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Erschienen in: Neuropsychology Review 4/2014

01.12.2014 | Review

Blast-Related Mild Traumatic Brain Injury: A Bayesian Random-Effects Meta-Analysis on the Cognitive Outcomes of Concussion among Military Personnel

verfasst von: Justin E. Karr, Corson N. Areshenkoff, Emily C. Duggan, Mauricio A. Garcia-Barrera

Erschienen in: Neuropsychology Review | Ausgabe 4/2014

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Abstract

Throughout their careers, many soldiers experience repeated blasts exposures from improvised explosive devices, which often involve head injury. Consequentially, blast-related mild Traumatic Brain Injury (mTBI) has become prevalent in modern conflicts, often occuring co-morbidly with psychiatric illness (e.g., post-traumatic stress disorder [PTSD]). In turn, a growing body of research has begun to explore the cognitive and psychiatric sequelae of blast-related mTBI. The current meta-analysis aimed to evaluate the chronic effects of blast-related mTBI on cognitive performance. A systematic review identified 9 studies reporting 12 samples meeting eligibility criteria. A Bayesian random-effects meta-analysis was conducted with cognitive construct and PTSD symptoms explored as moderators. The overall posterior mean effect size and Highest Density Interval (HDI) came to d = −0.12 [−0.21, −0.04], with executive function (−0.16 [−0.31, 0.00]), verbal delayed memory (−0.19 [−0.44, 0.06]) and processing speed (−0.11 [−0.26, 0.01]) presenting as the most sensitive cognitive domains to blast-related mTBI. When dividing executive function into diverse sub-constructs (i.e., working memory, inhibition, set-shifting), set-shifting presented the largest effect size (−0.33 [−0.55, −0.05]). PTSD symptoms did not predict cognitive effects sizes, β PTSD  = −0.02 [−0.23, 0.20]. The results indicate a subtle, but chronic cognitive impairment following mTBI, especially in set-shifting, a relevant aspect of executive attention. These findings are consistent with past meta-analyses on multiple mTBI and correspond with past neuroimaging research on the cognitive correlates of white matter damage common in mTBI. However, all studies had cross-sectional designs, which resulted in universally low quality ratings and limited the conclusions inferable from this meta-analysis.
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Metadaten
Titel
Blast-Related Mild Traumatic Brain Injury: A Bayesian Random-Effects Meta-Analysis on the Cognitive Outcomes of Concussion among Military Personnel
verfasst von
Justin E. Karr
Corson N. Areshenkoff
Emily C. Duggan
Mauricio A. Garcia-Barrera
Publikationsdatum
01.12.2014
Verlag
Springer US
Erschienen in
Neuropsychology Review / Ausgabe 4/2014
Print ISSN: 1040-7308
Elektronische ISSN: 1573-6660
DOI
https://doi.org/10.1007/s11065-014-9271-8

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