Top

Published in:

01-12-2014 | Review

Blast-Related Mild Traumatic Brain Injury: A Bayesian Random-Effects Meta-Analysis on the Cognitive Outcomes of Concussion among Military Personnel

Authors: Justin E. Karr, Corson N. Areshenkoff, Emily C. Duggan, Mauricio A. Garcia-Barrera

Published in: Neuropsychology Review | Issue 4/2014

Abstract

Throughout their careers, many soldiers experience repeated blasts exposures from improvised explosive devices, which often involve head injury. Consequentially, blast-related mild Traumatic Brain Injury (mTBI) has become prevalent in modern conflicts, often occuring co-morbidly with psychiatric illness (e.g., post-traumatic stress disorder [PTSD]). In turn, a growing body of research has begun to explore the cognitive and psychiatric sequelae of blast-related mTBI. The current meta-analysis aimed to evaluate the chronic effects of blast-related mTBI on cognitive performance. A systematic review identified 9 studies reporting 12 samples meeting eligibility criteria. A Bayesian random-effects meta-analysis was conducted with cognitive construct and PTSD symptoms explored as moderators. The overall posterior mean effect size and Highest Density Interval (HDI) came to d = −0.12 [−0.21, −0.04], with executive function (−0.16 [−0.31, 0.00]), verbal delayed memory (−0.19 [−0.44, 0.06]) and processing speed (−0.11 [−0.26, 0.01]) presenting as the most sensitive cognitive domains to blast-related mTBI. When dividing executive function into diverse sub-constructs (i.e., working memory, inhibition, set-shifting), set-shifting presented the largest effect size (−0.33 [−0.55, −0.05]). PTSD symptoms did not predict cognitive effects sizes, β _PTSD = −0.02 [−0.23, 0.20]. The results indicate a subtle, but chronic cognitive impairment following mTBI, especially in set-shifting, a relevant aspect of executive attention. These findings are consistent with past meta-analyses on multiple mTBI and correspond with past neuroimaging research on the cognitive correlates of white matter damage common in mTBI. However, all studies had cross-sectional designs, which resulted in universally low quality ratings and limited the conclusions inferable from this meta-analysis.

Available only for authorised users

*Amick, M.M., Clark, A., Fortier, C.B., Esterman, M., Rasmusson, A.M., Kenna, A., & McGlinchey, R. (2013). PTSD modifies performance on a task of affective executive control among deployed OEF/OIF veterans with mild traumatic brain injury. Journal of the International Neuropsychological Society, 19(7), 792–801. doi:10.1017/S1355617713000544.

Baker, A. J., Topolovec-Vranic, J., Michalak, A., Pollmann-Mudryj, M. A., Ouchterlony, D., Cheung, B., & Tien, H. C. (2011). Controlled blast exposure during forced explosive entry training and mild traumatic brain injury. Journal of Trauma and Acute Care Surgery, 71(5), S472–S477. doi:10.1097/TA.0b013e318232e7da.

Barth, J. T., Isler, W. C., Helmick, K. M., Wingler, I. M., & Jaffee, M. S. (2010). Acute battlefield assessment of concussion/mild TBI and return-to-duty evaluations. In C. H. Kennedy & J. L. Moore (Eds.), Military neuropsychology (pp. 29–55). New York: Springer Publishing Co.

Bauman, R. A., Ling, G., Tong, L., Januszkiewicz, A., Agoston, D., Delanerolle, N., & Parks, S. (2009). An introductory characterization of a combat-casualty-care relevant swine model of closed head injury resulting from exposure to explosive blast. Journal of Neurotrauma, 26(6), 841–860. doi:10.1089/neu. 2009.0898.PubMed

Bazarian, J., Donnelly, K., Peterson, D., Warner, G., Zhu, T., & Zhong, J. (2013). The relation between posttraumatic stress disorder and mild traumatic brain injury acquired during Operations Enduring Freedom and Iraqi Freedom. The Journal of Head Trauma Rehabilitation, 28(1), 1–12. doi:10.1097/HTR.0b013e318256d3d3.PubMed

Belanger, H. G., Kretzmer, T., Yoash-Gantz, R., Pickett, T., & Tupler, L. A. (2009). Cognitive sequelae of blast-related versus other mechanisms of brain trauma. Journal of the International Neuropsychological Society, 15(1), 1–8. doi:10.1017/S1355617708090036.PubMed

Belanger, H. G., Spiegel, E., & Vanderploeg, R. (2010). Neuropsychological performance following a history of multiple self-reported concussions: A meta-analysis. Journal of the International Neuropsychological Society, 16(2), 262–267. doi:10.1017/S1355617709991287.PubMed

Belanger, H. G., Proctor-Weber, Z., Kretzmer, T., Kim, M., French, L. M., & Vanderploeg, R. D. (2011). Symptom complaints following reports of blast versus non-blast mild TBI: Does mechanism of injury matter? The Clinical Neuropsychologist, 25(5), 702–715. doi:10.1080/13854046.2011.566892.PubMed

Belanger, H. G., Curtiss, G., Demery, J. A., Lebowitz, B. K., & Vanderploeg, R. D. (2005). Factors moderating neuropsychological outcomes following mild traumatic brain injury: A meta-analysis. Journal of the International Neuropsychological Society, 11(3), 215–227. doi:10.1017/S1355617705050277..PubMed

Belanger, H. G., & Vanderploeg, R. D. (2005). The neuropsychological impact of sports-related concussion: A meta-analysis. Journal of the International Neuropsychological Society, 11(4), 345–357.PubMed

Belanger, H., Vanderploeg, R., Curtiss, G., & Warden, D. (2007). Recent neuroimaging techniques in mild traumatic brain injury. The Journal of Neuropsychiatry and Clinical Neurosciences, 19(1), 5–20.PubMed

Benzinger, T. L., Brody, D., Cardin, S., Curley, K. C., Mintun, M. A., Mun, S. K., & Wrathall, J. R. (2009). Blast-related brain injury: Imaging for clinical and research applications: Report of the 2008 St. Louis workshop. Journal of Neurotrauma, 26(12), 2127–2144. doi:10.1089/neu.2009.0885.PubMedCentralPubMed

Binder, L. M., Rohling, M. L., & Larrabee, G. J. (1997). A review of mild head trauma: I. Meta-analytic review of neuropsychological studies. Journal of Clinical and Experimental Neuropsychology, 19(3), 421–431. doi:10.1080/01688639708403870.PubMed

Blake, D. D., Weathers, F. W., Nagy, L. M., Kaloupek, D. G., Gusman, F. D., Charney, D. S., & Keane, T. M. (1995). The development of a clinician-administered PTSD scale. Journal of Traumatic Stress, 8, 75–90. doi:10.1002/jts.2490080106.PubMed

Bogdanova, Y., & Verfaellie, M. (2012). Cognitive sequelae of blast-induced traumatic brain injury: Recovery and rehabilitation. Neuropsychology Review, 22(1), 4–20. doi:10.1007/s11065-012-9192-3.PubMed

Bryan, C., & Hernandez, A. M. (2012). Magnitudes of decline on automated neuropsychological assessment metrics subtest scores relative to predeployment baseline performance among service members evaluated for traumatic brain injury in Iraq. The Journal of Head Trauma Rehabilitation, 27(1), 45–54. doi:10.1097/HTR.0b013e318238f146.PubMed

Bryant, R. (2011). Post-traumatic stress disorder vs traumatic brain injury. Dialogues in Clinical Neuroscience, 13(3), 251–262.PubMedCentralPubMed

Cabeza, R., & Nyberg, L. (2000). Imaging cognition II: An empirical review of 275 PET and fMRI studies. Journal of Cognitive Neuroscience, 12(1), 1–47. doi:10.1162/08989290051137585.PubMed

Carlson, K. F., Kehle, S. M., Meis, L. A., Greer, N., MacDonald, R., Rutks, I., & Wilt, T. J. (2011). Prevalence, assessment, and treatment of mild traumatic brain injury and posttraumatic stress disorder: A systematic review of the evidence. The Journal of Head Trauma Rehabilitation, 26(2), 103–115.PubMed

Cernak, I., & Noble-Haeusslein, L. J. (2010). Traumatic brain injury: An overview of pathobiology with emphasis on military populations. Journal of Cerebral Blood Flow & Metabolism, 30(2), 255–266. doi:10.1038/jcbfm.2009.203.

Chapman, J. C., & Diaz-Arrastia, R. (2014). Military traumatic brain injury: A review. Alzheimer’s & Dementia, 10(3), S97–S104. doi:10.1016/j.jalz.2014.04.012.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: Lawrence Erlbaum Associates.

Comper, P., Hutchison, M., Magrys, S., Mainwaring, L., & Richards, D. (2010). Evaluating the methodological quality of sports neuropsychology concussion research: A systematic review. Brain Injury, 24(11), 1257–1271. doi:10.3109/02699052.2010.506854.

Cooper, D. B., Chau, P. M., Armistead-Jehle, P., Vanderploeg, R. D., & Bowles, A. O. (2012). Relationship between mechanism of injury and neurocognitive functioning in OEF/OIF service members with mild traumatic brain injuries. Military Medicine, 177(10), 1157–1160. doi:10.7205/MILMED-D-12-00098.PubMed

Dobie, D. J., Kivlahan, D. R., Maynard, C., Bush, K. R., McFall, M. E., Epler, A. J., & Bradley, K. A. (2002). Screening for posttraumatic stress disorder in female Veteran’s Affairs patients: Validation of the PTSD Checklist. General Hospital Psychiatry, 24, 367–374.PubMed

Dolan, S., Martindale, S., Robinson, J., Kimbrel, N. A., Meyer, E. C., Kruse, M. I., & Gulliver, S. B. (2012). Neuropsychological sequelae of PTSD and TBI following war deployment among OEF/OIF veterans. Neuropsychology Review, 22(1), 21–34. doi:10.1007/s11065-012-9190-5.PubMed

Dougan, B. K., Horswill, M. S., & Geffen, G. M. (2013). Athletes’ age, sex, and years of education moderate the acute neuropsychological impact of sports-related concussion: A meta-analysis. Journal of the International Neuropsychological Society, 19, 1–17.

Eierud, C., Craddock, R. C., Fletcher, S., Aulakh, M., King-Casas, B., Kuehl, D., & LaConte, S. M. (2014). Neuroimaging after mild traumatic brain injury: Review and meta-analysis. NeuroImage: Clinical, 4, 283–294. doi:10.1016/j.nicl.2013.12.009.

Fortier, C. B., Amick, M. M., Grande, L., McGlynn, S., Kenna, A., Morra, L., & McGlinchey, R. E. (2014). The Boston assessment of traumatic brain injury–lifetime (BAT-L) semistructured interview: Evidence of research utility and validity. The Journal of Head Trauma Rehabilitation, 29(1), 89–98. doi:10.1097/HTR.0b013e3182865859.PubMed

French, L. M., Iverson, G. L., Lange, R. T., & Bryant, R. A. (2011). Neuropsychological consequences of injury in military personnel. In S. S. Bush & G. L. Iverson (Eds.), Neuropsychological assessment of work-related injuries (pp. 127–160). New York: The Guilford Press.

Frencham, K. A., Fox, A. M., & Maybery, M. (2005). Neuropsychological studies of mild traumatic brain injury: A meta-analytic review of research since 1995. Journal of Clinical and Experimental Neuropsychology, 27(3), 334–351.PubMed

Gavett, B. E., Stern, R. A., & McKee, A. C. (2011). Chronic traumatic encephalopathy: A potential late effect of sport-related concussive and subconcussive head trauma. Clinics in Sports Medicine, 30, 179–188. doi:10.1016/j.csm.2010.09.007.PubMedCentralPubMed

Gelman, A. (2006). Prior distributions for variance parameters in hierarchical models. Bayesian Analysis, 1(3), 515–534.

Goldstein, L., Fisher, A., Tagge, C., Zhang, X., Velisek, L., Sullivan, J., & McKee, A. (2012). Chronic traumatic encephalopathy in blast-exposed military veterans and a blast neurotrauma mouse model. Science Translational Medicine, 4(134), 134ra60. doi:10.1126/scitranslmed.3003716.PubMedCentralPubMed

Gondusky, J. S., & Reiter, M. P. (2005). Protecting military convoys in Iraq: An examination of battle injuries sustained by a mechanized battalion during Operation Iraqi Freedom II. Military Medicine, 170(6), 546–549.PubMed

Greiffenstein, M. F. (2010). Noncredible neuropsychological presentation in service members and veterans. In C. H. Kennedy & J. L. Moore (Eds.), Military neuropsychology (pp. 81–100). New York: Springer Publishing Co.

Greiffenstein, M. F., & Baker, W. J. (2008). Validity testing in dually diagnosed post-traumatic stress disorder and mild closed head injury. The Clinical Neuropsychologist, 22(3), 565–582.PubMed

Gunning-Dixon, F. M., & Raz, N. (2000). The cognitive correlates of white matter abnormalities in normal aging: A quantitative review. Neuropsychology, 14(2), 224–232. doi:10.1037/0894-4105.14.2.224.PubMed

Guskiewicz, K., Marshall, S., Bailes, J., McCrea, M., Cantu, R., Randolph, C., & Jordan, B. (2005). Association between recurrent concussion and late-life cognitive impairment in retired professional football players. Neurosurgery, 57, 719–726. doi:10.1227/01.NEU.0000175725.75780.DD.PubMed

Halterman, C. I., Langan, J., Drew, A., Rodriguez, E., Osternig, L. R., Chou, L. S., & Van Donkelaar, P. (2006). Tracking the recovery of visuospatial attention deficits in mild traumatic brain injury. Brain, 129(3), 747–753.PubMed

Hayes, J., Morey, R., & Tupler, L. (2012). A case of frontal neuropsychological and neuroimaging signs following multiple primary-blast exposure. Neurocase, 18(3), 258–269. doi:10.1080/13554794.2011.588181.PubMedCentralPubMed

Hayward, P. (2008). Traumatic brain injury: The signature of modern conflicts. The Lancet Neurology, 7, 200–201. doi:10.1016/S1474-4422(08)70032-2.PubMed

Hoge, C. W., McGurk, D., Thomas, J. L., Cox, A. L., Engel, C. C., & Castro, C. A. (2008). Mild traumatic brain injury in US soldiers returning from Iraq. New England Journal of Medicine, 358(5), 453–463. doi:10.1056/NEJMoa072972.PubMed

Hurley, R. A., McGowan, J. C., Arfanakis, K., & Taber, K. H. (2004). Traumatic axonal injury: Novel insights into evolution and identification. The Journal of Neuropsychiatry and Clinical Neurosciences, 16(1), 1–7. doi:10.1176/appi.neuropsych.16.1.1.PubMed

Jorge, R., Acion, L., White, T., Tordesillas-Gutierrez, D., Pierson, R., Crespo-Facorro, B., & Magnotta, V. (2012). White matter abnormalities in veterans with mild traumatic brain injury. The American Journal of Psychiatry, 169(12), 1284–1291. doi:10.1176/appi.ajp.2012.12050600.PubMedCentralPubMed

Karantzoulis, S., & Randolph, C. (2013). Modern chronic traumatic encephalopathy in retired athletes: What is the evidence? Neuropsychology Review, 23(4), 350–360. doi:10.1007/s11065-013-9243-4.PubMed

Karr, J. E., Areshenkoff, C. N., & Garcia-Barrera, M. A. (2014a). The neuropsychological outcomes of concussion: A systematic review of meta-analyses on the cognitive sequelae of mild traumatic brain injury. Neuropsychology, 28(3), 321–336. doi:10.1037/neu0000037.PubMed

Karr, J. E., Garcia-Barrera, M. A., & Areshenkoff, C. N. (2014b). Executive functions and intra-individual variability following concussion. Journal of Clinical and Experimental Neuropsychology, 36(1), 15–31. doi:10.1080/13803395.2013.863833.PubMed

Kelly, M. P., Coldren, R. L., Parish, R. V., Dretsch, M. N., & Russell, M. L. (2012). Assessment of acute concussion in the combat environment. Archives of Clinical Neuropsychology, 27(4), 375–388. doi:10.1093/arclin/acs036.PubMed

Khachaturian, A. S., & Khachaturian, Z. S. (2014). Military risk factors for Alzheimer’s dementia and neurodegenerative disease. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 10(3), S90–S91. doi:10.1016/j.jalz.2014.05.1085.

Kocsis, J. D., & Tessler, A. (2009). Pathology of blast-related brain injury. Journal of Rehabilitation Research and Development, 46(6), 667–672. doi:10.1682/JRRD.2008.08.0100.PubMed

Koliatsos, V. E., Cernak, I., Xu, L., Song, Y., Savonenko, A., Crain, B. J., & Lee, D. (2011). A mouse model of blast injury to brain: Initial pathological, neuropathological, and behavioral characterization. Journal of Neuropathology & Experimental Neurology, 70(5), 399–416. doi:10.1097/NEN.0b013e3182189f06.

*Kontos, A.P., Kotwal, R.S., Elbin, R.J., Lutz, R.H., Forsten, R.D., Benson, P.J., & Guskiewicz, K.M. (2013). Residual effects of combat-related mild traumatic brain injury. Journal of Neurotrauma, 30(8), 680–686. doi:10.1089/neu.2012.2506.

Lange, R. T., Pancholi, S., Brickell, T. A., Sakura, S., Bhagwat, A., Merritt, V., & French, L. M. (2012). Neuropsychological outcome from blast versus non-blast: Mild traumatic brain injury in U.S. military service members. Journal of the International Neuropsychological Society, 18(3), 595–605. doi:10.1017/S1355617712000239.PubMed

Lee, R. R., & Huang, M. (2014). Magnetoencephalography in the diagnosis of concussion. Progress in Neurological Surgery, 28, 94–111. doi:10.1159/000358768.PubMed

Lehman, E. J., Hein, M., Baron, S., & Gersic, C. (2012). Neurodegenerative causes of death among retired national football league players. Neurology, 79, 1970–1974. doi:10.1212/WNL.0b013e31826daf50.PubMedCentralPubMed

Leung, L. Y., VandeVord, P. J., Dal Cengio, A. L., Bir, C., Yang, K. H., & King, A. I. (2008). Blast related neurotrauma: A review of cellular injury. Molecular & Cellular Biomechanics, 5(3), 155–168.

Levin, H., Wilde, E., Troyanskaya, M., Petersen, N., Scheibel, R., Newsome, M., & Li, X. (2010). Diffusion tensor imaging of mild to moderate blast-related traumatic brain injury and its sequelae. Journal of Neurotrauma, 27(4), 683–694. doi:10.1089/neu.2009.1073.PubMed

Lew, H., Thomander, D., Chew, K., & Bleiberg, J. (2007). Review of sports-related concussion: Potential for application in military settings. Journal of Rehabilitation Research and Development, 44(7), 963–973. doi:10.1682/JRRD.2006.12.0169.PubMed

Lew, H. L., Vanderploeg, R. D., Moore, D. F., Schwab, K., Friedman, L., Yesavage, J., & Sigford, B. J. (2008). Overlap of mild TBI and mental health conditions in returning OIF/OEF service members and veterans. Journal of Rehabilitation Research and Development, 45(3), xi–xvi. doi:10.1682/JRRD.2008.05.0064.PubMed

Lippa, S. M., Pastorek, N. J., Benge, J. F., & Thornton, G. (2010). Postconcussive symptoms after blast and nonblast-related mild traumatic brain injuries in Afghanistan and Iraq war veterans. Journal of the International Neuropsychological Society, 16(5), 856–866. doi:10.1017/S1355617710000743.PubMed

Lipton, M., Gulko, E., Zimmerman, M., Friedman, B., Kim, M., Gellella, E., & Branch, C. (2009). Diffusion-tensor imaging implicates prefrontal axonal injury in executive function impairment following very mild traumatic brain injury. Radiology, 252(3), 816–824. doi:10.1148/radiol.2523081584.PubMed

Luethcke, C. A., Bryan, C. J., Morrow, C. E., & Isler, W. C. (2011). Comparison of concussive symptoms, cognitive performance, and psychological symptoms between acute blast-versus nonblast-induced mild traumatic brain injury. Journal of the International Neuropsychological Society, 17(1), 36–45. doi:10.1017/S1355617710001207.PubMed

Mac Donald, C., Johnson, A., Cooper, D., Malone, T., Sorrell, J., Shimony, J., & Brody, D. (2013). Cerebellar white matter abnormalities following primary blast injury in US military personnel. PLoS ONE, 8(2), e55823. doi:10.1371/journal.pone.0055823.PubMedCentralPubMed

Mac Donald, C., Johnson, A., Cooper, D., Nelson, E., Werner, N., Shimony, J., & Brody, D. (2011). Detection of blast-related traumatic brain injury in U.S. military personnel. The New England Journal of Medicine, 364(22), 2091–2100. doi:10.1056/NEJMoa1008069.PubMedCentralPubMed

MacGregor, A., Dougherty, A., & Galarneau, M. (2011). Injury-specific correlates of combat-related traumatic brain injury in Operation Iraqi Freedom. The Journal of Head Trauma Rehabilitation, 26(4), 312–318. doi:10.1097/HTR.0b013e3181e94404.PubMed

Matthews, S. C., Spadoni, A. D., Lohr, J. B., Strigo, I. A., & Simmons, A. N. (2012). Diffusion tensor imaging evidence of white matter disruption associated with loss versus alteration of consciousness in warfighters exposed to combat in Operations Enduring and Iraqi Freedom. Psychiatry Research: Neuroimaging, 204(2–3), 149–154. doi:10.1016/j.pscychresns.2012.04.018.PubMed

Matthews, S. C., Strigo, I. A., Simmons, A. N., O’Connell, R. M., Reinhardt, L. E., & Moseley, S. A. (2011). A multimodal imaging study in U.S. veterans of Operations Iraqi and Enduring Freedom with and without major depression after blast-related concussion. NeuroImage, 54(Suppl 1), S69–S75. doi:10.1016/j.neuroimage.2010.04.269.PubMed

Mayer, A. R., Mannell, M. V., Ling, J., Gasparovic, C., & Yeo, R. A. (2011). Functional connectivity in mild traumatic brain injury. Human Brain Mapping, 32(11), 1825–1835. doi:10.1002/hbm.21151.PubMedCentralPubMed

McCrory, P., Meeuwisse, W. H., Aubry, M., Cantu, B., Dvořák, J., Echemendia, R. J., & Turner, M. (2013). Consensus statement on concussion in sport: The 4th international conference on concussion in sport held in Zurich, November 2012. British Journal of Sports Medicine, 47(5), 250–258. doi:10.1136/bjsports-2013-092313.PubMed

McKee, A. C., Cantu, R., Nowinski, C., Hedley-Whyte, E., Gavett, B., Budson, A., & Stern, R. (2009). Chronic traumatic encephalopathy in athletes: Progressive tauopathy after repetitive head injury. Journal of Neuropathology and Experimental Neurology, 68, 709–735. doi:10.1097/NEN.0b013e3181a9d503.PubMedCentralPubMed

McKee, A. C., Stein, T. D., Nowinski, C. J., Stern, R. A., Daneshvar, D. H., Alvarez, V. E., & Cantu, R. C. (2013). The spectrum of disease in chronic traumatic encephalopathy. Brain, 136(1), 43–64. doi:10.1093/brain/aws307.PubMedCentralPubMed

Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000). The unity and diversity of executive functions and their contributions to complex “Frontal Lobe” tasks: A latent variable analysis. Cognitive Psychology, 41(1), 49–100. doi:10.1006/cogp.1999.0734.PubMed

Moher, D., Liberati, A., Tetzlaff, J., Altman, D., & the PRISMA Group. (2009). Preferred reporting items for systematic reviews and metaanalyses: The PRISMA statement. Annals of Internal Medicine, 151, 264–269. doi:10.7326/0003-4819-151-4-200908180-00135.PubMed

Mori, S., & Zhang, J. (2006). Principles of diffusion tensor imaging and its applications to basic neuroscience research. Neuron, 51(5), 527–539. doi:10.1016/j.neuron.2006.08.012.PubMed

Murray, C. K., Reynolds, J. C., Schroeder, J. M., Harrison, M. B., Evans, O. M., & Hospenthal, D. R. (2005). Spectrum of care provided at an Echelon II medical unit during Operation Iraqi Freedom. Military Medicine, 170(6), 516–520.PubMed

*Nelson, N.W., Hoelzle, J.B., Doane, B.M., McGuire, K.A., Ferrier-Auerbach, A.G., Charlesworth, M.J, & Sponheim, S.R. (2012). Neuropsychological outcomes of US veterans with report of remote blast-related concussion and current psychopathology. Journal of the International Neuropsychological Society, 18(5), 845–855. doi:10.1017/S1355617712000616.

*Nelson, N.W., Hoelzle, J.B., McGuire, K.A., Ferrier-Auerbach, A.G., Charlesworth, M.J., & Sponheim, S.R. (2010). Evaluation context impacts neuropsychological performance of OEF/OIF veterans with reported combat-related concussion. Archives of Clinical Neuropsychology, 25, 713–723. doi:10.1093/arclin/acq075.

Niogi, S., & Mukherjee, P. (2010). Diffusion tensor imaging of mild traumatic brain injury. The Journal of Head Trauma Rehabilitation, 25(4), 241–255. doi:10.1097/HTR.0b013e3181e52c2a.PubMed

Niogi, S. N., Mukherjee, P., Ghajar, J., Johnson, C. E., Kolster, R., Lee, H., & McCandliss, B. D. (2008). Structural dissociation of attentional control and memory in adults with and without mild traumatic brain injury. Brain, 131(12), 3209–3221.PubMed

OCEBM (Oxford Centre for Evidence-Based Medicine) Levels of Evidence Working Group. (2011). The Oxford Levels of Evidence 2. Retrieved from http://www.cebm.net/index.aspx?o=5653.

Okie, S. (2005). Traumatic brain injury in the war zone. New England Journal of Medicine, 352(20), 2043–2047. doi:10.1056/NEJMp058102.PubMed

Omalu, B., Hammers, J. L., Bailes, J., Hamilton, R. L., Kamboh, M. I., Webster, G., & Fitzsimmons, R. P. (2011). Chronic traumatic encephalopathy in an Iraqi war veteran with posttraumatic stress disorder who committed suicide. Neurosurgical Focus, 31(5), E3. doi:10.3171/2011.9.FOCUS11178.PubMed

Owens, B. D., Kragh, J. F., Jr., Wenke, J. C., Macaitis, J., Wade, C. E., & Holcomb, J. B. (2008). Combat wounds in operation Iraqi Freedom and operation Enduring Freedom. The Journal of Trauma: Injury, Infection, and Critical Care, 64(2), 295–299. doi:10.1097/TA.0b013e318163b875.

Packwood, S., Hodgetts, H. M., & Tremblay, S. (2011). A multiperspective approach to the conceptualization of executive functions. Journal of Clinical and Experimental Neuropsychology, 33(4), 456–470. doi:10.1080/13803395.2010.533157.PubMed

Pertab, J. L., James, K. M., & Bigler, E. (2009). Limitations of mild traumatic brain injury meta-analyses. Brain Injury, 23(6), 498–508.PubMed

*Peskind, E.R., Petrie, E.C., Cross, D.J., Pagulayan, K., McCraw, K., Hoff, D., & Minoshima, S. (2011). Cerebrocerebellar hypometabolism associated with repetitive blast exposure mild traumatic brain injury in 12 Iraq war Veterans with persistent post-concussive symptoms. Neuroimage, 54, S76–S82. doi:10.1016/j.neuroimage.2010.04.008.

Petrie, E., Cross, D., Yarnykh, V., Richards, T., Martin, N., Pagulayan, K., & Peskind, E. (2014). Neuroimaging, behavioral, and psychological sequelae of repetitive combined blast/impact mild traumatic brain injury in Iraq and Afghanistan war veterans. Journal of Neurotrauma, 31(5), 425–436. doi:10.1089/neu.2013.2952.PubMed

Pietrzak, R. H., Johnson, D. C., Goldstein, M. B., Malley, J. C., & Southwick, S. M. (2009). Posttraumatic stress disorder mediates the relationship between mild traumatic brain injury and health and psychosocial functioning in veterans of Operations Enduring Freedom and Iraqi Freedom. The Journal of Nervous and Mental Disease, 197(10), 748–753. doi:10.1097/NMD.0b013e3181b97a75.PubMed

Posner, M. I., & Rothbart, M. K. (2007). Research on attention networks as a model for the integration of psychological science. Annual Review of Psychology, 58, 1–23. doi:10.1146/annurev.psych.58.110405.085516.PubMed

Posner, M. I., Rothbart, M. K., Sheese, B. E., & Tang, Y. (2007). The anterior cingulate gyrus and the mechanism of self-regulation. Cognitive, Affective, & Behavioral Neuroscience, 7(4), 391–395. doi:10.3758/CABN.7.4.391.

Prigatano, G. P., & Borgaro, S. R. (2006). Neuropsychological testing after traumatic brain injury. In R. W. Evans (Ed.), Neurology and trauma (2nd ed., pp. 230–237). New York: Oxford University Press.

Development Core Team, R. (2008). R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing.

Roebuck-Spencer, T. M., Vincent, A. S., Twillie, D. A., Logan, B. W., Lopez, M., Friedl, K. E., & Kirby, G. (2012). Cognitive change associated with self‐reported mild traumatic brain injury sustained during the OEF/OIF conflicts. The Clinical Neuropsychologist, 26(3), 473–489. doi:10.1080/13854046.2011.650214.PubMed

Rohling, M. L., Binder, L. M., Demakis, G. J., Larrabee, G. J., Ploetz, D. M., & Langhinrichsen-Rohling, J. (2011). A meta-analysis of neuropsychological outcome after mild traumatic brain injury: Re-analyses and reconsiderations of Binder et al. (1997), Frencham et al. (2005), and Pertab et al. (2009). The Clinical Neuropsychologist, 25(4), 608–623. doi:10.1080/13854046.2011.565076.PubMed

Rosenfeld, J. V., McFarlane, A. C., Bragge, P., Armonda, R. A., Grimes, J. B., & Ling, G. S. (2013). Blast-related traumatic brain injury. The Lancet Neurology, 12(9), 882–893.PubMed

Rustemeyer, J., Kranz, V., & Bremerich, A. (2007). Injuries in combat from 1982–2005 with particular reference to those to the head and neck: A review. British Journal of Oral and Maxillofacial Surgery, 45(7), 556–560. doi:10.1016/j.bjoms.2007.01.003.PubMed

*Scheibel, R.S., Newsome, M.R., Troyanskaya, M., Lin, X., Steinberg, J.L., Radaideh, M., & Levin, H.S. (2012). Altered brain activation in military personnel with one or more traumatic brain injuries following blast. Journal of the International Neuropsychological Society, 18(1), 89–100. doi:10.1017/S1355617711001433.

Schreiber, S., Barkai, G., Gur-Hartman, T., Peles, E., Tov, N., Dolberg, O. T., & Pick, C. G. (2008). Long-lasting sleep patterns of adult patients with minor traumatic brain injury (mTBI) and non-mTBI subjects. Sleep Medicine, 9(5), 481–487. doi:10.1016/j.sleep.2007.04.014.PubMed

Schretlen, D. J., & Shapiro, A. (2003). A quantitative review of the effects of traumatic brain injury on cognitive functioning. International Review of Psychiatry, 15(4), 341–349. doi:10.1080/09540260310001606728.PubMed

Seegmiller, R. A., & Kane, R. L. (2010). The future of military neuropsychology. In C. H. Kennedy & J. L. Moore (Eds.), Military neuropsychology (pp. 383–404). New York: Springer Publishing Co.

*Shandera-Ochsner, A.L., Berry, D.T., Harp, J.P., Edmundson, M., Graue, L. O., Roach, A., & High Jr, W.M. (2013). Neuropsychological Effects of Self-Reported Deployment-Related Mild TBI and Current PTSD in OIF/OEF Veterans. The Clinical Neuropsychologist, 27(6), 881–907. doi:10.1080/13854046.2013.802017.

Shenton, M. E., Hamoda, H. M., Schneiderman, J. S., Bouix, S., Pasternak, O., Rathi, Y., & Zafonte, R. (2012). A review of magnetic resonance imaging and diffusion tensor imaging findings in mild traumatic brain injury. Brain Imaging and Behavior, 6(2), 137–192. doi:10.1007/s11682-012-9156-5.PubMedCentralPubMed

Sibener, L., Zaganjor, I., Snyder, H. M., Bain, L. J., Egge, R., & Carrillo, M. C. (2014). Alzheimer's Disease prevalence, costs, and prevention for military personnel and veterans. Alzheimer's & Dementia, 10(3), S105–S110. doi:10.1016/j.jalz.2014.04.011.

Sorg, S. F., Delano-Wood, L., Luc, N., Schiehser, D. M., Hanson, K. L., Nation, D. A., & Bondi, M. W. (2014). White matter integrity in veterans with mild traumatic brain injury: Associations with executive function and loss of consciousness. The Journal of Head Trauma Rehabilitation, 29(1), 21–32. doi:10.1097/HTR.0b013e31828a1aa4.PubMed

Sosnoff, J. J., Broglio, S. P., Hillman, C. H., & Ferrara, M. S. (2007). Concussion does not impact intraindividual response time variability. Neuropsychology, 21(6), 796–802. doi:10.1037/0894-4105.21.6.796.PubMed

Sponheim, S., McGuire, K., Kang, S., Davenport, N., Aviyente, S., Bernat, E., & Lim, K. (2011). Evidence of disrupted functional connectivity in the brain after combat-related blast injury. NeuroImage, 54(Suppl 1), S21–S29. doi:10.1016/j.neuroimage.2010.09.007.PubMed

Stan Development Team. (2014). RStan: The R interface to Stan (Version 2.3) [Computer software]. http://mc-stan.org/rstan.html.

Sutton, A. J., & Abrams, K. R. (2001). Bayesian methods in meta-analysis and evidence synthesis. Statistical Methods in Medical Research, 10(4), 277–303. doi:10.1177/096228020101000404.PubMed

Tanielian, T. L., & Jaycox, L. (Eds.). (2008). Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica: Rand Corporation.

Thornton, A., & Lee, P. (2000). Publication bias in meta-analysis: Its causes and consequences. Journal of Clinical Epidemiology, 53(2), 207–216. doi:10.1016/S0895-4356(99)00161-4.PubMed

U.S. Department of Defense. (2014). DoD TBI Worldwide Numbers since 2000. Retrieved from http://dvbic.dcoe.mil/sites/default/files/uploads/Worldwide%20Totals%202000-2014Q1.pdf.

Vanderploeg, R. D., & Schinka, J. A. (2004). Estimation of premorbid cognitive abilities: Issues and approaches. In J. H. Ricker (Ed.), Differential diagnosis in adult neuropsychological assessment (pp. 27–65). New York: Springer Publishing Company.

*Vakhtin, A.A., Calhoun, V.D., Jung, R.E., Prestopnik, J.L., Taylor, P.A., & Ford, C.C. (2013). Changes in intrinsic functional brain networks following blast-induced mild traumatic brain injury. Brain Injury, 27(11), 1304–1310. doi:10.3109/02699052.2013.823561.

Vasterling, J. J., & Dikmen, S. (2012). Mild traumatic brain injury and posttraumatic stress disorder: Clinical and conceptual complexities. Journal of the International Neuropsychological Society, 18(3), 390–393. doi:10.1017/S1355617712000367.PubMed

Vasterling, J. J., Proctor, S. P., Amoroso, P., Kane, R., Heeren, T., & White, R. F. (2006). Neuropsychological outcomes of army personnel following deployment to the Iraq war. The Journal of the American Medical Association, 296(5), 519–529. doi:10.1001/jama.296.5.519.

Verfaellie, M., Lafleche, G., Spiro, A., III, & Bousquet, K. (2014). Neuropsychological outcomes in OEF/OIF veterans with self-report of blast exposure: Associations with mental health, but not MTBI. Neuropsychology, 28(3), 337–346. doi:10.1037/neu0000027.PubMed

Wilk, J. E., Thomas, J. L., McGurk, D. M., Riviere, L. A., Castro, C. A., & Hoge, C. W. (2010). Mild traumatic brain injury (concussion) during combat: Lack of association of blast mechanism with persistent postconcussive symptoms. The Journal of Head Trauma Rehabilitation, 25(1), 9–14. doi:10.1097/HTR.0b013e3181bd090f.PubMed

Witt, S. T., Lovejoy, D. W., Pearlson, G. D., & Stevens, M. C. (2010). Decreased prefrontal cortex activity in mild traumatic brain injury during performance of an auditory oddball task. Brain Imaging and Behavior, 4(3–4), 232–247. doi:10.1007/s11682-010-9102-3.PubMed

Xydakis, M. S., Fravell, M. D., Nasser, K. E., & Casler, J. D. (2005). Analysis of battlefield head and neck injuries in Iraq and Afghanistan. Otolaryngology-Head and Neck Surgery, 133(4), 497–504. doi:10.1016/j.otohns.2005.07.003.PubMed

Yeh, P. H., Wang, B., Oakes, T. R., French, L. M., Pan, H., Graner, J., & Riedy, G. (2014). Postconcussional disorder and PTSD symptoms of military‐related traumatic brain injury associated with compromised neurocircuitry. Human Brain Mapping, 35(6), 2652–2673. doi:10.1002/hbm.22358.PubMed

Zakzanis, K. K., Leach, L., & Kaplan, E. (1999). Mild traumatic brain injury. In K. K. Zakzanis, L. Leach, & E. Kaplan (Eds.), Neuropsychological differential diagnosis (pp. 163–171). Lisse Netherlands: Swets & Zeitlinger Publishers.

Title: Blast-Related Mild Traumatic Brain Injury: A Bayesian Random-Effects Meta-Analysis on the Cognitive Outcomes of Concussion among Military Personnel
Authors: Justin E. Karr
Corson N. Areshenkoff
Emily C. Duggan
Mauricio A. Garcia-Barrera
Publication date: 01-12-2014
Publisher: Springer US
Published in: Neuropsychology Review / Issue 4/2014
Print ISSN: 1040-7308
Electronic ISSN: 1573-6660
DOI: https://doi.org/10.1007/s11065-014-9271-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Blast-Related Mild Traumatic Brain Injury: A Bayesian Random-Effects Meta-Analysis on the Cognitive Outcomes of Concussion among Military Personnel

Abstract

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2014

Functional Plasticity in Childhood Brain Disorders: When, What, How, and Whom to Assess

Behavior at the Choice Point: Decision Making in Hidden Pathway Maze Learning

Event-Related Brain Potentials in the Study of Inhibition: Cognitive Control, Source Localization and Age-Related Modulations

Negative Neuroplasticity in Chronic Traumatic Brain Injury and Implications for Neurorehabilitation

A Protective Effect of Musical Expertise on Cognitive Outcome Following Brain Damage?

Understanding the Neuropsychiatric Phenotype of Fragile X-Associated Tremor Ataxia Syndrome: a Systematic Review