Blast-related mild traumatic brain injury in the acute phase: Acute stress reactions partially mediate the relationship between loss of consciousness and symptoms. (July 2014)

• Record Type: Journal Article
• Authors: Norris, Jacob N.; Sams, Richard; Lundblad, Peter; Frantz, Earl; Harris, Erica
• Is Part Of: Brain injury. Volume 28:Number 8(2014)
• Page Start: 1052
• Page End: 1062
• Publication Date: 2014-07
• Subjects: Brain damage -- Periodicals; Brain -- Wounds and injuries -- Periodicals; Brain Injuries -- Periodicals; 617.481
• DOI: 10.3109/02699052.2014.891761
• Languages: English
• ISSNs: 0269-9052

Abstract

<abstract> <title>Abstract</title> <p> <italic>Primary objective</italic>: The objective was to compare symptoms in service members diagnosed with a blast-related mTBI (mild traumatic brain injury) with a loss of consciousness (LOC) to those without LOC.</p> <p> <italic>Research design</italic>: Clinicians saw US military personnel within 72 hours of sustaining a blast-related mTBI and at a follow-up visit 48–72 hours later (<italic>n</italic> = 210).</p> <p> <italic>Methods and procedures</italic>: Demographics, post-concussive symptoms, diagnosis of acute stress reaction (ASR) and simple reaction time data from the Automated Neuropsychological Assessment Metric (ANAM) were collected.</p> <p> <italic>Main outcomes and results</italic>: ASRs were significantly more likely in patients reporting LOC versus patients reporting no LOC. At the first post-injury visit, LOC was associated with difficulty sleeping, hearing loss, memory problems and reporting more symptoms. A follow-up analysis explored if symptomatic differences were influenced by ASR. Adjusting for ASR, the statistical relationships between LOC and symptoms were weaker (i.e. reduced Odds Ratios). At the follow-up visit, difficulty sleeping was associated with LOC before and after adjusting for ASR. Patients with both ASR and LOC had the slowest simple reaction times.</p> <p> <italic>Conclusions</italic>: Results suggest ASR may partially mediate symptom presentation and cognitive dysfunction in the acute phase following blast-related mTBI. Future research is warranted.</p> </abstract>