Mild TBI Sustained in Traumatic Context Associated With Worse Long-Term Outcomes
Mild traumatic brain injury (mTBI) that occurred in the context of psychological trauma, or peritraumatic mTBI, was associated with poorer long-term outcomes, including greater posttraumatic stress disorder (PTSD) severity, postconcussive symptoms, and disability, according to a study published in JAMA Network Open.
“In contrast, and perhaps most critically, the nonperitraumatic mTBI and no TBI groups did not significantly differ in any study outcomes, which indicated that mTBI was only associated with negative long-term outcomes when it co-occurred with a traumatic event exposure,” wrote corresponding author Emily J. Van Etten, PhD, of the Veterans Affairs Boston Healthcare System, Boston, Massachusetts, and study coauthors.
The cohort study included 567 post-9/11 US veterans with an average age of 33.72 years. Among them, 195 veterans had a history of peritraumatic mTBI, 189 veterans had a history of nonperitraumatic mTBI, and 183 veterans had no TBI history.
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Researchers compared PTSD severity as measured by the Clinician-Administered PTSD Scale–4th edition, postconcussive symptoms as measured by the Neurobehavioral Symptom Inventory, and self-reported disability status among the groups.
Analyses showed that veterans with a history of peritraumatic mTBI had more severe PTSD, more postconcussive symptoms, and more disability than the nonperitraumatic mTBI and no TBI groups. However, when researchers compared the nonperitraumatic mTBI and no TBI groups, they found no significant differences on any long-term outcome measures.
“This finding raises a novel hypothesis of the association of mTBI with PTSD, in which the acute biological and physiological outcomes of mTBI may be associated with temporarily scaffolding the formation of PTSD symptoms,” researchers wrote, “which could enhance the production of long-term postconcussive symptoms and disability.”
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