Can Mild Traumatic Brain Injury Alter Cognition Chronically? A LIMBIC-CENC Multicenter Study

Objective: While outcome from mild traumatic brain injury (mTBI) is generally favorable, concern remains over potential negative long-term effects, including impaired cognition. This study examined the link between cognitive performance and remote mTBIs within the Long-term Impact of Military-releva...

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Published in:Neuropsychology 2023-01, Vol.37 (1), p.1-19
Main Authors: Walker, William C., O'Neil, Maya E., Ou, Zhining, Pogoda, Terri K., Belanger, Heather G., Scheibel, Randall S., Presson, Angela P., Miles, Shannon R., Wilde, Elisabeth A., Tate, David F., Troyanskaya, Maya, Pugh, Mary Jo, Jak, Amy, Cifu, David X.
Format: Article
Language:English
Subjects:
Brain Concussion
Brain Concussion - complications
Brain Concussion - psychology
Cognition
Cognitive Impairment
Cross-Sectional Studies
Female
Human
Humans
Life Span
Male
Measurement
Military Personnel
Military Veterans
Neuropsychological Assessment
Neuropsychological Tests
Stress Disorders, Post-Traumatic - psychology
Traumatic Brain Injury
Veterans - psychology
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Summary:Objective: While outcome from mild traumatic brain injury (mTBI) is generally favorable, concern remains over potential negative long-term effects, including impaired cognition. This study examined the link between cognitive performance and remote mTBIs within the Long-term Impact of Military-relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) multicenter, observational study of Veterans and service members (SMs) with combat exposure. Method: Baseline data of the participants passing all cognitive performance validity tests (n = 1,310) were used to conduct a cross-sectional analysis. Using multivariable regression models that adjusted for covariates, including age and estimated preexposure intellectual function, positive mTBI history groups, 1-2 lifetime mTBIs (nonrepetitive, n = 614), and 3+ lifetime mTBIs (repetitive; n = 440) were compared to TBI negative controls (n = 256) on each of the seven cognitive domains computed by averaging Z scores of prespecified component tests. Significance levels were adjusted for multiple comparisons. Results: Neither of the mTBI positive groups differed from the mTBI negative control group on any of the cognitive domains in multivariable analyses. Findings were also consistently negative across sensitivity analyses (e.g., mTBIs as a continuous variable, number of blast-related mTBIs, or years since the first and last mTBI). Conclusions: Our findings demonstrate that the average veteran or SM who experienced one or more mTBIs does not have postacute objective cognitive deficits due to mTBIs alone. A holistic health care approach including comorbidity assessment is indicated for patients reporting chronic cognitive difficulties after mTBI(s), and strategies for addressing misattribution may be beneficial. Future study is recommended with longitudinal designs to assess within-subjects decline from potential neurodegeneration. Key Points Question: Is cognitive performance altered long-term after mild traumatic brain injury (mTBI) relative to non-TBI controls? Findings: Among combat-exposed Veterans and service members (SMs), neither of the mTBI positive groups, nonrepetitive (1-2) or repetitive (≥3), differed from the TBI negative controls on any cognitive testing domain when adjusting for other factors. Importance: Remote mTBI alone, even if repetitive, does not cause objective cognitive problems in the average veteran or SM. A holistic health care approach including comorbidity assessm
ISSN:0894-4105
1931-1559
1931-1559
DOI:10.1037/neu0000855