Abstract
Objective
To determine if elevated rapid-response impulsivity after blast exposure (as a putative
marker of ventral prefrontal cortex [vPFC] damage) is predictive of future elevated
affective symptomatology in blast-exposed service members.
Design
Longitudinal design with neurocognitive testing at initial assessment and 1-year follow-up
assessment of psychiatric symptomatology by telephone interview.
Setting
Veterans Administration medical centers and postdeployment assessment centers at military
bases.
Participants
Blast-exposed U.S. military personnel (N=84) ages 19 to 39 years old.
Interventions
Not applicable.
Main Outcome Measures
Center for Epidemiological Studies-Depression Scale (CES-D) scores, Posttraumatic
Stress Disorder Checklist Version 5 (PCL-5) scores, and Alcohol Use Disorders Identification
Test-C (AUDIT-C) scores at the 12-month follow-up telephone interview.
Results
After controlling for age and affective symptom scores reported at the initial assessment,
commission errors on the Continuous Performance Test-II of the initial assessment
were predictive of higher symptom scores on the CES-D and PCL-5 at follow-up, but
were not predictive of AUDIT-C scores.
Conclusions
Elevated rapid-response impulsivity, as a behavioral marker of reduced top-down frontocortical
control, is a risk factor for elevated mood and posttraumatic stress disorder symptoms
over time in blast-exposed individuals. Future longitudinal studies with predeployment
neurobehavioral testing could enable attribution of this relation to blast-related
vPFC damage.
Keywords
List of abbreviations:
AUDIT-C (Alcohol Use Disorders Identification Test-C), CE (commission error), CES-D (Center for Epidemiological Studies-Depression Scale), CPT-II (Continuous Performance Test version II), fMRI (functional magnetic resonance imaging), mTBI (mild traumatic brain injury), OE (omission error), OEF/OIF/OND (Operations Enduring Freedom, Iraqi Freedom, and/or New Dawn), PCL-5 (Posttraumatic Stress Disorder Checklist Version 5), PTSD (posttraumatic stress disorder), TBI (traumatic brain injury), ToMM (Test of Memory Malingering), vPFC (ventral prefrontal cortex), WTAR (Wechsler Test of Adult Reading)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 21, 2017
Footnotes
Supported by the Congressionally Directed Medical Research Projects (award no. W91ZSQ8118N620); the Defense and Veterans Brain Injury Center; the National Institutes of Health (grant nos. 1U01DA041120, P50DA033935, U54DA038999, and R01DA034131); Boehringer-Ingelheim; and the Veterans Health Administration, Office of Research and Development.
The views expressed are those of the authors and do not necessarily represent or reflect the policy or position of the Department of the Army, Department of Defense, the U.S. Government, the Department of Veterans Affairs, or any of the institutions with which the authors are affiliated.
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
