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Teasing out the long-term effects of TBI

thumbnail TBI effects on thinking skills— Veteran Lonny Ellison (right) works with an occupational therapy team as part of a special cognitive training program at the San Francisco VA Medical Center. VA research has determined that for many Veterans, effectively treating PTSD and depression may help greatly in restoring cognitive function following TBI. (Photo by Roy Kaltschmidt)

Neurocognitive tests measure people's cognitive function�how well they think, learn, perceive and process information, make decisions. The tests cover intellect, attention, memory, motor skill, and other areas that depend on healthy brain function. In a study of 760 Army soldiers who had suffered mild traumatic brain injury in Iraq, VA researchers and colleagues in Boston found that milder TBIs typically have "limited lasting neuropsychological consequences." On the other hand, posttraumatic stress disorder and depression, when not treated effectively, can have longer-term impacts on cognitive function.

Psychologist Jennifer Vasterling, PhD, and her team compared neuropsychological results from before and after the soldiers were deployed. They used a variety of tests and questionnaires to tease out which effects were due to TBI, and which to other factors, such as PTSD and depression.

"The take-home message for Veterans and their family members is that recovery from mild TBI can be influenced by a number of factors in addition to the actual brain damage," says Vasterling. "This is good news because some contributing factors may be modifiable."

She says PTSD and depression are likely to be among the factors that can slow recovery after TBI. Treating or managing the two conditions is "critical in its own right," says Vasterling, but doing so is also likely to help restore function following mild TBI.

"It may be that swift and effective psychiatric and psychosocial intervention may have broad effects by not only alleviating emotional distress but by also proving an important secondary benefit in terms of reversing deployment-related neuropsychological decrements," wrote Vasterling's team.

Vasterling notes that the study involved soldiers who had suffered TBIs but were healthy enough to still be on active duty. The results might be different with troops or Veterans with more severe or repeated TBIs and other serious medical problems. (British Journal of Psychiatry, September 2012)

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