INS NYC 2024 Program

Poster	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 #47 Increased Errors in Color Word Interference within Veterans with mTBI and PTSD Lauren Meier, Virginia Polytechnic Institute and State University, Blacksburg, United States Lisa Cruz, Mental Illness Research, Education, and Clinical Center, VA Palo Alto Health Care System, Palo Alto, United States Nicole Walker, Stanford University School of Medicine, Stanford, United States Michelle Madore, Stanford University School of Medicine, Stanford, United States Category: Concussion/Mild TBI (Adult) Keyword 1: post-traumatic stress disorder Keyword 2: traumatic brain injury Keyword 3: executive functions Objective: Research demonstrates high comorbidity of mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) among Veterans. However, the symptomology of mTBI and PTSD tend to overlap, specifically with executive dysfunction, making it challenging to distinguish symptom attribution between the two conditions. For Veterans with mTBI or PTSD, executive dysfunction is commonly reported, consistent with vulnerability to the frontal lobes and anterior brain networks. Research is still limited regarding whether there is a greater risk of executive dysfunction based on cumulative mTBI and PTSD symptoms, compared to mTBI diagnosis alone. Further, there is conflicting research regarding which specific aspects of executive functioning are affected in Veterans with mTBI (e.g., working memory, attention). Therefore, the goal of the present study was to examine the relationship between facets of executive dysfunction in Veterans with mTBI, with and without comorbid PTSD. It was hypothesized that individuals with comorbid mTBI and PTSD would perform more poorly on executive functioning tasks compared to individuals with mTBI alone. Participants and Methods: Participants included 39 Veterans (10.3% female; age M = 46.03, SD = 13.26; years of education M = 14.74, SD = 1.71) with a history of mTBI. Twenty-four Veterans met the criteria for clinically significant PTSD using the PTSD Checklist for DSM-IV (PCL; index score cutoff of 35 or greater). Participants completed the Color Word Interference Test (CWIT) from the Delis-Kaplan Executive Functioning System (D-KEFS), with a particular interest in Conditions 3 and 4 given the increased complexity compared to the other conditions. Independent samples t-tests were used to analyze relationships between executive functioning in Veterans with mTBI, with and without PTSD. Results: There were non-significant differences between the two groups across the CWIT subtests regarding overall raw and standardized scores (all ps > 0.05). However, Veterans with comorbid mTBI and PTSD exhibited significantly more errors on CWIT Condition 4 (M = 2.04, SD = 1.97), compared to Veterans with mTBI alone (M = 0.67, SD = 0.72), t = -3.10, p = .004. Conclusions: The current study found that among Veterans with mTBI, those with comorbid PTSD exhibited increased errors on a task requiring contemporaneous inhibitory control and set-shifting relative to Veterans with mTBI only. Given that other facets of executive functioning were similar between the groups (e.g., Condition 3: Inhibition), findings suggest potentially increased cognitive vulnerability for individuals with comorbid brain injury and psychiatric symptoms when increased cognitive demand and flexibility are required. This is consistent with prior research demonstrating brain network alterations in instances of aggregate brain injury and trauma. Given the high overlap of TBI and PTSD symptoms among Veterans, future research should include larger samples of Veterans with varying severity of TBI with and without PTSD, to better understand cognitive abilities in the context of increased cognitive demand, as well as investigate relationships to functional outcomes.

Poster

02/15/2024
09:30 am - 10:40 am
Room: Shubert Complex (Posters 1-60)

Poster Session 03: Neurotrauma | Neurovascular

Final Abstract #47

Increased Errors in Color Word Interference within Veterans with mTBI and PTSD

Lauren Meier, Virginia Polytechnic Institute and State University, Blacksburg, United States
Lisa Cruz, Mental Illness Research, Education, and Clinical Center, VA Palo Alto Health Care System, Palo Alto, United States
Nicole Walker, Stanford University School of Medicine, Stanford, United States
Michelle Madore, Stanford University School of Medicine, Stanford, United States

Category: Concussion/Mild TBI (Adult)

Keyword 1: post-traumatic stress disorder
Keyword 2: traumatic brain injury
Keyword 3: executive functions

Objective:

Research demonstrates high comorbidity of mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) among Veterans. However, the symptomology of mTBI and PTSD tend to overlap, specifically with executive dysfunction, making it challenging to distinguish symptom attribution between the two conditions. For Veterans with mTBI or PTSD, executive dysfunction is commonly reported, consistent with vulnerability to the frontal lobes and anterior brain networks. Research is still limited regarding whether there is a greater risk of executive dysfunction based on cumulative mTBI and PTSD symptoms, compared to mTBI diagnosis alone. Further, there is conflicting research regarding which specific aspects of executive functioning are affected in Veterans with mTBI (e.g., working memory, attention). Therefore, the goal of the present study was to examine the relationship between facets of executive dysfunction in Veterans with mTBI, with and without comorbid PTSD. It was hypothesized that individuals with comorbid mTBI and PTSD would perform more poorly on executive functioning tasks compared to individuals with mTBI alone.

Participants and Methods:

Participants included 39 Veterans (10.3% female; age M = 46.03, SD = 13.26; years of education M = 14.74, SD = 1.71) with a history of mTBI. Twenty-four Veterans met the criteria for clinically significant PTSD using the PTSD Checklist for DSM-IV (PCL; index score cutoff of 35 or greater). Participants completed the Color Word Interference Test (CWIT) from the Delis-Kaplan Executive Functioning System (D-KEFS), with a particular interest in Conditions 3 and 4 given the increased complexity compared to the other conditions. Independent samples t-tests were used to analyze relationships between executive functioning in Veterans with mTBI, with and without PTSD.

Results:

There were non-significant differences between the two groups across the CWIT subtests regarding overall raw and standardized scores (all ps > 0.05). However, Veterans with comorbid mTBI and PTSD exhibited significantly more errors on CWIT Condition 4 (M = 2.04, SD = 1.97), compared to Veterans with mTBI alone (M = 0.67, SD = 0.72), t = -3.10, p = .004.

Conclusions:

The current study found that among Veterans with mTBI, those with comorbid PTSD exhibited increased errors on a task requiring contemporaneous inhibitory control and set-shifting relative to Veterans with mTBI only. Given that other facets of executive functioning were similar between the groups (e.g., Condition 3: Inhibition), findings suggest potentially increased cognitive vulnerability for individuals with comorbid brain injury and psychiatric symptoms when increased cognitive demand and flexibility are required. This is consistent with prior research demonstrating brain network alterations in instances of aggregate brain injury and trauma. Given the high overlap of TBI and PTSD symptoms among Veterans, future research should include larger samples of Veterans with varying severity of TBI with and without PTSD, to better understand cognitive abilities in the context of increased cognitive demand, as well as investigate relationships to functional outcomes.