Journal of the International Neuropsychological Society

Research Articles

Cognitive sequelae of blast-related versus other mechanisms of brain trauma

HEATHER G. BELANGERa1a2a3 c1, TRACY KRETZMERa1, RUTH YOASH-GANTZa4a5a6, TREVEN PICKETTa3a4a7a8 and LARRY A. TUPLERa4a9a9

a1 Department of Mental Health and Behavioral Sciences, James A. Haley Veterans Hospital, Tampa, Florida

a2 Department of Psychology, University of South Florida, Tampa, Florida

a3 Defense and Veterans Brain Injury Center (DVBIC)

a4 Mid-Atlantic (VISN 6) Mental Illness Research, Education and Clinical Center (MIRECC), North Carolina, Virginia, West Virginia

a5 Department of Mental Health and Behavioral Sciences, Hefner Veterans Affairs Medical Center, Salisbury, North Carolina

a6 Department of Psychiatry and Behavioral Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina

a7 Mental Health Service, McGuire Veterans Affairs Medical Center, Richmond, Virginia

a8 Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia

a9 Mental Health Service, Durham Veterans Affairs Medical Center, Durham, North Carolina

a10 Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina

Abstract

The use of improvised explosive devices has become the hallmark of modern warfare and has resulted in an ever-increasing number of blast-related traumatic brain injuries (TBIs). Despite this fact, very little is actually known about the cognitive sequelae of blast-related TBIs. The purpose of the current study was to compare patterns of performance on neuropsychological measures in subjects who have sustained TBIs as a result of blast (or explosion) with those who have sustained TBIs from non-blast or blunt force trauma (motor vehicle accident, fall, assault, etc.). Participants were categorized as blast-related TBI or non-blast-related TBI and according to severity of injury (mild or moderate-to-severe). No main effects were observed in analysis of covariance between blast-related TBI participants and non-blast-related TBI participants across any of the neuropsychological variables, although an interaction was observed on a visual memory test showing stronger performance for mild blast-related and poorer performance for moderate-to-severe blast-related participants compared with both non-blast groups. Overall, the results do not provide any strong evidence that blast is categorically different from other TBI mechanisms, at least with regard to cognitive sequelae on select measures. Additional findings included a marginally increased incidence of reported posttraumatic stress disorder symptoms among blast-injured participants. (JINS, 2009, 15, 1–8.)

(Received March 17 2008)

(Reviewed August 25 2008)

(Accepted August 28 2008)

Correspondence:

c1 Correspondence and reprint requests to: Heather G. Belanger, James A. Haley Veterans Hospital Psychology Service, 116B 13000 Bruce B. Downs Boulevard, Tampa, Florida 33612. E-mail: heather.belanger@va.gov.

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