Poster Session 03 Program Schedule
02/15/2024
09:30 am - 10:40 am
Room: Shubert Complex (Posters 1-60)
Poster Session 03: Neurotrauma | Neurovascular
Final Abstract #16
Does Post-Traumatic Stress Disorder Impact the Efficacy of Cognitive Rehabilitation?
Ida Babakhanyan, Traumatic Brain Injury Center of Excellence, Silver Spring, United States
Andrew Darr, Traumatic Brain Injury Center of Excellence, Camp Pendleton, United States
Juan Lopez, Traumatic Brain Injury Center of Excellence, Camp Pendleton, United States
Melissa Caswell, Traumatic Brain Injury Center of Excellence, Camp Pendleton, United States
Angela Basham, Traumatic Brain Injury Center of Excellence, Camp Pendleton, United States
Jason Bailie, Traumatic Brain Injury Center of Excellence, Camp Pendleton, United States
Category: Concussion/Mild TBI (Adult)
Keyword 1: post-traumatic stress disorder
Keyword 2: cognitive rehabilitation
Keyword 3: cognitive functioning
Objective:
There is a known high rate of comorbidity between mild traumatic brain injury (mTBI) and PTSD, and this co-morbid presentation is recognized as a key factor for negative health outcomes for military service members (SMs). The objective of this study was to examine if SMs response to cognitive rehabilitation was impacted by post-traumatic stress (PTS) and combat exposure.
Participants and Methods:
Participants were active duty SMs recruited from a military treatment facility. Participants had at least one diagnosed mTBI with persistent cognitive complaints, as well as objective cognitive impairment as determined by the Global Deficit Scale (GDS). GDS was calculated from 11 cognitive measures: Hopkins Verbal Learning Test-Revised Total Recall and Delayed Recall, Delis Kaplan Executive Functioning System Color Word Conditions 1-4 and Trail Making Conditions 1-4, Paced Auditory Serial Addition Test, and the Symbol Digit Modality Test. Demographically corrected t-scores for each cognitive measure were converted to deficit scores. T-score to deficit score conversions were as follows: >40 = 0, 35-39 = 1, 30-34 = 2, 25-29 = 3, 20-24 = 4, <20 = 5. The deficit scores were averaged to calculate GDS and scores greater than .5 were atypical.
A total of 54 SMs were included in this analysis. They were on average 32.9 years old (SD = 8.4) with an average of 4.3 lifetime mTBI’s (SD = 2.5); the most recent mTBI was on average 6.0 years prior (SD=5.4). PTS was assessed with the PTSD Checklist-Military (PCL-M). Patients completed manualized clinician directed cognitive rehabilitation program which ranged from 4 to 6 weeks in duration. The primary outcome was change in cognitive functioning as measured by pre and post treatment GDS. Participants were excluded if they did not pass performance validity testing.
Results:
A repeated measures analysis of variance revealed that cognitive rehabilitation had a large impact on GDS (p 65) revealed that even those with the most PTS symptoms can benefit from cognitive rehabilitation efforts (p =.637, partial η2 = .004).
Conclusions:
PTSD has been shown to negatively impact outcomes of SM recovery from a mTBI; however, our results indicate that PTS does not impact remediation of cognitive deficits in military personnel with a history of TBI. This was true even for those with the most extreme PTS scores. Overall, this supports the use of cognitive rehabilitation for warfighters irrespective of ongoing PTS symptoms.
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