Factors Influencing Cognitive Functioning Following Mild Traumatic Brain Injury in OIF/OEF Burn Patients
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
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To examine the relationship between mild traumatic brain injury mTBI, psychiatric conditions, pain medications, and injury severity on cognitive functioning in service members admitted to a burn unit. We hypothesize that psychiatric co-morbidity and pain medications will have a stronger relationship with cognitive dysfunction than mTBI diagnosis in this population. Method Retrospective review of clinical evaluations n 194 completed between September 2005 October 2007 on service members with burn injuries secondary to explosive munitions. Evaluations were completed during the acute stage of recovery mean 7.87 weeks. mTBI diagnosis n 50 was made through a clinical interview using ACRM criteria 1. Exclusion criteria included duration of posttraumatic amnesia greater than 24 hours n 10 and inability to complete neurocognitive measures due to severe bimanual burns andor amputations n 17. Cognitive functioning was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status RBANS. Results Subjects who sustained mTBI demonstrated significantly greater difficulty on the RBANS visuospatial and attentionprocessing speed indices. A hierarchical linear regression, using mTBI diagnosis, psychiatric diagnosis, time since injury, presence of pain medications, and measures of trauma severity as predictive factors, found that mTBI diagnosis had a significant, but small unique effect on cognitive functioning. Contrary to our hypothesis, psychiatric co-morbidity was not shown to have a significant effect on this population of acutely injured service members.
- Anatomy and Physiology
- Medicine and Medical Research
- Weapons Effects (Biological)
- Military Forces and Organizations