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Verbal Memory Deficits in OEF/OIF/OND Veterans Exposed to Blasts at Close Range

Published online by Cambridge University Press:  24 January 2018

Laura J. Grande ,
Meghan E. Robinson ,
Lauren J. Radigan ,
Laura K. Levin ,
Catherine B. Fortier ,
William P. Milberg  and
Regina E. McGlinchey
Laura J. Grande*
Affiliation:
Psychology Service, VA Boston Healthcare System, Boston, Massachusetts Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
Meghan E. Robinson
Affiliation:
Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, Massachusetts Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
Lauren J. Radigan
Affiliation:
Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts Department of Psychology, Wayne State University, Detroit, Massachusetts
Laura K. Levin
Affiliation:
Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts
Catherine B. Fortier
Affiliation:
Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
William P. Milberg
Affiliation:
Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
Regina E. McGlinchey
Affiliation:
Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
*
Correspondence and reprint requests to: Laura J. Grande, Psychology Service (116B), 150 South Huntington Avenue, Boston, MA 02132. E-mail: [email protected]
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Abstract

Objectives: This study investigated the relationship between close proximity to detonated blast munitions and cognitive functioning in OEF/OIF/OND Veterans. Methods: A total of 333 participants completed a comprehensive evaluation that included assessment of neuropsychological functions, psychiatric diagnoses and history of military and non-military brain injury. Participants were assigned to a Close-Range Blast Exposure (CBE) or Non-Close-Range Blast Exposure (nonCBE) group based on whether they had reported being exposed to at least one blast within 10 meters. Results: Groups were compared on principal component scores representing the domains of memory, verbal fluency, and complex attention (empirically derived from a battery of standardized cognitive tests), after adjusting for age, education, PTSD diagnosis, sleep quality, substance abuse disorder, and pain. The CBE group showed poorer performance on the memory component. Rates of clinical impairment were significantly higher in the CBE group on select CVLT-II indices. Exploratory analyses examined the effects of concussion and multiple blasts on test performance and revealed that number of lifetime concussions did not contribute to memory performance. However, accumulating blast exposures at distances greater than 10 meters did contribute to poorer performance. Conclusions: Close proximity to detonated blast munitions may impact memory, and Veterans exposed to close-range blast are more likely to demonstrate clinically meaningful deficits. These findings were observed after statistically adjusting for comorbid factors. Results suggest that proximity to blast should be considered when assessing for memory deficits in returning Veterans. Comorbid psychiatric factors may not entirely account for cognitive difficulties. (JINS, 2018, 24, 466–475)

Keywords

BlastMemoryReturning VeteransConcussionmTBIPTSD
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 24 , Issue 5 , May 2018 , pp. 466 - 475
Copyright
Copyright © The International Neuropsychological Society 2018 

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References

REFERENCES

Alosco, M., Asian, M., Du, M., Ko, J., Grande, L., Proctor, S., & Vasterling, J. (2015). Consistency of recall for deployment-related traumatic brain injury. The Journal of Head Trauma Rehabilitation, 31(5), 360–368. doi: 10.1097/HTR.0000000000000201 Google Scholar
Armistead-Jehle, P. (2010). Symptom validity test performance in U.S. veterans referred for evaluation of mild TBI. Applied Neuropsychology, 17(1), 52–59. doi: 10.1080/09084280903526182 Google Scholar
Armstrong, T., Zald, D.H., & Olatunji, B.O. (2011). Attentional control in OCD and GAD: Specificity and associations with core cognitive symptoms. Behaviour Research and Therapy, 49(11), 756–762. doi: 10.1016/j.brat.2011.08.003 Google Scholar
Bazarian, J., Donnelly, K., Peterson, D., Warner, G., Zhu, T., & Zhong, J. (2012). The relation between posttraumatic stress disorder and mild traumatic brain injury acquired during Operations Enduring Freedom and Iraqi Freedom. The Journal of Head Trauma Rehabilitation, 28(1), 1–12.Google Scholar
Belanger, H.G., Kretzmer, T., Yoash-Gantz, R., Pickett, T., & Tupler, L.A. (2009). Cognitive sequelae of blast-related versus other mechanisms of brain trauma. Journal of the International Neuropsychological Society, 15(01), 1–8.Google Scholar
Blake, D., Weathers, F., Nagy, L., Kaloupek, D., Gusman, F., Charney, D., & Keane, T.M. (2006). The development of a clinician-administered PTSD scale. Journal of Traumatic Stress, 8(1), 75–90.Google Scholar
Breedlove, E., Robinson, M., Talavage, T., Morigaki, K., Yoruk, U., O’Keefe, K., & Nauman, E. (2012). Biomechanical correlates of symptomatic and asymptomatic neurophysiological impairment in high school football. Journal of Biomechanics, 45(7), 1265–1272.Google Scholar
Brenner, L.A., Terrio, H., Homaifar, B.Y., Gutierrez, P.M., Staves, P.J., Harwood, J., & Warden, D. (2010). Neuropsychological test performance in soldiers with blast-related mild TBI. Neuropsychology, 24(2), 160.Google Scholar
Buysse, D., Reynolds, C., Month, T., Berman, S., & Kupfer, D. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28, 193–213.Google Scholar
Clark, A.L., Amick, M.M., Fortier, C., Milberg, W.P., & McGlinchey, R.E. (2014). Poor performance validity predicts clinical characteristics and cognitive test performance of OEF/OIF/OND Veterans in a research setting. The Clinical Neuropsychologist, 28(5), 802–825.Google Scholar
Clark, S., Oscar-Berman, M., Shagrin, B., & Pencina, M. (2007). Alcoholism and judgments of affective stimuli. Neuropsychology, 21(3), 346–362. doi: 10.1037/0894-4105.21.3.346 Google Scholar
Cooper, D.B., Chau, P.M., Armistead-Jehle, P., Vanderploeg, R.D., & Bowles, A.O. (2012). Relationship between mechanism of injury and neurocognitive functioning in OEF/OIF service members with mild traumatic brain injuries. Military Medicine, 177(10), 1157–1160.Google Scholar
Cooper, D.B., Vanderploeg, R.D., Armistead-Jehle, P., Lewis, J.D., & Bowles, A.O. (2014). Factors associated with neurocognitive performance in OIF/OEF servicemembers with postconcussive complaints in postdeployment clinical settings. Journal of Rehabilitation Research and Development, 51(7), 1023–1034. doi: 10.1682/JRRD.2013.05.0140 Google Scholar
Davenport, N.D., Lim, K.O., Armstrong, M.T., & Sponheim, S.R. (2012). Diffuse and spatially variable white matter disruptions are associated with blast-related mild traumatic brain injury. Neuroimage, 59(3), 2017–2024.Google Scholar
Delis, D., Kramer, J., Kaplan, E., & Ober, B. (1999). California Verbal Learning Test – Second Edition (CVLT-II) Manual. New York: The Psychological Cooperation.Google Scholar
Delis, D.C., Kaplan, E., & Kramer, J.H. (2001). Delis-Kaplan Executive Function System (D-KEFS). San Antonio, TX: Psychological Corporation.Google Scholar
First, M. B., Spitzer, R. L, Gibbon, M., & Williams, J. B. W. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV). Washington, D.C.: American Psychiatric Press, Inc.Google Scholar
Fortier, C.B., Amick, M.M., Grande, L., McGlynn, S., Kenna, A., Morra, L., & McGlinchey, R. (2014). The Boston Assessment of Traumatic Brain Injury-Lifetime (BAT-L) Semistructured interview: Evidence of research utility and validity. The Journal of Head Trauma Rehabilitation, 29(1), 89–98.Google Scholar
Fortier-Brochu, E., Beaulieu-Bonneau, S., Ivers, H., & Morin, C. (2012). Insomnia and daytime cognitive performance: A meta analysis. Sleep Medicine Reviews, 16, 83–94.Google Scholar
Golinkoff, M., & Sweeney, J.A. (1989). Cognitive impairments in depression. Journal of Affective Disorders, 17(2), 105–112.Google Scholar
Green, P. (2004). Medical Symptom Validity Test (MSVT) for Microsoft Windows: User’s manual. Paul Green Pub.Google Scholar
Greenberg, L.M., & Waldmant, I.D. (1993). Developmental normative data on The test of variables of attention (TOVA). Journal of Child Psychology and Psychiatry, 34(6), 1019–1030.Google Scholar
Han, K., Mac Donald, C.L., Johnson, A.M., Barnes, Y., Wierzechowski, L., Zonies, D., & Brody, L. (2014). Disrupted modular organization of resting-state cortical functional connectivity in US military personnel following concussive ‘mild’ blast-related traumatic brain injury. NeuroImage, 84, 76–96.Google Scholar
Heaton, R., Miller, W., Taylor, M., & Grant, I. (2004). Revised comprehensive norms for an expanded Halstead-Reitan Battery: Demographically adjucted neuropsychological norms for African American and Caucasian adults. Professional Manual. Lutz, FL: Psychological Assessment Resources, Inc.Google Scholar
Hoge, C.W., McGurk, D., Thomas, J.L., Cox, A.L., Engel, C.C., & Castro, C.A. (2008). Mild traumatic brain injury in US soldiers returning from Iraq. New England Journal of Medicine, 358(5), 453–463.Google Scholar
Huber, B. R., Meabon, J. S., Martin, T. J., Mourad, P. D., Bennett, R., Kraemer, B. C., & Cook, D. G. (2013). Blast exposure causes early and persistent aberrant phospho- and cleaved-tau expression in a murine model of mild blast-induced traumatic brain injury. Journal of Alzheimers Disease, 37(2), 309–323.Google Scholar
Iudicello, J.E., Weber, E., Grant, I., Weinborn, M., & Woods, S.P., HIV Neurobehavioral Research Center (HNRC) Group. (2011). Misremembering future intentions in methamphetamine-dependent individuals. The Clinical Neuropsychologist, 25(2), 269–286. doi: 10.1080/13854046.2010.546812 Google Scholar
Johnson, B., Neuberger, T., Gay, M., Hallett, M., & Slobounov, S. (2014). Effects of subconcussive head trauma on the default mode network of the brain. Journal of Neurotrauma, 31(23), 1907–1913.Google Scholar
Jorge, R.E., Acion, L., White, T., Tordesillas-Gutierrez, D., Pierson, R., Crespo-Facorro, B., && Magnotta, V.A. (2012). White matter abnormalities in veterans with mild traumatic brain injury. American Journal of Psychiatry, 169(12), 1284–1291.Google Scholar
Kaiser, H.F. (1960). The application of electronic computers to factor analysis. Educational and Psychological Measurement, 20, 141–151.Google Scholar
Kim, J.S., Yang, J.J., Lee, D.K., Lee, J.M., Youn, J., & Cho, J.W. (2015). Cognitive impairment and its structural correlates in the Parkinsonian subtype of multiple system atrophy. Neuro-Degenerative Diseases, 15(5), 294–300. doi: 10.1159/000430953 CrossRefGoogle ScholarPubMed
Koerte, I.K., Lin, A.P., Muehlmann, M., Merugumala, S., Liao, H., Starr, T., & Shenton, M. (2015). Altered neurochemistry in former professional soccer players without a history of concussion. Journal of Neurotrauma, 32, 1287–1293.Google Scholar
Levin, H.S., Wilde, E., Troyanskaya, M., Petersen, N.J., Scheibel, R.S., Newsome, M.R., & Li, X. (2010). Diffusion tensor imaging of mild to moderate blast-related traumatic brain injury and its sequelae. Journal of Neurotrauma, 27(4), 683–694.Google Scholar
Lippa, S., Fonda, J., Fortier, C., Amick, M., Kenna, A., Milberg, W., && McGlinchey, R. (2014). Deployment-related psychological and behavioral conditions and their association with functional disability in OEF/OIF/OND Veterans. Journal of Traumatic Stress, 28(1), 25–33.Google Scholar
Lippa, S.M., Pastorek, N.J., Benge, J.F., & Thornton, G. (2010). Postconcussive symptoms after blast and nonblast-related mild traumatic brain injuries in Afghanistan and Iraq war veterans. Journal of the International Neuropsychological Society, 16(05), 856–866.Google Scholar
Luethcke, C.A., Bryan, C.J., Morrow, C.E., & Isler, W.C. (2011). Comparison of concussive symptoms, cognitive performance, and psychological symptoms between acute blast-versus nonblast-induced mild traumatic brain injury. Journal of the International Neuropsychological Society, 17(01), 36–45.Google Scholar
MacDonald, C.L., Barber, J., Andre, J., Evans, N., Panks, C., Sun, S., & Temkin, N. (2017). 5-Year imaging sequelae of concussive blast injury and relation to early clinical outcome. Neuroimage. Clinical, 9(14), 371–383.Google Scholar
MacDonald, C.L., Barber, J., Jordan, M., Johnson, A.M., Dikmen, S., Fann, J.R., && Temkin, N. (2017). Early clinical predictors of 5-year outcome after concussive blast traumatic brain injury. JAMA Neurology, 74(7), 821–829.CrossRefGoogle Scholar
MacNamara, A., & Proudfit, G.H. (2014). Cognitive load and emotional processing in generalized anxiety disorder: Electrocortical evidence for increased distractibility. Journal of Abnormal Psychology, 123(3), 557–565. doi: 10.1037/a0036997 Google Scholar
Management of Concussion/mTBI Working Group. (2009). VA/DoD clinical practice guideline for the management of concussion/mild traumatic brain injury. Journal of Rehabilitation Research and Development, 46, CP1–CP68.CrossRefGoogle Scholar
McCormick, C.L., Yoash-Gantz, R.E., McDonald, S.D., Campbell, T.C., & Tupler, L.A. (2013). Performance on the Green Word Memory Test following Operation Enduring Freedom/Operation Iraqi Freedom-era military service: Test failure is related to evaluation context. Archives of Clinical Neuropsychology, 28(8), 808–823. doi: 10.1093/arclin/act050 Google Scholar
McGlinchey, R., Milberg, W., Fonda, J., & Fortier, C. (2017). A methodology for assessing deployment trauma and its consequences in OEF/OIF/OND veterans: The TRACTS longitudinal prospective cohort study. International Journal of Methods in Psychiatric Research, 26, e1556. doi.org/ 10.1002/mpr.1556 CrossRefGoogle ScholarPubMed
Melzack, R. (1987). The short-form McGill Pain Questionnaire. Pain, 30, 191–197.Google Scholar
Mendez, M.F., Owens, E.M., Reza Berenji, G., Peppers, D.C., Liang, L.J., & Licht, E.A. (2013). Mild traumatic brain injury from primary blast vs. blunt forces: Post-concussion consequences and functional neuroimaging. NeuroRehabilitation, 32(2), 397–407. doi: 10.3233/NRE-130861 Google Scholar
Miller, M.A. (2015). The role of sleep and sleep disorders in the development, diagnosis, and management of neurocognitive disorders. Frontiers in Neurology, 6, 224. doi: 10.3389/fneur.2015.00224 Google Scholar
Montgomery, C., Seddon, A.L., Fisk, J.E., Murphy, P.N., & Jansari, A. (2012). Cannabis-related deficits in real-world memory. Human Psychopharmacology, 27(2), 217–225. doi: 10.1002/hup.1273 Google Scholar
Neipert, L., Pastorek, N.J., Troyanskaya, M., Scheibel, R.S., Petersen, N.J., & Levin, H.S. (2014). Effect of clinical characteristics on cognitive performance in service members and veterans with histories of blast-related mild traumatic brain injury. Brain Injury, 28(13-14), 1667–1674. doi: 10.3109/02699052.2014.947623 Google Scholar
O’Connor, B.P. (2000). SPSS and SAS programs for determining the number of components using parallel analysis and Velicer’s MAP test. Behavior Research Methods, Instrumentation, and Computers, 32, 396–402.Google Scholar
O’Neil, M.E., Carlson, K.F., Storzbach, D., Brenner, L.A., Freeman, M., Quinones, A.R., & Kansagara, D. (2014). Factors associated with mild traumatic brain injury in veterans and military personnel: A systematic review. Journal of the International Neuropsychological Society, 20(3), 249–261. doi: 10.1017/S1355617714000204 Google Scholar
Owens, B.D., Kragh, J.F. Jr, Wenke, J.C., Macaitis, J., Wade, C.E., & Holcomb, J.B. (2008). Combat wounds in Operation Iraqi Freedom and Operation Enduring Freedom. Journal of Trauma and Acute Care Surgery, 64(2), 295–299.Google Scholar
Petrie, E.C., Cross, D.J., Yarnykh, V.L., Richards, T., Martin, N.M., Pagulayan, K., & Peskind, E.R. (2013). Neuroimaging, behavioral, and psychological sequelae of repetitive combined blast/impact mild traumatic brain injury in Iraq and Afghanistan war veterans. Journal of Neurotrauma, 31(5), 425–436. doi: 10.1089/neu.2013.2952 CrossRefGoogle Scholar
Piechatzek, M., Indlekofer, F., Daamen, M., Glasmacher, C., Lieb, R., Pfister, H., & Schutz, G. (2009). Is moderate substance use associated with altered executive functioning in a population-based sample of young adults? Human Psychopharmacology, 24(8), 650–665. doi: 10.1002/hup.1069 Google Scholar
Poole, V., Abbas, K., Shenk, T., Breedlove, E., Breedlove, K., Robinson, M., & Dydak, U. (2014). MR spectroscopic evidence of brain injury in the non-diagnosed collision sport athlete. Journal of Developmental Neuropsychology, 39(6), 459–473.Google Scholar
Robinson, M.E., Lindemer, E.R., Fonda, J.R., Milberg, W.P., McGlinchey, R.E., & Salat, D.H. (2015). Close-range blast exposure is associated with altered functional connectivity in Veterans independent of concussion symptoms at time of exposure. Human Brain Mapping, 36(3), 911–922.Google Scholar
Robinson, M.E., Shenk, T.E., Breedlove, E.L., Leverenz, L.J., Nauman, E.A., & Talavage, T.M. (2015). The role of location of subconcussive head impacts in fMRI brain activation changes. Journal of Developmental Neuropsychology, 40(2), 74–79.Google Scholar
Rourke, S., & Grant, I. (2009). The neurobehavioral correlates of alcoholism. In I. Grant & K. Adams (Eds.), Neuropsychological assessment of neuropsychiatric and neuromedical disorders (pp. 398–454). Oxford: Oxford University Press.Google Scholar
Soble, J.R., Spanierman, L.B., & Fitzgerald Smith, J. (2013). Neuropsychological functioning of combat veterans with posttraumatic stress disorder and mild traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 35(5), 551–561. doi: 10.1080/13803395.2013.798398 Google Scholar
Solowij, N., & Battisti, R. (2008). The chronic effects of cannabis on memory in humans: A review. Curr Drug Abuse Reviews, 1(1), 81–98.Google Scholar
Stevens, S. (2002). Applied Multivariate Statistics for Social Sciences Fourth Edition. Mahwah: Lawrence Erlbaum Association.Google Scholar
Storzbach, D., O’Neil, M.E., Roost, S.M., Kowalski, H., Iverson, G.L., Binder, L.M., & Huckins, M. (2015). Comparing the neuropsychological test performance of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans with and without blast exposure, mild traumatic brain injury, and posttraumatic stress symptoms. Journal of the International Neuropsychological Society, 21(5), 353–363. doi: 10.1017/S1355617715000326 Google Scholar
Stricker, N., Lippa, S., Green, D., McGlynn, S., Grande, L., Milberg, W., & McGlinchey, R. (2016). Elevated rates of memory impairment in military service-members and veterans with posttraumatic stress disorder. Journal of Clinical and Experimental Neuropyschology, 15, 1–18. doi.org/ 10.1080/13803395.2016.1264575 Google Scholar
Taber, K., Hurley, R., Haswell, C., Rowland, J., Hurt, S., Lamar, C., & Morey, R. (2015). White matter compromise in veterans exposed to primary blastforces. The Journal of Head Trauma Rehabilitation, 30(1), E15–E25.Google Scholar
Tompkins, P., Tesiram, Y., Lerner, M., Gonzalez, L., Lightfoot., S., Rabb, C., & Brackett, D. (2013). Brain injury: Neuroinflammation, cognitive deficit, and magnetic resonance imaging in a model of blast induced traumatic brain injury. Journal of Neurotrauma, 30, 1888–1897.Google Scholar
Trotter, B.B., Robinson, M.E., Milberg, W.P., McGlinchey, R.E., & Salat, D.H. (2015). Military blast exposure, ageing, and white matter integrity. Brain, 138(8), 2278–2292.Google Scholar
Tweedie, D., Rachmany, L., Rubovitch, V., Zhang, Y., Becker, K.G., Perez, E., & Greig, N. (2013). Changes in mouse cognition and hippocampal gene expression observed in a mild physical-and blast-traumatic brain injury. Neurobiology of Disease, 54, 1–11.Google Scholar
Verfaellie, M., Lafleche, G., Spiro, A., Tun, C., & Bousquet, K. (2012). Chronic postconcussion symptoms and functional outcomes in OEF/OIF veterans with self-report of blast exposure. Journal of the International Neuropsychological Society, 19(1), 1.CrossRefGoogle ScholarPubMed
Whitney, K.A., Shepard, P.H., Williams, A.L., Davis, J.J., & Adams, K.M. (2009). The Medical Symptom Validity Test in the evaluation of Operation Iraqi Freedom/Operation Enduring Freedom soldiers: A preliminary study. Archives of Clinical Neuropsychology, 24(2), 145–152. doi: 10.1093/arclin/acp020 Google Scholar
Wong, Y., Ng, K., Kan, E., Tan, M., Verma, S., Prakesh, B., & Lu, J. (2014). White matter injury in a rodent model of blast injury. Journal of Neurotrauma, 31(12), A25.Google Scholar
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