There is no shortage of clinical research articles on traumatic brain injury (TBI). In fact, a team of experts from Defense and Veterans Brain Injury Center (DVBIC) recently reviewed more than 250 abstracts from literature published in 2016. The team, with a variety of clinical backgrounds, reviewed the latest in brain injury research and selected 10 articles that advance brain injury research.
In recognition of Brain Injury Awareness Month, here is our top 10 list of TBI research articles, with summaries, categorized by topic. Click on the article title to access the abstract or article on PubMed, a service of the U.S. National Library of Medicine.
Although concussions can affect quality of life, assessing post-concussion health-related quality of life is not currently standard practice for clinicians. This study evaluated the usefulness of an assessment tool called the TBI quality-of-life scale and found it an effective means for checking on health-related quality of life in military concussion patients as compared to service members without TBI. Further research will also explore usefulness of the tool in civilian settings.
Posttraumatic stress disorder (PTSD) and depression often accompany combat-related TBI. In this study, researchers looked at outcomes for service members who sustained a combat-related TBI between 2008 and 2013. After examining possible correlations between PTSD, depression and TBI, they found a trend toward less PTSD in later groups of service members. Overall, however, long-term outcomes for these co-occurring conditions have improved only slightly and are often poor — confirming the importance of early care for PTSD and depression in TBI patients.
More women are serving in combat-related roles and sustaining concussions, although combat-related concussion remains less prevalent among women. This study compared 86 women to 86 men, all of whom sustained a concussion while serving on active duty. Women reported significantly more symptoms than their male counterparts, including nausea, sensitivity to light, changes in taste, smell, and appetite, fatigue, poor sleep, difficulty concentrating, trouble remembering a stressful event, and disturbing memories, thoughts, and images. Analyzing gender-related differences in symptom reporting requires more research to better recognize, understand and treat combat-related concussions.
Researchers want to learn more about the outcomes of concussions that happen during deployment. This study identified predictors of persistent post-concussive symptoms among U.S. Army personnel who sustained a concussion while deployed in Afghanistan. These service members experienced an increased risk for more severe persistent symptoms. Severity of symptoms at follow-up was also associated with a history of pre-deployment TBI, pre-deployment psychological distress, more severe deployment stress, and loss of consciousness or lapse of memory (versus being “dazed”) as a result of deployment-related concussion. Knowing more about persistent post-concussive symptoms following deployment-acquired concussion enables health care providers to take preventive measures.
In this study, researchers looked at Operation Enduring Freedom and Operation Iraqi Freedom veterans exposed to a blast-related event and compared those who experienced a concussion to those who didn’t experience a concussion, to determine whether concussion is independently associated with noise and light sensitivity. Sensory symptoms were reported more frequently in the concussion group. After controlling for PTSD and other conditions, noise and light sensitivity persisted, suggesting that these particular symptoms may occur with concussion alone.
Did you know that healthy people sometimes report symptoms resembling persistent post-concussive symptoms? In this study, clinicians administered a test called the Neurobehavioral Symptom Inventory to 215 healthy service members without a history of concussion. Among them, 2-15 percent met criteria for persistent post-concussive symptoms. This highlights the importance of using normative data when evaluating a service member or veteran and when evaluating the likelihood that a change in symptom reporting is reliable and clinically meaningful.
This study found a relationship between impulsivity and symptoms relating to moods, feelings and attitudes in service members and veterans with concussion, but noted that the relationship between impulsivity and blast exposure requires further clarification.
Neurocognitive Baseline Tests
The Defense Department mandates pre-deployment neurocognitive tests to set individual baseline scores for assessment of combat-related concussion. However, the large amount of information collected raises questions about the effectiveness of baseline testing relative to other approaches. To figure out whether baseline scores are necessary, this study compared baseline-referenced neurocognitive testing and other approaches in concussed service members. Results suggest that there is no clear advantage to using baseline-referenced scores.
Does it matter how soon you get proper rest for both mind and body after a concussion? For children, it matters a lot. This study looked at how delayed rest affected children’s recovery time. Patients who started mental and physical rest immediately after injury were more likely to recover within 30 days, compared to those who delayed it for one to seven days. Among patients who recovered within 30 days, those with immediate rest recovered 4.6 days sooner than those with delayed rest.
Group-based compensatory cognitive training is a type of cognitive rehabilitation designed to help improve attention, learning, memory and other cognitive functions. This study explored compensatory cognitive training for combat veterans with a history of concussion. Those who participated in the training reported significantly fewer cognitive difficulties and greater use of cognitive strategies. They also demonstrated significant improvements on neurocognitive tests. Overall findings show that this training was successful in enhancing the use of cognitive strategies and facilitated improvement in specific cognitive domains.