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Factors Associated with Mild Traumatic Brain Injury in Veterans and Military Personnel: A Systematic Review

Published online by Cambridge University Press:  05 February 2014

Maya E. O'Neil*
Affiliation:
Portland VA Medical Center, Portland, Oregon Psychiatry, Oregon Health & Science University, Portland, Oregon Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon
Kathleen F. Carlson
Affiliation:
Portland VA Medical Center, Portland, Oregon Public Health & Preventive Medicine, Oregon Health & Science University, Portland, Oregon
Daniel Storzbach
Affiliation:
Portland VA Medical Center, Portland, Oregon Psychiatry, Oregon Health & Science University, Portland, Oregon
Lisa A. Brenner
Affiliation:
Denver VA Medical Center, VISN 19 MIRECC, Denver, Colorado Psychiatry, Neurology, and Physical Medicine and Rehabilitation, University of Colorado Denver, Denver, Colorado
Michele Freeman
Affiliation:
Portland VA Medical Center, Portland, Oregon
Ana R. Quiñones
Affiliation:
Portland VA Medical Center, Portland, Oregon Public Health & Preventive Medicine, Oregon Health & Science University, Portland, Oregon
Makalapua Motu'apuaka
Affiliation:
Portland VA Medical Center, Portland, Oregon
Devan Kansagara
Affiliation:
Portland VA Medical Center, Portland, Oregon General Internal Medicine, Oregon Health & Science University, Portland, Oregon
*
Correspondence and reprint requests to: Maya E. O'Neil, 3710 SW U.S. Veterans Hospital Road, Mail Code: R&D 71, Portland, OR 97239. E-mail: maya.oneil@va.gov

Abstract

A history of mild traumatic brain injury (mTBI) is common among military members who served in Operations Enduring Freedom, Iraqi Freedom, and New Dawn (OEF/OIF/OND). We completed a systematic review to describe the cognitive, mental health, physical health, functional, social, and cost consequences of mTBI in Veteran and military personnel. Of 2668 reviewed abstracts, the 31 included studies provided very low strength evidence for the questions of interest. Cognitive, physical, and mental health symptoms were commonly reported by Veterans/military members with a history of mTBI. On average, these symptoms were not significantly more common in those with a history of mTBI than in those without, although a lack of significant mean differences does not preclude the possibility that some individuals could experience substantial effects related to mTBI history. Evidence of potential risk or protective factors moderating mTBI outcomes was unclear. Although the overall strength of evidence is very low due to methodological limitations of included studies, our findings are consistent with civilian studies. Appropriate re-integration services are needed to address common comorbid conditions, such as treatment for post-traumatic stress disorder, substance use disorders, headaches, and other difficulties that Veterans and members of the military may experience after deployment regardless of mTBI history. (JINS, 2014, 20, 1–13)

Type
Critical Review
Copyright
Copyright © The International Neuropsychological Society 2014 

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