Chronic Pain and Traumatic Brain Injury in OEF/OIF Service Members and Veterans

2013 ◽  
pp. n/a-n/a ◽  
Author(s):  
Michelle A. Bosco ◽  
Jennifer L. Murphy ◽  
Michael E. Clark
Keyword(s):  
Traumatic Brain Injury ◽  
Chronic Pain ◽  
Brain Injury ◽  
Service Members

scholarly journals Prevalence of Polytrauma Clinical Triad Among Active Duty Service Members

2021 ◽  
Author(s):  
Sharon Laughter ◽  
Munziba Khan ◽  
Amanda Banaag ◽  
Cathaleen Madsen ◽  
Tracey Perez Koehlmoos
Keyword(s):  
Traumatic Brain Injury ◽  
Chronic Pain ◽  
Brain Injury ◽  
Active Duty ◽  
Service Members ◽  
Team Approach ◽  
Military Population ◽  
Administrative Claim Data ◽  
Active Duty Military ◽  
Clinical Triad

ABSTRACT Introduction The polytrauma clinical triad (PCT), encompassing traumatic brain injury, PTSD, and chronic pain, has been identified as a significant concern in the Military Health System (MHS). Conditions in this triad mutually reinforce one another and can pose a significant challenge to treatment for patients and providers. Polytrauma clinical triad has previously been studied in deployed veterans but remains understudied in the active duty military population. Therefore, this novel study seeks to determine the prevalence of PCT among active duty service members and to identify the subpopulations most at risk for PCT. Materials and Methods This cross-section study used the MHS Data Repository in order to retrospectively review all administrative claim data for active duty service members within the Army, Navy, Air Force, and Marine Corps from fiscal years 2010 to 2015. Specific ICD-9 codes were extracted that correlated with traumatic brain injury, PTSD, and chronic pain to determine the risk of PCT. We used logistic regression to compare individuals presenting with the PCT conditions to those service members without any of the PCT diagnoses codes. Results The study identified 2,441,698 active duty service members eligible for inclusion. The prevalence of all three conditions of PCT was 5.99 per 1,000 patients. Patients with PCT were most likely to be 20–29 years old (52.15%), male (89.83%), White (59.07%), married (64.18%), Junior Enlisted (55.27%), and serving in the Army (74.71%). Conclusion This study is the first to identify the risk of PCT in the active duty military population. Awareness of the risk and subsequent prompt identification of the triad will enable treatment through an integrated, team approach, which should alleviate potential patient suffering and improve the efficiency of care and readiness of service members.

Assessment of Cognitive-Communicative Disorders of Mild Traumatic Brain Injury Sustained in Combat

2009 ◽  
Vol 19 (2) ◽  
pp. 47-57 ◽  
Author(s):  
Christine Parrish ◽  
Carole Roth ◽  
Brooke Roberts ◽  
Gail Davie
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Psychological Health ◽  
Communication Disorders ◽  
Service Members ◽  
Patient Questionnaire ◽  
Speech Language Pathologists ◽  
Test Protocol ◽  
Communication Deficits

Abstract Background: Mild traumatic brain injury (mTBI) is recognized as the signature injury of the current conflicts in Iraq and Afghanistan, yet there remains limited understanding of the persisting cognitive deficits of mTBI sustained in combat. Speech-language pathologists (SLPs) have traditionally been responsible for evaluating and treating the cognitive-communication disorders following severe brain injuries. The evaluation instruments historically used are insensitive to the subtle deficits found in individuals with mTBI. Objectives: Based on the limited literature and clinical evidence describing traditional and current tests for measuring cognitive-communication deficits (CCD) of TBI, the strengths and weaknesses of the instruments are discussed relative to their use with mTBI. It is necessary to understand the nature and severity of CCD associated with mTBI for treatment planning and goal setting. Yet, the complexity of mTBI sustained in combat, which often co-occurs with PTSD and other psychological health and physiological issues, creates a clinical challenge for speech-language pathologists worldwide. The purpose of the paper is to explore methods for substantiating the nature and severity of CCD described by service members returning from combat. Methods: To better understand the nature of the functional cognitive-communication deficits described by service members returning from combat, a patient questionnaire and a test protocol were designed and administered to over 200 patients. Preliminary impressions are described addressing the nature of the deficits and the challenges faced in differentiating the etiologies of the CCD. Conclusions: Speech-language pathologists are challenged with evaluating, diagnosing, and treating the cognitive-communication deficits of mTBI resulting from combat-related injuries. Assessments that are sensitive to the functional deficits of mTBI are recommended. An interdisciplinary rehabilitation model is essential for differentially diagnosing the consequences of mTBI, PTSD, and other psychological and physical health concerns.

Blood Biomarkers Relate to Cognitive Performance Years after Traumatic Brain Injury in Service Members and Veterans

2020 ◽  
pp. 1-7
Author(s):  
Sara M. Lippa ◽  
Jessica Gill ◽  
Tracey A. Brickell ◽  
Louis M. French ◽  
Rael T. Lange
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Outcome ◽  
Service Members ◽  
Neurocognitive Performance ◽  
Blood Biomarkers ◽  
Post Injury ◽  
Blood Draw ◽  
Neurofilament Light ◽  
History Of

Abstract Objective: This study examines the relationship of serum total tau, neurofilament light (NFL), ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1), and glial fibrillary acidic protein (GFAP) with neurocognitive performance in service members and veterans with a history of traumatic brain injury (TBI). Method: Service members (n = 488) with a history of uncomplicated mild (n = 172), complicated mild, moderate, severe, or penetrating TBI (sTBI; n = 126), injured controls (n = 116), and non-injured controls (n = 74) prospectively enrolled from Military Treatment Facilities. Participants completed a blood draw and neuropsychological assessment a year or more post-injury. Six neuropsychological composite scores and presence/absence of mild neurocognitive disorder (MNCD) were evaluated. Within each group, stepwise hierarchical regression models were conducted. Results: Within the sTBI group, increased serum UCH-L1 was related to worse immediate memory and delayed memory (R2Δ = .065–.084, ps < .05) performance, while increased GFAP was related to worse perceptual reasoning (R2Δ = .030, p = .036). Unexpectedly, within injured controls, UCH-L1 and GFAP were inversely related to working memory (R2Δ = .052–.071, ps < .05), and NFL was related to executive functioning (R2Δ = .039, p = .021) and MNCD (Exp(B) = 1.119, p = .029). Conclusions: Results suggest GFAP and UCH-L1 could play a role in predicting poor cognitive outcome following complicated mild and more severe TBI. Further investigation of blood biomarkers and cognition is warranted.

Prevalence and Severity of Psychiatric Disorders and Suicidal Behavior in Service Members and Veterans With and Without Traumatic Brain Injury

2020 ◽  
Vol 35 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Nancy Greer ◽  
Nina A. Sayer ◽  
Michele Spoont ◽  
Brent C. Taylor ◽  
Princess E. Ackland ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Psychiatric Disorders ◽  
Suicidal Behavior ◽  
Service Members
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