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Analysis of Post-Deployment Cognitive Performance and Symptom Recovery in U.S. Marines

BACKGROUND: Computerized neurocognitive testing (NCAT) has been proposed to be useful as a screening tool for post-deployment cognitive deficits in the setting of mild traumatic brain injury (mTBI). We assessed the clinical utility of post-injury/post-deployment Automated Neurocognitive Assessment M...

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Autores principales: Haran, F. J., Alphonso, Aimee L., Creason, Alia, Campbell, Justin S., Johnson, Dagny, Young, Emily, Tsao, Jack W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3842275/
https://www.ncbi.nlm.nih.gov/pubmed/24312183
http://dx.doi.org/10.1371/journal.pone.0079595
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author Haran, F. J.
Alphonso, Aimee L.
Creason, Alia
Campbell, Justin S.
Johnson, Dagny
Young, Emily
Tsao, Jack W.
author_facet Haran, F. J.
Alphonso, Aimee L.
Creason, Alia
Campbell, Justin S.
Johnson, Dagny
Young, Emily
Tsao, Jack W.
author_sort Haran, F. J.
collection PubMed
description BACKGROUND: Computerized neurocognitive testing (NCAT) has been proposed to be useful as a screening tool for post-deployment cognitive deficits in the setting of mild traumatic brain injury (mTBI). We assessed the clinical utility of post-injury/post-deployment Automated Neurocognitive Assessment Metric (ANAM) testing, using a longitudinal design to compare baseline ANAM tests with two post-deployment ANAM tests in a group of Marines who experienced combat during deployment. METHODS AND FINDINGS: Post-deployment cognitive performance and symptom recovery were compared in a subsample of 1324 U.S. Marines with high rates of combat exposure during deployment. Of the sample, 169 Marines had available baseline and twice repeated post-deployment ANAM results. A retrospective analysis of the ANAM data, which consisted of a self-report questionnaire about deployment-related blast exposure, recent history of mTBI, current clinical symptoms, and cognitive performance. Self-reported concussion sustained anytime during deployment was associated with a decrease in cognitive performance measured between 2–8 weeks post-deployment. At the second post-deployment test conducted on average eight months later, performance on the second simple reaction time test, in particular, remained impaired and was the most consistent and sensitive indicator of the cognitive decrements. Additionally, post-concussive symptoms were shown to persist in injured Marines with a self-reported history of concussion for an additional five months after most cognitive deficits resolved. Results of this study showed a measurable deployment effect on cognitive performance, although this effect appears to resolve without lasting clinical sequelae in those without history of deployment-related concussion. CONCLUSIONS: These results highlight the need for a detailed clinical examination for service members with history of concussion and persistent clinical symptoms. Reliance solely upon computerized neurocognitive testing as a method for identifying service members requiring clinical follow-up post-concussion is not recommended, as cognitive functioning only slowly returned to baseline levels in the setting of persistent clinical symptoms.
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spelling pubmed-38422752013-12-05 Analysis of Post-Deployment Cognitive Performance and Symptom Recovery in U.S. Marines Haran, F. J. Alphonso, Aimee L. Creason, Alia Campbell, Justin S. Johnson, Dagny Young, Emily Tsao, Jack W. PLoS One Research Article BACKGROUND: Computerized neurocognitive testing (NCAT) has been proposed to be useful as a screening tool for post-deployment cognitive deficits in the setting of mild traumatic brain injury (mTBI). We assessed the clinical utility of post-injury/post-deployment Automated Neurocognitive Assessment Metric (ANAM) testing, using a longitudinal design to compare baseline ANAM tests with two post-deployment ANAM tests in a group of Marines who experienced combat during deployment. METHODS AND FINDINGS: Post-deployment cognitive performance and symptom recovery were compared in a subsample of 1324 U.S. Marines with high rates of combat exposure during deployment. Of the sample, 169 Marines had available baseline and twice repeated post-deployment ANAM results. A retrospective analysis of the ANAM data, which consisted of a self-report questionnaire about deployment-related blast exposure, recent history of mTBI, current clinical symptoms, and cognitive performance. Self-reported concussion sustained anytime during deployment was associated with a decrease in cognitive performance measured between 2–8 weeks post-deployment. At the second post-deployment test conducted on average eight months later, performance on the second simple reaction time test, in particular, remained impaired and was the most consistent and sensitive indicator of the cognitive decrements. Additionally, post-concussive symptoms were shown to persist in injured Marines with a self-reported history of concussion for an additional five months after most cognitive deficits resolved. Results of this study showed a measurable deployment effect on cognitive performance, although this effect appears to resolve without lasting clinical sequelae in those without history of deployment-related concussion. CONCLUSIONS: These results highlight the need for a detailed clinical examination for service members with history of concussion and persistent clinical symptoms. Reliance solely upon computerized neurocognitive testing as a method for identifying service members requiring clinical follow-up post-concussion is not recommended, as cognitive functioning only slowly returned to baseline levels in the setting of persistent clinical symptoms. Public Library of Science 2013-11-27 /pmc/articles/PMC3842275/ /pubmed/24312183 http://dx.doi.org/10.1371/journal.pone.0079595 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration, which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.
spellingShingle Research Article
Haran, F. J.
Alphonso, Aimee L.
Creason, Alia
Campbell, Justin S.
Johnson, Dagny
Young, Emily
Tsao, Jack W.
Analysis of Post-Deployment Cognitive Performance and Symptom Recovery in U.S. Marines
title Analysis of Post-Deployment Cognitive Performance and Symptom Recovery in U.S. Marines
title_full Analysis of Post-Deployment Cognitive Performance and Symptom Recovery in U.S. Marines
title_fullStr Analysis of Post-Deployment Cognitive Performance and Symptom Recovery in U.S. Marines
title_full_unstemmed Analysis of Post-Deployment Cognitive Performance and Symptom Recovery in U.S. Marines
title_short Analysis of Post-Deployment Cognitive Performance and Symptom Recovery in U.S. Marines
title_sort analysis of post-deployment cognitive performance and symptom recovery in u.s. marines
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3842275/
https://www.ncbi.nlm.nih.gov/pubmed/24312183
http://dx.doi.org/10.1371/journal.pone.0079595
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