury (mTBI) referred to a combat support hospital in Iraq. BACKGROUND: Although TBI and headache sequelae have been documented for military combatants, little is known about factors associated with headache severity. METHODS: Military personnel (n = 157) and civilian (n = 4) contractors referred to a combat support hospital in Iraq underwent a standardized intake evaluation which included computerized neurocognitive testing, psychological and physical health questionnaires, a clinical interview, and a physical examination by a physician. RESULTS: Results of zero-inflated Poisson regression modeling suggest that insomnia is associated with increased likelihood for endorsement of any headache, but loss of consciousness, post-traumatic stress disorder symptoms, and slowed reaction time only are predictive of headache severity. Among the subset of patients presenting to the combat support hospital within 7 days of mTBI (n = 101), number of TBI symptoms demonstrated a non-significant trend toward increased likelihood of headache endorsement of any kind, with loss of consciousness, post-traumatic stress disorder, and slowed reaction time demonstrating significant relationships with headache severity. CONCLUSION: Knowledge of predictors of post-concussive headache onset and severity may assist clinicians in making important decisions regarding treatment recommendations for veterans with mTBI.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Coldren, Rodney L; Russell, Michael L; Kelly, Mark P; Parish, Robert V; Dretsch, Michael
Re: Automated neuropsychological assessment metrics (ANAM) Journal Article
In: Military Medicine, vol. 176, pp. iv, 2011.
BibTeX | Tags: Military Military LB - Military
@article{Coldren2011,
title = {Re: Automated neuropsychological assessment metrics (ANAM)},
author = {Coldren, Rodney L and Russell, Michael L and Kelly, Mark P and Parish, Robert V and Dretsch, Michael},
year = {2011},
date = {2011-01-01},
journal = {Military Medicine},
volume = {176},
pages = {iv},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Nelson, N W; Hoelzle, J B; Doane, B M; McGuire, K A; Ferrier-Auerbach, A G; Charlesworth, M J; Polusny, M A; Arbisi, P A; Lamberty, G J; Sponheim, S R
Neuropsychological outcomes of United States veterans with report of remote blast concussion and concurrent psychological distress Journal Article
In: Clinical Neuropsychologist, vol. 25, pp. 553–554, 2011, ISSN: 1385-4046.
BibTeX | Tags: Military Military LB - Military
@article{Nelson2011b,
title = {Neuropsychological outcomes of United States veterans with report of remote blast concussion and concurrent psychological distress},
author = {Nelson, N W and Hoelzle, J B and Doane, B M and McGuire, K A and Ferrier-Auerbach, A G and Charlesworth, M J and Polusny, M A and Arbisi, P A and Lamberty, G J and Sponheim, S R},
issn = {1385-4046},
year = {2011},
date = {2011-01-01},
journal = {Clinical Neuropsychologist},
volume = {25},
pages = {553--554},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Erickson, Jay C
Treatment outcomes of chronic post-traumatic headaches after mild head trauma in US soldiers: an observational study Journal Article
In: Headache, vol. 51, pp. 932–944, 2011.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Erickson2011,
title = {Treatment outcomes of chronic post-traumatic headaches after mild head trauma in US soldiers: an observational study},
author = {Erickson, Jay C},
year = {2011},
date = {2011-01-01},
journal = {Headache},
volume = {51},
pages = {932--944},
address = {Neurology Service, Madigan Army Medical Center, Tacoma, WA, USA. jay.erickson@us.army.mil},
abstract = {BACKGROUND: he effectiveness of medical therapies for chronic post-traumatic headaches (PTHs) attributable to mild head trauma in military troops has not been established. OBJECTIVE: To determine the treatment outcomes of acute and prophylactic medical therapies prescribed for chronic PTHs after mild head trauma in US Army soldiers. METHODS: A retrospective cohort study was conducted with 100 soldiers undergoing treatment for chronic PTH at a single US Army neurology clinic. Headache frequency and Migraine Disability Assessment (MIDAS) scores were determined at the initial clinic visit and then again by phone 3 months after starting headache prophylactic medication. Response rates of headache abortive medications were also determined. Treatment outcomes were compared between subjects with blast-related PTH and non-blast PTH. RESULTS: Ninety-nine of 100 subjects were male. Seventy-seven of 100 subjects had blast PTH and 23/100 subjects had non-blast PTH. Headache characteristics were similar for blast PTH and non-blast PTH with 96% and 95%, respectively, resembling migraine. Headache frequency among all PTH subjects decreased from 17.1 days/month at baseline to 14.5 days/month at follow-up (P = .009). Headache frequency decreased by 41% among non-blast PTH compared to 9% among blast PTH. Fifty-seven percent of non-blast PTH subjects had a 50% or greater decline in headache frequency compared to 29% of blast PTH subjects (P =.023). A significant decline in headache frequency occurred in subjects treated with topiramate (n = 29, -23%},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Snell, Frances I; Halter, Margaret Jordan
A signature wound of war: mild traumatic brain injury Journal Article
In: Journal of Psychosocial Nursing & Mental Health Services, vol. 48, pp. 22–28, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Snell2010,
title = {A signature wound of war: mild traumatic brain injury},
author = {Snell, Frances I and Halter, Margaret Jordan},
year = {2010},
date = {2010-01-01},
journal = {Journal of Psychosocial Nursing \& Mental Health Services},
volume = {48},
pages = {22--28},
address = {Louis Stokes Cleveland VA Medical Center, Akron Community-Based Outpatient Clinic, Akron, OH 44319, USA. Frances.Snell@va.gov},
abstract = {Improvised explosive devices are the weapons of choice for the insurgent enemy in Iraq and Afghanistan. More soldiers are surviving these blast injuries due to improved torso protection yet are sustaining head and neck wounds in numbers that exceed those from previous wars. Although moderate and severe traumatic head injuries are easily identified and aggressively treated, mild traumatic brain injuries (m-TBIs), or concussions, had previously been deemed inconsequential and often overlooked. Recently, however, the U.S. Department of Defense and Veterans Health Administration have placed emphasis on identifying service members at risk for m-TBI because a select number continue to have disabling symptoms that can negatively affect quality of life. Research regarding the effects and treatment of blasts injury are gaining momentum, but further work needs to be accomplished. This article provides a three-question screening tool that can be used to identify these at-risk veterans.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Caplan, L J; Ivins, B; Poole, J H; Vanderploeg, R D; Jaffee, M S; Schwab, K
The structure of postconcussive symptoms in 3 US military samples Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 25, pp. 447–458, 2010, ISSN: 0885-9701.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Caplan2010,
title = {The structure of postconcussive symptoms in 3 US military samples},
author = {Caplan, L J and Ivins, B and Poole, J H and Vanderploeg, R D and Jaffee, M S and Schwab, K},
doi = {10.1097/HTR.0b013e3181d5bdbd},
issn = {0885-9701},
year = {2010},
date = {2010-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {25},
pages = {447--458},
abstract = {Objective: To evaluate alternative models of symptom clusters for the 22-item Neurobehavioral Symptom Inventory. Participants: Three military samples, including 2 nonclinical samples (n = 2420},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Meyer, Kimberly S; Marion, Donald W; Coronel, Helen; Jaffee, Michael S
Combat-related traumatic brain injury and its implications to military healthcare Journal Article
In: Psychiatric Clinics of North America, vol. 33, pp. 783–796, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Meyer2010,
title = {Combat-related traumatic brain injury and its implications to military healthcare},
author = {Meyer, Kimberly S and Marion, Donald W and Coronel, Helen and Jaffee, Michael S},
year = {2010},
date = {2010-01-01},
journal = {Psychiatric Clinics of North America},
volume = {33},
pages = {783--796},
address = {Defense and Veterans Brain Injury Center, PO Box 59181, Washington, DC 20012, USA. kimberly.meyer1@us.army.mil},
abstract = {Traumatic brain injury (TBI) is a known injury in today's combat arena. Improved screening and surveillance methods have diagnosed TBI with increasing frequency. Current treatment plans are based largely on information gleaned from sports injuries. However, these management paradigms fail to address the effect of physiologic stress (fatigue, dehydration) and psychological stress at the time of injury as well as the number of previous concussions that may affect recovery from combat-related TBI. This article presents current evaluation and management of combat-related injury and discusses other psychological conditions that may coexist with TBI.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Brenner, L A; Terrio, H; Homaifar, B Y; Gutierrez, P M; Staves, P J; Harwood, J E F; Reeves, D; Adler, L E; Ivins, B J; Helmick, K; Warden, D
Neuropsychological test performance in soldiers with blast-related mild TBI Journal Article
In: Neuropsychology, vol. 24, pp. 160–167, 2010, ISSN: 0894-4105.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Brenner2010,
title = {Neuropsychological test performance in soldiers with blast-related mild TBI},
author = {Brenner, L A and Terrio, H and Homaifar, B Y and Gutierrez, P M and Staves, P J and Harwood, J E F and Reeves, D and Adler, L E and Ivins, B J and Helmick, K and Warden, D},
doi = {10.1037/a0017966},
issn = {0894-4105},
year = {2010},
date = {2010-01-01},
journal = {Neuropsychology},
volume = {24},
pages = {160--167},
abstract = {This exploratory study was conducted to increase understanding of neuropsychological test performance in those with blast-related mild traumatic brain injury (mTBI). The two variables of interest for their impact oil test performance were presence of mTBI symptoms and history of posttraumatic stress disorder (PTSD). Forty-five soldiers postblast mTBI, 27 with enduring mTBI symptoms and 18 without, completed a series of neuropsychological tests. Seventeen of the 45 met criteria for PTSD. The Paced Auditory Serial Addition Test (Frencham, Fox, \& Mayberry. 2005; Spreen \& Strauss, 1998) was the primary Outcome Measure. Two-sided. 2-sample t tests were used to compare scores between groups of interest. Presence of mTBI symptoms did not impact test performance. In addition, no significant differences between soldiers with and without PTSD were identified. Standard neuropsychological assessment may not increase understanding about impairment associated with mTBI symptoms. Further research in this area is indicated.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Wilk, Joshua E; Thomas, Jeffrey L; McGurk, Dennis M; Riviere, Lyndon A; Castro, Carl A; Hoge, Charles W
Mild traumatic brain injury (concussion) during combat: lack of association of blast mechanism with persistent postconcussive symptoms Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 25, pp. 9–14, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Wilk2010,
title = {Mild traumatic brain injury (concussion) during combat: lack of association of blast mechanism with persistent postconcussive symptoms},
author = {Wilk, Joshua E and Thomas, Jeffrey L and McGurk, Dennis M and Riviere, Lyndon A and Castro, Carl A and Hoge, Charles W},
year = {2010},
date = {2010-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {25},
pages = {9--14},
address = {Division of Psychiatry and Neuroscience, Walter Reed Army Institute of Research, US Army Medical Research and Materiel Command, Silver Spring, Maryland 20910, USA. joshua.wilk@amedd.army.mil},
abstract = {OBJECTIVE: To determine whether screening for a blast mechanism of concussion identifies individuals at higher risk of persistent postconcussive symptoms (PCS). SETTING: United States Army post. PARTICIPANTS: 3952 US Army infantry soldiers were administered anonymous surveys 3 to 6 months after returning from a yearlong deployment to Iraq. MAIN OUTCOME MEASURES: Self-reported concussion (defined as an injury that resulted in being "dazed, confused, or 'seeing stars'"; "not remembering the injury"; or "losing consciousness [knocked out]): Patient Health Questionnaire 15-item scale for physical symptoms and PCS; Posttraumatic Stress Disorder Checklist; and Patient Health Questionnaire depression module. RESULTS: Of the 587 soldiers (14.9% of the total sample) who met criteria for concussion, 201 (34.2%) reported loss of consciousness, and 373 (63.5%) reported only an alteration of consciousness without loss of consciousness; 424 (72.2%) reported a blast mechanism, and 150 (25.6%) reported a nonblast mechanism. Among soldiers who lost consciousness, blast mechanism was significantly associated with headaches and tinnitus 3 to 6 months postdeployment compared with a nonblast mechanism. However, among the larger group of soldiers reporting concussions without loss of consciousness, blast was not associated with adverse health outcomes. CONCLUSIONS: Blast mechanism of concussion was inconsistently associated with PCS, depending on the definition of concussion utilized. A self-reported history of blast mechanism was not associated with persistent PCS for the majority of US soldiers with concussions.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Nyein, Michelle K; Jason, Amanda M; Yu, Li; Pita, Claudio M; Joannopoulos, John D; Moore, David F; Radovitzky, Raul A
In silico investigation of intracranial blast mitigation with relevance to military traumatic brain injury.[Erratum appears in Proc Natl Acad Sci U S A. 2011 Jan 4;108(1):433] Journal Article
In: Proceedings of the National Academy of Sciences of the United States of America, vol. 107, pp. 20703–20708, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Nyein2010,
title = {In silico investigation of intracranial blast mitigation with relevance to military traumatic brain injury.[Erratum appears in Proc Natl Acad Sci U S A. 2011 Jan 4;108(1):433]},
author = {Nyein, Michelle K and Jason, Amanda M and Yu, Li and Pita, Claudio M and Joannopoulos, John D and Moore, David F and Radovitzky, Raul A},
year = {2010},
date = {2010-01-01},
journal = {Proceedings of the National Academy of Sciences of the United States of America},
volume = {107},
pages = {20703--20708},
address = {Department of Aeronautics and Astronautics, Institute for Soldier Nanotechnologies, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.},
abstract = {Blast-induced traumatic brain injury is the most prevalent military injury in Iraq and Afghanistan, yet little is known about the mechanical effects of blasts on the human head, and still less is known about how personal protective equipment affects the brain's response to blasts. In this study we investigated the effect of the Advanced Combat Helmet (ACH) and a conceptual face shield on the propagation of stress waves within the brain tissue following blast events. We used a sophisticated computational framework for simulating coupled fluid-solid dynamic interactions and a three-dimensional biofidelic finite element model of the human head and intracranial contents combined with a detailed model of the ACH and a conceptual face shield. Simulations were conducted in which the unhelmeted head, head with helmet, and head with helmet and face shield were exposed to a frontal blast wave with incident overpressure of 10[NON-BREAKING SPACE]atm. Direct transmission of stress waves into the intracranial cavity was observed in the unprotected head and head with helmet simulations. Compared to the unhelmeted head, the head with helmet experienced slight mitigation of intracranial stresses. This suggests that the existing ACH does not significantly contribute to mitigating blast effects, but does not worsen them either. By contrast, the helmet and face shield combination impeded direct transmission of stress waves to the face, resulting in a delay in the transmission of stresses to the intracranial cavity and lower intracranial stresses. This suggests a possible strategy for mitigating blast waves often associated with military concussion.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Lippa, S M; Pastorek, N J; Benge, J F; Thornton, G M
Postconcussive symptoms after blast and nonblast-related mild traumatic brain injuries in Afghanistan and Iraq war veterans Journal Article
In: Journal of the International Neuropsychological Society, vol. 16, pp. 856–866, 2010, ISSN: 1355-6177.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Lippa2010,
title = {Postconcussive symptoms after blast and nonblast-related mild traumatic brain injuries in Afghanistan and Iraq war veterans},
author = {Lippa, S M and Pastorek, N J and Benge, J F and Thornton, G M},
doi = {10.1017/s1355617710000743},
issn = {1355-6177},
year = {2010},
date = {2010-01-01},
journal = {Journal of the International Neuropsychological Society},
volume = {16},
pages = {856--866},
abstract = {Blast injury is common in current warfare, but little is known about the effects of blast-related mild traumatic brain injury (mTBI). Profile analyses were conducted investigating differences in self-reported postconcussive (PC) symptoms in 339 veteran outpatients with mTBI histories reporting current symptoms based on mechanism of injury (blast only, nonblast only, or both blast and nonblast), number of blast injuries, and distance from the blast. Veterans with any blast-related mTBI history were younger and reported higher posttraumatic stress symptoms than veterans with nonblast-related mTBI histories, with a marginally significant difference in posttraumatic stress symptom report between veterans reporting blast-related mTBI only and those reporting nonblast-related mTBI. The groups did not differ in terms of PC symptom severity or PC symptom cluster profiles. Among veterans with blast-related mTBI histories, PC symptom report did not vary by number of blast-related mTBIs or proximity to blast. Overall, posttraumatic stress symptoms accounted for a substantial portion of variance in PC symptom report. In veteran outpatients with remote mTBI histories who have enduring symptom complaints related to the mTBI, mechanism of injury did not clearly contribute to differential PC symptom severity or PC symptom cluster profile. Proximal rather than distal factors may be important intervention targets in returning symptomatic veterans with mTBI histories. (JINS, 2010, 16, 856-866.)},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Svetlov, Stanislav I; Prima, Victor; Kirk, Daniel R; Gutierrez, Hector; Curley, Kenneth C; Hayes, Ronald L; Wang, Kevin K W
Morphologic and biochemical characterization of brain injury in a model of controlled blast overpressure exposure Journal Article
In: Journal of Trauma, vol. 69, pp. 795–804, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Svetlov2010,
title = {Morphologic and biochemical characterization of brain injury in a model of controlled blast overpressure exposure},
author = {Svetlov, Stanislav I and Prima, Victor and Kirk, Daniel R and Gutierrez, Hector and Curley, Kenneth C and Hayes, Ronald L and Wang, Kevin K W},
year = {2010},
date = {2010-01-01},
journal = {Journal of Trauma},
volume = {69},
pages = {795--804},
address = {Center of Innovative Research, Banyan Biomarkers, Inc, Alachua, Florida 32615, USA. ssvetlov@banyanbio.com},
abstract = {OBJECTIVES: Existing experimental approaches for studies of blast impact in small animals are insufficient and lacking consistency. Here, we present a comprehensive model, with repeatable blast signatures of controlled duration, peak pressure, and transmitted impulse, accurately reproducing blast impact in laboratory animals. MATERIALS: Rat survival, brain pathomorphology, and levels of putative biomarkers of brain injury glial fibrillary acid protein (GFAP), neuron-specific enolase, and ubiquitin C-terminal hydrolase (UCH)-L1 were examined in brain, cerebrospinal fluid (CSF), and blood after 10 msec of 358 kPa peak overpressure blast exposure. RESULTS: The high-speed imaging demonstrated a strong head acceleration/jolting accompanied by typical intracranial hematomas and brain swelling. Microscopic injury was revealed by prominent silver staining in deep brain areas, including the nucleus subthalamicus zone, suggesting both diffused and focal neurodegeneration. GFAP and 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNPase), markers of astroglia and oligodendroglia, accumulated substantially in the hippocampus 24 hours after blast and persisted for 30 days postblast. However, GFAP content in the blood significantly increased 24 hours after injury, followed by a decline and subsequent accumulation in CSF in a time-dependent fashion. A similar profile is shown for UCH-L1 increase in blood, whereas increased CSF levels of UCH-L1 persisted throughout 14 days after blast and varied significantly in individual rats. Neuron-specific enolase levels in blood were significantly elevated within 24 hours and 48 hours postblast. CONCLUSIONS: The proposed model of controlled nonpenetrating blast in rats demonstrates the critical pathologic and biochemical signatures of blast brain injury that may be triggered by cerebrovascular responses, including blood-brain barrier disruption, glia responses, and neuroglial alterations.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Bradley, E; Lockwood, C; Hull, A; Poole, J
Neuropsychological performance in veterans following concussion due to blast versus non-blast injuries Journal Article
In: Archives of Clinical Neuropsychology, vol. 25, pp. 569, 2010, ISSN: 0887-6177.
BibTeX | Tags: Military Military LB - Military
@article{Bradley2010,
title = {Neuropsychological performance in veterans following concussion due to blast versus non-blast injuries},
author = {Bradley, E and Lockwood, C and Hull, A and Poole, J},
issn = {0887-6177},
year = {2010},
date = {2010-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {25},
pages = {569},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Burgess, Paula; Sullivent, Ernest E; Sasser, Scott M; Wald, Marlena M; Ossmann, Eric; Kapil, Vikas
Managing traumatic brain injury secondary to explosions Journal Article
In: Journal of Emergencies, Trauma, and Shock, vol. 3, pp. 164–172, 2010.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Burgess2010,
title = {Managing traumatic brain injury secondary to explosions},
author = {Burgess, Paula and Sullivent, Ernest E and Sasser, Scott M and Wald, Marlena M and Ossmann, Eric and Kapil, Vikas},
doi = {DOI: 10.4103/0974-2700.62120},
year = {2010},
date = {2010-01-01},
journal = {Journal of Emergencies, Trauma, and Shock},
volume = {3},
pages = {164--172},
abstract = {Explosions and bombings are the most common deliberate cause of disasters with large numbers of casualties. Despite this fact, disaster medical response training has traditionally focused on the management of injuries following natural disasters and terrorist attacks with biological, chemical, and nuclear agents. The following article is a clinical primer for physicians regarding traumatic brain injury (TBI) caused by explosions and bombings. The history, physics, and treatment of TBI are outlined.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Lew, H L; Amick, M M; Kraft, M; Stein, M B; Cifu, D X
Potential driving issues in combat returnees Journal Article
In: Neurorehabilitation, vol. 26, pp. 271–278, 2010, ISSN: 1053-8135.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Lew2010a,
title = {Potential driving issues in combat returnees},
author = {Lew, H L and Amick, M M and Kraft, M and Stein, M B and Cifu, D X},
doi = {10.3233/nre-2010-0562},
issn = {1053-8135},
year = {2010},
date = {2010-01-01},
journal = {Neurorehabilitation},
volume = {26},
pages = {271--278},
abstract = {The driving abilities of service members returning from Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) have not been well reported and are an important aspect of their return to normal life. This article reviews the unique risk factors for unsafe driving in this cohort. In particular, the cognitive and psychological symptoms of mild traumatic brain injury and postraumatic stress disorder, two of the most common diagnoses affecting these returning warriors, are specified, and their possible association with impaired driving is examined. The potential negative impact of the "battlemind driving tactics" (i.e., evasive driving skills) acquired by these service members as part of their military tours is also highlighted. The article concludes with comments about the functional consequences of impaired driving in this population, including limits to participation in rehabilitation and community reintegration, as well as recognition of the need for further research in this area.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Brenner, Lisa A; Ivins, Brian J; Schwab, Karen; Warden, Deborah; Nelson, Lonnie A; Jaffee, Michael; Terrio, Heidi
Traumatic brain injury, posttraumatic stress disorder, and postconcussive symptom reporting among troops returning from Iraq Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 25, pp. 307–312, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Brenner2010a,
title = {Traumatic brain injury, posttraumatic stress disorder, and postconcussive symptom reporting among troops returning from Iraq},
author = {Brenner, Lisa A and Ivins, Brian J and Schwab, Karen and Warden, Deborah and Nelson, Lonnie A and Jaffee, Michael and Terrio, Heidi},
year = {2010},
date = {2010-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {25},
pages = {307--312},
address = {VA VISN 19 Mental Illness Research Education and Clinical Center, Denver, Colorado, USA. lisa.brenner@va.gov},
abstract = {OBJECTIVES: Analyze the contribution of mild traumatic brain injury (mTBI) and/or posttraumatic stress disorder (PTSD) to the endorsement of postconcussive (PC) symptoms during Post Deployment Health Assessment. Determine whether a combination of mTBI and PTSD was more strongly associated with symptoms than either condition alone. METHODS: Cross-sectional study design where both the exposure, mTBI and/or PTSD, and the outcomes of interest, PC symptoms, were ascertained after return from deployment. Subjects were injured soldiers (n = 1247) from one Fort Carson Brigade Combat Team (n = 3973). MAIN OUTCOME MEASURES: Positive history of PC symptoms. RESULTS: PTSD and mTBI together were more strongly associated with having PC symptoms (adjusted prevalence ratio 6.27; 95% CI: 4.13-9.43) than either mTBI alone (adjusted prevalence ratio = 4.03; 95% CI: 2.67-6.07) or PTSD alone (adjusted prevalence ratio = 2.74; 95% CI: 1.58-4.74) after adjusting for age, gender, education, rank, and Military Occupational Specialty. CONCLUSIONS: In soldiers with histories of physical injury, mTBI and PTSD were independently associated with PC symptom reporting. Those with both conditions were at greater risk for PC symptoms than those with either PTSD, mTBI, or neither. Findings support the importance of continued screening for both conditions with the aim of early identification and intervention.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Coldren, Rodney L; Kelly, Mark P; Parish, Robert V; Dretsch, Michael; Russell, Michael L
Evaluation of the Military Acute Concussion Evaluation for use in combat operations more than 12 hours after injury Journal Article
In: Military Medicine, vol. 175, pp. 477–481, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Coldren2010,
title = {Evaluation of the Military Acute Concussion Evaluation for use in combat operations more than 12 hours after injury},
author = {Coldren, Rodney L and Kelly, Mark P and Parish, Robert V and Dretsch, Michael and Russell, Michael L},
year = {2010},
date = {2010-01-01},
journal = {Military Medicine},
volume = {175},
pages = {477--481},
address = {Uniformed Services University of the Health Sciences, Department of Preventive Medicine and Biometrics, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.},
abstract = {The diagnosis and management of concussion can be difficult in a combat environment, especially in the absence of loss of consciousness or post-traumatic amnesia. As no validated test exists to diagnose or grade neurocognitive impairment from a concussion, the military currently employs the Military Acute Concussion Evaluation (MACE) in Iraq. This is a two-part test, which incorporates the standardized assessment of concussion (SAC) as its objective score, although it has not been shown to be valid unless administered shortly after injury. A research team deployed to Iraq between January and April 2009 to examine the validity of several tests of neurocognitive function following a concussion, including the MACE. When administered more than 12 hours after the concussive injury, the MACE lacked sufficient sensitivity and specificity to be clinically useful.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Caldroney, Ralph D; Radike, James
Experience with mild traumatic brain injuries and postconcussion syndrome at Kandahar, Afghanistan Journal Article
In: US Army Medical Department Journal, pp. 22–30, 2010.
BibTeX | Tags: Military Military LB - Military
@article{Caldroney2010,
title = {Experience with mild traumatic brain injuries and postconcussion syndrome at Kandahar, Afghanistan},
author = {Caldroney, Ralph D and Radike, James},
year = {2010},
date = {2010-01-01},
journal = {US Army Medical Department Journal},
pages = {22--30},
address = {135th Expeditionary Sustainment Command, Kandahar Air Field, Afghanistan.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Kozminski, Matthew
Combat-related posttraumatic headache: diagnosis, mechanisms of injury, and challenges to treatment Journal Article
In: Journal of the American Osteopathic Association, vol. 110, pp. 514–519, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Kozminski2010,
title = {Combat-related posttraumatic headache: diagnosis, mechanisms of injury, and challenges to treatment},
author = {Kozminski, Matthew},
year = {2010},
date = {2010-01-01},
journal = {Journal of the American Osteopathic Association},
volume = {110},
pages = {514--519},
address = {Neurology Clinic, Darnall Army Medical Center, 36000 Darnall Loop, Fort Hood, TX 76544, USA. mpkst17@yahoo.com},
abstract = {CONTEXT: Studies have revealed the rates of posttraumatic stress disorder (PTSD) and concussion among US soldiers returning from combat, but only one study has focused on the subpopulation of soldiers with headache. OBJECTIVES: To determine the rate of PTSD among US soldiers with comorbid chronic posttraumatic headache attributed to head injury, to identify common mechanisms of head injury, and to identify the common challenges a healthcare provider must face when treating US soldiers with chronic posttraumatic headache attributed to head injury. METHODS: Between July 2007 and December 2008, the author examined 42 US Army soldiers with complaint of chronic headache. In March 2009, the author retrospectively reviewed the outpatient records for diagnoses, mechanisms of injury, and challenges to treatment. RESULTS: The rate of concussion, defined by the Defense and Veterans Brain Injury Center Working Group on the Acute Management of Mild Traumatic Brain Injury in Military Operational Settings, was 95%. The rate of PTSD, as determined either with the PTSD Checklist or by confirming a prior diagnosis by another healthcare provider, was 97.9%. Both rates are remarkably higher than rates reported in the literature. The most common mechanisms of injury were proximity to blast (18 [45.2%]) and direct target of blast (15 [35.7%]). The most common treatment challenges were overuse of headache-abortive medications (10 [23.8%]) and poor patient followup (7 [16.7%]). CONCLUSION: Physicians should be aware that the rates of PTSD and concussion for US soldiers, most often linked to involvement in or proximity to a blast, are higher for soldiers complaining of chronic headache. Physicians should also be aware of the potential for overuse of medications in this patient population.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Rosenfeld, Jeffrey V; Ford, Nick L
Bomb blast, mild traumatic brain injury and psychiatric morbidity: a review Journal Article
In: Injury, vol. 41, pp. 437–443, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Rosenfeld2010,
title = {Bomb blast, mild traumatic brain injury and psychiatric morbidity: a review},
author = {Rosenfeld, Jeffrey V and Ford, Nick L},
year = {2010},
date = {2010-01-01},
journal = {Injury},
volume = {41},
pages = {437--443},
address = {Department of Surgery, Monash University, Australia. j.rosenfeld@alfred.org.au},
abstract = {Traumatic brain injury (TBI) arising from blast exposure during war is common, and frequently complicated by psychiatric morbidity. There is controversy as to whether mild TBI from blast is different from other causes of mild TBI. Anxiety and affective disorders such as Post-traumatic Stress Disorder (PTSD) and depression are common accompaniments of blast injury with a significant overlap in the diagnostic features of PTSD with post-concussive syndrome (PCS). This review focuses on this overlap and the effects of mild TBI due to bomb blast. Mild TBI may have been over diagnosed by late retrospective review of returned servicemen and women using imprecise criteria. There is therefore a requirement for clear and careful documentation by health professionals of a TBI due to bomb blast shortly after the event so that the diagnosis of TBI can be made with confidence. There is a need for the early recognition of symptoms of PCS, PTSD and depression and early multi-disciplinary interventions focussed on expected return to duties. There also needs to be a continued emphasis on the de-stigmatization of psychological conditions in military personnel returning from deployment.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Hettich, Thomas; Whitfield, Ethan; Kratz, Kris; Frament, Colin
Case report: use of the Immediate Post Concussion Assessment and Cognitive Testing (ImPACT) to assist with return to duty determination of special operations soldiers who sustained mild traumatic brain injury Journal Article
In: Journal of Special Operations Medicine, vol. 10, pp. 48–55, 2010.
BibTeX | Tags: Military Military LB - Military
@article{Hettich2010,
title = {Case report: use of the Immediate Post Concussion Assessment and Cognitive Testing (ImPACT) to assist with return to duty determination of special operations soldiers who sustained mild traumatic brain injury},
author = {Hettich, Thomas and Whitfield, Ethan and Kratz, Kris and Frament, Colin},
year = {2010},
date = {2010-01-01},
journal = {Journal of Special Operations Medicine},
volume = {10},
pages = {48--55},
address = {Usasoc, usa.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Theeler, Brett J; Flynn, Frederick G; Erickson, Jay C
Headaches after concussion in US soldiers returning from Iraq or Afghanistan Journal Article
In: Headache, vol. 50, pp. 1262–1272, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Theeler2010,
title = {Headaches after concussion in US soldiers returning from Iraq or Afghanistan},
author = {Theeler, Brett J and Flynn, Frederick G and Erickson, Jay C},
year = {2010},
date = {2010-01-01},
journal = {Headache},
volume = {50},
pages = {1262--1272},
address = {William Beaumont Army Medical Center, Department of Medicine, Neurology Service, Medical Corps, United States Army, Fort Bliss, TX 79920-5001, USA.},
abstract = {OBJECTIVES: To determine the prevalence, characteristics, impact, and treatment patterns of headaches after concussion in US Army soldiers returning from a deployment to Iraq or Afghanistan. METHODS: A cross-sectional study was conducted with a cohort of soldiers undergoing postdeployment evaluation during a 5-month period at the Madigan Traumatic Brain Injury Program at Ft. Lewis, WA. All soldiers screening positive for a deployment-related concussion were given a 13-item headache questionnaire. RESULTS: A total of 1033 (19.6%) of 5270 returning soldiers met criteria for a deployment-related concussion. Among those with a concussion, 957 (97.8%) reported having headaches during the final 3 months of deployment. Posttraumatic headaches, defined as headaches beginning within 1 week after a concussion, were present in 361 (37%) soldiers. In total, 58% of posttraumatic headaches were classified as migraine. Posttraumatic headaches had a higher attack frequency than nontraumatic headaches, averaging 10 days per month. Chronic daily headache was present in 27% of soldiers with posttraumatic headache compared with 14% of soldiers with nontraumatic headache. Posttraumatic headaches interfered with duty performance in 37% of cases and caused more sick call visits compared with nontraumatic headache. In total, 78% of soldiers with posttraumatic headache used abortive medications, predominantly over-the-counter analgesics, and most perceived medication as effective. CONCLUSIONS: More than 1 in 3 returning military troops who have sustained a deployment-related concussion have headaches that meet criteria for posttraumatic headache. Migraine is the predominant headache phenotype precipitated by a concussion during military deployment. Compared with headaches not directly attributable to head trauma, posttraumatic headaches are associated with a higher frequency of headache attacks and an increased prevalence of chronic daily headache.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Nelson, Nathaniel W; Hoelzle, James B; McGuire, Kathryn A; Ferrier-Auerbach, Amanda G; Charlesworth, Molly J; Sponheim, Scott R
Evaluation context impacts neuropsychological performance of OEF/OIF veterans with reported combat-related concussion Journal Article
In: Archives of Clinical Neuropsychology, vol. 25, pp. 713–723, 2010.
Abstract | BibTeX | Tags: Military Military LB - Military
@article{Nelson2010,
title = {Evaluation context impacts neuropsychological performance of OEF/OIF veterans with reported combat-related concussion},
author = {Nelson, Nathaniel W and Hoelzle, James B and McGuire, Kathryn A and Ferrier-Auerbach, Amanda G and Charlesworth, Molly J and Sponheim, Scott R},
year = {2010},
date = {2010-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {25},
pages = {713--723},
address = {Minneapolis VA Medical Center, MN, USA. nels5363@umn.edu},
abstract = {Although soldiers of Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) encounter combat-related concussion at an unprecedented rate, relatively few studies have examined how evaluation context, insufficient effort, and concussion history impact neuropsychological performances in the years following injury. The current study explores these issues in a sample of 119 U.S. veterans (OEF/OIF forensic concussion},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Lew, H L; Weihing, J; Myers, P J; Pogoda, T K; Goodrich, G L
Dual sensory impairment (DSI) in traumatic brain injury (TBI) - An emerging interdisciplinary challenge Journal Article
In: Neurorehabilitation, vol. 26, pp. 213–222, 2010, ISSN: 1053-8135.
Abstract | Links | BibTeX | Tags: Military Military LB - Military
@article{Lew2010,
title = {Dual sensory impairment (DSI) in traumatic brain injury (TBI) - An emerging interdisciplinary challenge},
author = {Lew, H L and Weihing, J and Myers, P J and Pogoda, T K and Goodrich, G L},
doi = {10.3233/nre-2010-0557},
issn = {1053-8135},
year = {2010},
date = {2010-01-01},
journal = {Neurorehabilitation},
volume = {26},
pages = {213--222},
abstract = {The present review characterizes dual sensory impairment (DSI) as co-existing auditory and visual deficits in TBI that can be peripherally or centrally based. Current research investigating DSI in the military population, along with applicable research which focuses on unimodal deficits, is considered. Due to the heterogenous nature of TBI lesions, an important challenge that the clinician faces is ruling out the influence of multiple sensory deficits and/or the influence of cognitive processes on diagnosis and rehabilitation of the patient. Treatment options for DSI involve remediation of the sensory deficits via existing sensory aids or training exercises.},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}
Felber, Eric S
Combat-related posttraumatic headache: diagnosis, mechanisms of injury, and challenges to treatment Journal Article
In: Journal of the American Osteopathic Association, vol. 110, pp. 737–738, 2010.
BibTeX | Tags: Military Military LB - Military
@article{Felber2010,
title = {Combat-related posttraumatic headache: diagnosis, mechanisms of injury, and challenges to treatment},
author = {Felber, Eric S},
year = {2010},
date = {2010-01-01},
journal = {Journal of the American Osteopathic Association},
volume = {110},
pages = {737--738},
keywords = {Military Military LB - Military},
pubstate = {published},
tppubtype = {article}
}