Poor cognitive scores indicate probable PTSD following TBI

Poor performance on cognitive tests assessing memory-related motor function and verbal recall is linked to probable PTSD in adults with traumatic brain injury, according to a cross-sectional study published in Brain and Spine.

“In addition to psychological and cognitive symptoms as a consequence of TBI, PTSD may be a contributing factor, and is also associated to cognitive impairment,” Dominique Van Praag, a researcher in the department of psychology at the University of Antwerp in Belgium, and colleagues wrote. “TBI is an established risk factor for PTSD: PTSD is diagnosed in 14% of TBI cases in the civilian setting within the first year after injury and in 7% after one year.”

Researchers conducted a study, part of the Collaborative European Neurotrauma Effectiveness Research (CENTER-TBI) project, to identify neurocognitive problems associated with probable PTSD following TBI within a sample of European civilians. They included 1,134 participants with varying levels of TBI, aged older than 15 years and with a Glasgow Outcome Score Extended (GOSE) above 3.

Participants were assessed at 6 months post-injury with several cognitive examinations, including PTSD Checklist-5 (PCL-5), the Trail Making Test (TMT), the Rey Auditory Verbal Learning Test (RAVLT) and the Cambridge Neuropsychological Test Automated Battery. Researchers used regression analyses to investigate associations between the PCL-5 and degree of cognition.

According to study results, 13.5% of participants tested positive for PTSD at the 6-month evaluation.. Probable PTSD was significantly associated with higher TMT-(B-A) (OR = 1.35; 95% CI, 1.14-1.60) and lower RAVLT-delayed recall scores (OR = 0.74; 95% CI, 0.61-0.91) after controlling for age, sex, psychiatric history, baseline Glasgow Coma Scale and education.

“Performance on tests of cognitive flexibility and, to a lesser extent, delayed verbal recall, are associated with probable PTSD following TBI, regardless of the severity of the injury,” Van Praag and colleagues wrote. “Future research should investigate the impact of cognitive functioning after TBI on the natural course of PTSD symptoms, explore which cognitive strengths or weaknesses influence its course, and investigate the effects of PTSD treatment on attention cognitive flexibility and verbal memory.”