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Roy MJ, Costanzo M, Gill J, et al. Predictors of Neurocognitive Syndromes in Combat Veterans. Cureus. 2015;7(7):e293doi: 10.7759/cureus.293.
Roy, M. J., Costanzo, M., Gill, J., Leaman, S., Law, W., Ndiongue, R., Taylor, P., Kim, H. S., Bieler, G. S., Garge, N., Rapp, P. E., Keyser, D., Nathan, D., Xydakis, M., Pham, D., & Wassermann, E. (2015). Predictors of Neurocognitive Syndromes in Combat Veterans. Cureus, 7(7), e293. https://doi.org/10.7759/cureus.293
Roy, Michael J, et al. "Predictors of Neurocognitive Syndromes in Combat Veterans." Cureus vol. 7,7 (2015): e293. doi: https://doi.org/10.7759/cureus.293
Roy MJ, Costanzo M, Gill J, Leaman S, Law W, Ndiongue R, Taylor P, Kim HS, Bieler GS, Garge N, Rapp PE, Keyser D, Nathan D, Xydakis M, Pham D, Wassermann E. Predictors of Neurocognitive Syndromes in Combat Veterans. Cureus. 2015 Jul 30;7(7):e293. doi: 10.7759/cureus.293. eCollection 2015 Jul. PMID: 26251769; PMCID: PMC4524772.
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Cureus. 2015 Jul 30;7(7):e293. doi: 10.7759/cureus.293. eCollection 2015 Jul.

Predictors of Neurocognitive Syndromes in Combat Veterans.

Cureus

Michael J Roy, Michelle Costanzo, Jessica Gill, Suzanne Leaman, Wendy Law, Rochelle Ndiongue, Patricia Taylor, Hyung-Suk Kim, Gayle S Bieler, Nikhil Garge, Paul E Rapp, David Keyser, Dominic Nathan, Michael Xydakis, Dzung Pham, Eric Wassermann

Affiliations

  1. Department of Medicine, Uniformed Services University of the Health Sciences.
  2. National Institute of Nursing Research, National Institutes of Health.
  3. Traumatic Brain Injury Service, Walter Reed National Military Medical Center.
  4. National Intrepid Center of Excellence, Walter Reed National Military Medical Center.
  5. National Institute of Nursing Research , National Institutes of Health.
  6. RTI International.
  7. Traumatic Injury Research Program, Uniformed Services University of the Health Sciences.
  8. Traumatic Brain Injury Service, Uniformed Services University of the Health Sciences.
  9. Department of Surgery , Uniformed Services University of the Health Sciences.
  10. Image Processing Core, Center for Neuroscience and Regenerative Medicine, Henry Jackson Foundation.
  11. Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health.

PMID: 26251769 PMCID: PMC4524772 DOI: 10.7759/cureus.293

Abstract

Traumatic brain injury, depression and posttraumatic stress disorder (PTSD) are neurocognitive syndromes often associated with impairment of physical and mental health, as well as functional status. These syndromes are also frequent in military service members (SMs) after combat, although their presentation is often delayed until months after their return. The objective of this prospective cohort study was the identification of independent predictors of neurocognitive syndromes upon return from deployment could facilitate early intervention to prevent disability. We completed a comprehensive baseline assessment, followed by serial evaluations at three, six, and 12 months, to assess for new-onset PTSD, depression, or postconcussive syndrome (PCS) in order to identify baseline factors most strongly associated with subsequent neurocognitive syndromes. On serial follow-up, seven participants developed at least one neurocognitive syndrome: five with PTSD, one with depression and PTSD, and one with PCS. On univariate analysis, 60 items were associated with syndrome development at p < 0.15. Decision trees and ensemble tree multivariate models yielded four common independent predictors of PTSD: right superior longitudinal fasciculus tract volume on MRI; resting state connectivity between the right amygdala and left superior temporal gyrus (BA41/42) on functional MRI; and single nucleotide polymorphisms in the genes coding for myelin basic protein as well as brain-derived neurotrophic factor. Our findings require follow-up studies with greater sample size and suggest that neuroimaging and molecular biomarkers may help distinguish those at high risk for post-deployment neurocognitive syndromes.

Keywords: biomarkers; combat military veterans; depression; neuroimaging; posttraumatic stress disorder; traumatic brain injury

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