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. 2021 Dec 22:2:100854.
doi: 10.1016/j.bas.2021.100854. eCollection 2022.

Neurocognitive correlates of probable posttraumatic stress disorder following traumatic brain injury

Collaborators, Affiliations

Neurocognitive correlates of probable posttraumatic stress disorder following traumatic brain injury

Dominique L G Van Praag et al. Brain Spine. .

Abstract

Introduction: Neurocognitive problems associated with posttraumatic stress disorder (PTSD) can interact with impairment resulting from traumatic brain injury (TBI).

Research question: We aimed to identify neurocognitive problems associated with probable PTSD following TBI in a civilian sample.

Material and methods: The study is part of the CENTER-TBI project (Collaborative European Neurotrauma Effectiveness Research) that aims to better characterize TBI. For this cross-sectional study, we included patients of all severities aged over 15, and a Glasgow Outcome Score Extended (GOSE) above 3. Participants were assessed at six months post-injury on the PTSD Checklist-5 (PCL-5), the Trail Making Test (TMT), the Rey Auditory Verbal Learning Test (RAVLT) and the Cambridge Neuropsychological Test Automated Battery (CANTAB). Primary analysis was a complete case analysis. Regression analyses were performed to investigate the association between the PCL-5 and cognition.

Results: Of the 1134 participants included in the complete case analysis, 13.5% screened positive for PTSD. Probable PTSD was significantly associated with higher TMT-(B-A) (OR ​= ​1.35, 95% CI: 1.14-1.60, p ​< ​.001) and lower RAVLT-delayed recall scores (OR ​= ​0.74, 95% CI: 0.61-0.91, p ​= ​.004) after controlling for age, sex, psychiatric history, baseline Glasgow Coma Scale and education.

Discussion and conclusion: Poorer performance on cognitive tests assessing task switching and, to a lesser extent, delayed verbal recall is associated with probable PTSD in civilians who have suffered TBI.

Keywords: Cognition; Head injury; Neuropsychology; Posttraumatic stress disorder; Stress.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flowchart of patient inclusion and exclusion.
Fig. 1
Fig. 1
Probable PTSD diagnosis differentiated for GCS rating.
Fig. 2
Fig. 2
Probable PTSD diagnosis differentiated for GOSE rating Note: GOSE 4: Upper Severe Disability – needs full assistance in activities of daily living, GOSE 5: Lower Moderate Disability – independent, but cannot resume work/school or all previous social activities, GOSE 6: Upper Moderate Disability – Some disability exists, but can partly resume work or previous activities, GOSE 7: Lower Good Recovery – Minor physical or mental deficits that affects daily life, GOSE 8: Upper Good Recovery – Full recovery or minor symptoms that do not affect daily life

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