Skip to main content

Advertisement

SpringerLink
Log in

Update on TBI and Cognitive Impairment in Military Veterans

  • Dementia (KS Marder, Section Editor)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Traumatic brain injury (TBI) is a common cause of morbidity and mortality in military life. Interest in military TBI has increased recently due to the conflicts in Iraq and Afghanistan. Certain types of TBI are relatively unique to the military, the most prominent being blast-related TBI. Blast-related mild TBI has been of particular concern in veterans from the most recent conflicts although controversy remains concerning its separation from post-traumatic stress disorder. TBI is also a risk factor for the later development of neurodegenerative diseases in which cognitive impairment is prominent putting veterans at risk for disorders including Alzheimer’s disease and chronic traumatic encephalopathy. Recent evidence associating TBI with chronic cognitive impairment is reviewed in the context of its relevance to military veterans.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Hyder AA, Wunderlich CA, Puvanachandra P, Gururaj G, Kobusingye OC. The impact of traumatic brain injuries: a global perspective. NeuroRehabilitation. 2007;22(5):341–53.

    PubMed  Google Scholar 

  2. Gardner RC, Yaffe K. Epidemiology of mild traumatic brain injury and neurodegenerative disease. Mol Cell Neurosci. 2015. doi:10.1016/j.mcn.2015.03.001.

    PubMed  Google Scholar 

  3. Gubata ME, Packnett ER, Blandford CD, Piccirillo AL, Niebuhr DW, Cowan DN. Trends in the epidemiology of disability related to traumatic brain injury in the US Army and Marine Corps: 2005 to 2010. J Head Trauma Rehabil. 2014;29(1):65–75. doi:10.1097/HTR.0b013e318295f590.

    Article  PubMed  Google Scholar 

  4. Stroupe KT, Smith BM, Hogan TP, St Andre JR. Healthcare utilization and costs of veterans screened and assessed for traumatic brain injury. J Rehabil Res Dev. 2013;50(8):1047–68. doi:10.1682/JRRD.2012.06.0107.

    Article  PubMed  Google Scholar 

  5. DePalma RG. TBI combat history, epidemiology and injury modes. In: Kobeissy F, editor. Brain neurotrauma: molecular, neuropsychological, and rehabilitation aspects. Boca Raton FL, USA: CRC Press; 2015. p. 5–14.

    Google Scholar 

  6. Kaufman HH. Treatment of head injuries in the American Civil War. J Neurosurg. 1993;78(5):838–45. doi:10.3171/jns.1993.78.5.0838.

    Article  CAS  PubMed  Google Scholar 

  7. Cifu DX, Cohen SI, Lew HL, Jaffee M, Sigford B. The history and evolution of traumatic brain injury rehabilitation in military service members and veterans. Am J Phys Med Rehabil. 2010;89(8):688–94. doi:10.1097/PHM.0b013e3181e722ad.

    Article  PubMed  Google Scholar 

  8. Defense and Veterans Brain Injury Center. http://dvbic.dcoe.mil/dod-worldwide-numbers-tbi. Accessed July 12, 2015

  9. Chapman JC, Diaz-Arrastia R. Military traumatic brain injury: a review. Alzheimers Dement. 2014;10(3 Suppl):S97–104. doi:10.1016/j.jalz.2014.04.012.

    Article  PubMed  Google Scholar 

  10. Rabinowitz AR, Levin HS. Cognitive sequelae of traumatic brain injury. Psychiatr Clin North Am. 2014;37(1):1–11. doi:10.1016/j.psc.2013.11.004.

    Article  PubMed Central  PubMed  Google Scholar 

  11. DeKosky ST, Ikonomovic MD, Gandy S. Traumatic brain injury: football, warfare, and long-term effects. N Engl J Med. 2010;363:1293–6.

    Article  CAS  PubMed  Google Scholar 

  12. Gandy S, Ikonomovic MD, Mitsis E, Elder G, Ahlers ST, Barth J, et al. Chronic traumatic encephalopathy: clinical-biomarker correlations and current concepts in pathogenesis. Mol Neurodegener. 2014;9:37. doi:10.1186/1750-1326-9-37.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. Soldiers returning from Iraq. N Engl J Med. 2008;358(5):453–63.

    Article  CAS  PubMed  Google Scholar 

  14. Tanielian T, Jaycox LH, editors. Invisible wounds of War: psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica, CA: Rand Corporation; 2008.

    Google Scholar 

  15. Bell RS, Vo AH, Neal CJ, Tigno J, Roberts R, Mossop C, et al. Military traumatic brain and spinal column injury: a 5-year study of the impact blast and other military grade weaponry on the central nervous system. J Trauma. 2009;66(4 Suppl):S104–11.

    Article  PubMed  Google Scholar 

  16. Chase RP, Nevin RL. Population estimates of undocumented incident traumatic brain injuries among combat-deployed US military personnel. J Head Trauma Rehabil. 2015;30(1):E57–64. doi:10.1097/HTR.0000000000000061. Documents the high incidence of unrecognized TBIs suffered by U.S. troops deployed to Iraq or Afghanistan during the period of January 2003 to October 2006.

    Article  PubMed  Google Scholar 

  17. Elder GA, Mitsis EM, Ahlers ST, Cristian A. Blast-induced mild traumatic brain injury. Psychiatr Clin North Am. 2010;33(4):757–81.

    Article  PubMed  Google Scholar 

  18. Military Acute Concussion Evaluation (MACE). https://www.jsomonline.org/TBI/MACE_Revised_2012.pdf. Accessed July 12, 2015.

  19. Coldren RL, Kelly MP, Parish RV, Dretsch M, Russell ML. Evaluation of the military acute concussion evaluation for use in combat operations more than 12 hours after injury. Mil Med. 2010;175(7):477–81.

    Article  PubMed  Google Scholar 

  20. Jaffee MS, Meyer KS. A brief overview of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) within the Department of Defense. Clin Neuropsychol. 2009;23(8):1291–8.

    Article  PubMed  Google Scholar 

  21. Coldren RL, Russell ML, Parish RV, Dretsch M, Kelly MP. The ANAM lacks utility as a diagnostic or screening tool for concussion more than 10 days following injury. Mil Med. 2012;177(2):179–83.

    Article  PubMed  Google Scholar 

  22. Norris JN, Carr W, Herzig T, Labrie DW, Sams R. ANAM4 TBI reaction time-based tests have prognostic utility for acute concussion. Mil Med. 2013;178(7):767–74. doi:10.7205/MILMED-D-12-00493.

    Article  PubMed  Google Scholar 

  23. Iverson GL, Langlois JA, McCrea MA, Kelly JP. Challenges associated with post-deployment screening for mild traumatic brain injury in military personnel. Clin Neuropsychol. 2009;23(8):1299–314.

    Article  PubMed  Google Scholar 

  24. Evans CT, St Andre JR, Pape TL, Steiner ML, Stroupe KT, Hogan TP, et al. An evaluation of the veterans affairs traumatic brain injury screening process among operation enduring freedom and/or operation Iraqi freedom veterans. PM R. 2013;5(3):210–20. doi:10.1016/j.pmrj.2012.12.004.

    Article  PubMed  Google Scholar 

  25. Hendricks AM, Amara J, Baker E, Charns MP, Gardner JA, Iverson KM, et al. Screening for mild traumatic brain injury in OEF-OIF deployed US military: an empirical assessment of VHA’s experience. Brain Inj. 2013;27(2):125–34. doi:10.3109/02699052.2012.729284.

    Article  PubMed  Google Scholar 

  26. United States Department of Veterans Affairs. http://www.polytrauma.va.gov. Accessed July 12, 2015.

  27. Bochicchio GV, Lumpkins K, O’Connor J, Simard M, Schaub S, Conway A, et al. Blast injury in a civilian trauma setting is associated with a delay in diagnosis of traumatic brain injury. Am Surg. 2008;74(3):267–70.

    PubMed  Google Scholar 

  28. Bigler ED, Maxwell WL. Neuropathology of mild traumatic brain injury: relationship to neuroimaging findings. Brain Imaging Behav. 2012;6(2):108–36. doi:10.1007/s11682-011-9145-0.

    Article  PubMed  Google Scholar 

  29. Xiong Y, Mahmood A, Chopp M. Animal models of traumatic brain injury. Nat Rev Neurosci. 2013;14(2):128–42. doi:10.1038/nrn3407.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  30. Kucherov Y, Hubler G, DePalma R. Blast induced mild traumatic brain injury/concussion: a physical Analysis. J Appl Phys. 2012;112:104701-1-5.

    Article  Google Scholar 

  31. Kobeissy F, Mondello S, Tumer N, Toklu HZ, Whidden MA, Kirichenko N, et al. Assessing neuro-systemic & behavioral components in the pathophysiology of blast-related brain injury. Front Neurol. 2013;4:186. doi:10.3389/fneur.2013.00186.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Elder GA, Gama Sosa MA, De Gasperi R, Stone JR, Dickstein DL, Haghighi F, et al. Vascular and inflammatory factors in the pathophysiology of blast-induced brain injury. Front Neurol. 2015;6:48. doi:10.3389/fneur.2015.00048.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Elder GA, Stone JR, Ahlers ST. Effects of low-level blast exposure on the nervous system: is there really a controversy? Front Neurol. 2014;5:269. doi:10.3389/fneur.2014.00269. 10.3389/fneur.2014.00269. Reviews the mTBI/PTSD controversy as well as animal and human literature on the effects of low level blast.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Jorge RE, Arciniegas DB. Mood disorders after TBI. Psychiatr Clin North Am. 2014;37(1):13–29. doi:10.1016/j.psc.2013.11.005.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Vasterling JJ, Verfaellie M, Sullivan KD. Mild traumatic brain injury and posttraumatic stress disorder in returning veterans: perspectives from cognitive neuroscience. Clin Psychol Rev. 2009;29(8):674–84.

    Article  PubMed  Google Scholar 

  36. IOM (Institute of Medicine). Gulf War and health: Long-term effects of blast exposures. Washington, DC2014.

  37. Jones E, Fear NT, Wessely S. Shell shock and mild traumatic brain injury: a historical review. Am J Psychiatry. 2007;164(11):1641–5.

    Article  PubMed  Google Scholar 

  38. Vanderploeg RD, Belanger HG, Curtiss G. Mild traumatic brain injury and posttraumatic stress disorder and their associations with health symptoms. Arch Phys Med Rehabil. 2009;90(7):1084–93.

    Article  PubMed  Google Scholar 

  39. Ruff RL, Riechers 2nd RG, Wang XF, Piero T, Ruff SS. A case-control study examining whether neurological deficits and PTSD in combat veterans are related to episodes of mild TBI. BMJ Open. 2012;2(2), e000312. doi:10.1136/bmjopen-2011-000312.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Elder GA, Dorr NP, De Gasperi R, Gama Sosa MA, Shaughness MC, Maudlin-Jeronimo E, et al. Blast exposure induces post-traumatic stress disorder-related traits in a rat model of mild traumatic brain injury. J Neurotrauma. 2012;29(16):2564–75. doi:10.1089/neu.2012.2510. Demonstrates that low-level blast exposure in rats can induce PTSD-related behavioral traits in the absence of a psychological stressor.

    Article  PubMed Central  PubMed  Google Scholar 

  41. Brenner LA, Homaifar BY, Olson-Madden JH, Nagamoto HT, Huggins J, Schneider AL, et al. Prevalence and screening of traumatic brain injury among veterans seeking mental health services. J Head Trauma Rehabil. 2013;28(1):21–30. doi:10.1097/HTR.0b013e31827df0b5. Study examining the frequency of a history of TBI among veterans seeking mental health services at a VA facility. 45% of those seeking treatment had suffered a probable TBI.

    Article  PubMed  Google Scholar 

  42. Brickell TA, Lange RT, French LM. Health-related quality of life within the first 5 years following military-related concurrent mild traumatic brain injury and polytrauma. Mil Med. 2014;179(8):827–38. doi:10.7205/MILMED-D-13-00506.

    Article  PubMed  Google Scholar 

  43. Brickell TA, Lange RT, French LM. Three-year outcome following moderate-to-severe TBI in U.S. military service members: a descriptive cross-sectional study. Mil Med. 2014;179(8):839–48. doi:10.7205/MILMED-D-14-00016.

    Article  PubMed  Google Scholar 

  44. Vincent AS, Roebuck-Spencer TM, Cernich A. Cognitive changes and dementia risk after traumatic brain injury: implications for aging military personnel. Alzheimers Dement. 2014;10(3 Suppl):S174–87. doi:10.1016/j.jalz.2014.04.006.

    Article  PubMed  Google Scholar 

  45. Barnes DE, Kaup A, Kirby KA, Byers AL, Diaz-Arrastia R, Yaffe K. Traumatic brain injury and risk of dementia in older veterans. Neurology. 2014;83(4):312–9. doi:10.1212/WNL.0000000000000616.

    Article  PubMed Central  PubMed  Google Scholar 

  46. Plassman BL, Havlik RJ, Steffens DC, Helms MJ, Newman TN, Drosdick D, et al. Documented head injury in early adulthood and risk of Alzheimer’s disease and other dementias. Neurology. 2000;55(8):1158–66.

    Article  CAS  PubMed  Google Scholar 

  47. Bazarian JJ, Cernak I, Noble-Haeusslein L, Potolicchio S, Temkin N. Long-term neurologic outcomes after traumatic brain injury. J Head Trauma Rehabil. 2009;24(6):439–51. doi:10.1097/HTR.0b013e3181c15600.

    Article  PubMed  Google Scholar 

  48. National Research Council. Gulf War and health: volume 7: long-term consequences of traumatic brain injury. Washington, DC: The National Academies Press; 2008.

    Google Scholar 

  49. Gardner RC, Burke JF, Nettiksimmons J, Kaup A, Barnes DE, Yaffe K. Dementia risk after traumatic brain injury vs nonbrain trauma: the role of age and severity. JAMA Neurol. 2014;71(12):1490–7. doi:10.1001/jamaneurol.2014.2668.

    Article  PubMed  Google Scholar 

  50. Lange RT, Brickell TA, Ivins B, Vanderploeg RD, French LM. Variable, not always persistent, postconcussion symptoms after mild TBI in U.S. military service members: a five-year cross-sectional outcome study. J Neurotrauma. 2013;30(11):958–69. doi:10.1089/neu.2012.2743.

    Article  PubMed  Google Scholar 

  51. Budde MD, Shah A, McCrea M, Cullinan WE, Pintar FA, Stemper BD. Primary blast traumatic brain injury in the rat: relating diffusion tensor imaging and behavior. Front Neurol 2. 2013;4:154. doi:10.3389/fneur.2013.00154. Study examining diffusion tensor imaging (DTI) after a blast injury in rats. Region specific decreases in fractional anisotropy were found that expanded during a 4 to 30 day observation period suggesting an evolving lesion.

    Google Scholar 

  52. Martland HS. Punch drunk. JAMA. 1928;91:1103–7. doi:10.1001/jama.1928.02700150029009.

    Article  Google Scholar 

  53. Corsellis JA, Bruton CJ, Freeman-Browne D. The aftermath of boxing. Psychol Med. 1973;3(3):270–303.

    Article  CAS  PubMed  Google Scholar 

  54. Omalu BI, DeKosky ST, Minster RL, Kamboh MI, Hamilton RL, Wecht CH. Chronic traumatic encephalopathy in a national football league player. Neurosurgery. 2005;57(1):128–34.

    Article  PubMed  Google Scholar 

  55. Maroon JC, Winkelman R, Bost J, Amos A, Mathyssek C, Miele V. Chronic traumatic encephalopathy in contact sports: a systematic review of all reported pathological cases. PLoS One. 2015;10(2), e0117338. doi:10.1371/journal.pone.0117338.

    Article  PubMed Central  PubMed  Google Scholar 

  56. McKee AC, Cantu RC, Nowinski CJ, Hedley-Whyte ET, Gavett BE, Budson AE, et al. Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury. J Neuropathol Exp Neurol. 2009;68(7):709–35. doi:10.1097/NEN.0b013e3181a9d503.

    Article  PubMed Central  PubMed  Google Scholar 

  57. McKee AC, Stern RA, Nowinski CJ, Stein TD, Alvarez VE, Daneshvar DH, et al. The spectrum of disease in chronic traumatic encephalopathy. Brain. 2013;136(Pt 1):43–64. doi:10.1093/brain/aws307. Describes the features of CTE in 68 cases including 21 military veterans.

    Article  PubMed Central  PubMed  Google Scholar 

  58. Omalu B, Hammers JL, Bailes J, Hamilton RL, Kamboh MI, Webster G, et al. Chronic traumatic encephalopathy in an Iraqi war veteran with posttraumatic stress disorder who committed suicide. Neurosurgical focus. 2011;31(5):E3. doi:10.3171/2011.9.FOCUS11178. Describes the first case of CTE in an Iraq veteran.

    Article  PubMed  Google Scholar 

  59. Goldstein LE, Fisher AM, Tagge CA, Zhang XL, Velisek L, Sullivan JA, et al. Chronic traumatic encephalopathy in blast-exposed military veterans and a blast neurotrauma mouse model. Sci Transl Med. 2012;4(134):134ra60. doi:10.1126/scitranslmed.3003716. Describes four cases of CTE in Iraq and Afghanistan veterans along with prominant tau pathology in an animal model of blast injury.

    Article  PubMed Central  PubMed  Google Scholar 

  60. Huber BR, Meabon JS, Martin TJ, Mourad PD, Bennett R, Kraemer BC, et al. Blast exposure causes early and persistent aberrant phospho- and cleaved-tau expression in a murine model of mild blast-induced traumatic brain injury. J Alzheimers Dis. 2013;37(2):309–23. doi:10.3233/JAD-130182.

    PubMed Central  CAS  PubMed  Google Scholar 

  61. Sibener L, Zaganjor I, Snyder HM, Bain LJ, Egge R, Carrillo MC. Alzheimer’s disease prevalence, costs, and prevention for military personnel and veterans. Alzheimers Dement. 2014;10(3 Suppl):S105–10. doi:10.1016/j.jalz.2014.04.011.

    Article  PubMed  Google Scholar 

  62. Veitch DP, Friedl KE, Weiner MW. Military risk factors for cognitive decline, dementia and Alzheimer’s disease. Curr Alzheimer Res. 2013;10(9):907–30.

    Article  CAS  PubMed  Google Scholar 

  63. Fleminger S, Oliver DL, Lovestone S, Rabe-Hesketh S, Giora A. Head injury as a risk factor for Alzheimer’s disease: the evidence 10 years on; a partial replication. J Neurol Neurosurg Psychiatry. 2003;74(7):857–62.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  64. Nemetz PN, Leibson C, Naessens JM, Beard M, Kokmen E, Annegers JF, et al. Traumatic brain injury and time to onset of Alzheimer’s disease: a population-based study. Am J Epidemiol. 1999;149(1):32–40.

    Article  CAS  PubMed  Google Scholar 

  65. Gandy S. The role of cerebral amyloid beta accumulation in common forms of Alzheimer disease. J Clin Invest. 2005;115(5):1121–9. doi:10.1172/JCI25100.

    PubMed Central  CAS  PubMed  Google Scholar 

  66. Uryu K, Chen XH, Martinez D, Browne KD, Johnson VE, Graham DI, et al. Multiple proteins implicated in neurodegenerative diseases accumulate in axons after brain trauma in humans. Exp Neurol. 2007;208(2):185–92.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  67. Loane DJ, Pocivavsek A, Moussa CE, Thompson R, Matsuoka Y, Faden AI, et al. Amyloid precursor protein secretases as therapeutic targets for traumatic brain injury. Nat Med. 2009;15(4):377–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  68. Lawrence DW, Comper P, Hutchison MG, Sharma B. The role of apolipoprotein E episilon (epsilon)-4 allele on outcome following traumatic brain injury: a systematic review. Brain Inj. 2015;1:14. doi:10.3109/02699052.2015.1005131.

    Google Scholar 

  69. De Gasperi R, Gama Sosa MA, Kim SH, Steele JW, Shaughness MC, Maudlin-Jeronimo E, et al. Acute blast injury reduces brain abeta in two rodent species. Front Neurol. 2012;3:177. doi:10.3389/fneur.2012.00177. Describes the acute lowering of brain Abeta following blast injury in animals.

    Article  PubMed Central  PubMed  Google Scholar 

  70. Pierce JE, Trojanowski JQ, Graham DI, Smith DH, McIntosh TK. Immunohistochemical characterization of alterations in the distribution of amyloid precursor proteins and beta-amyloid peptide after experimental brain injury in the rat. J Neurosci. 1996;16(3):1083–90.

    CAS  PubMed  Google Scholar 

  71. Tweedie D, Rachmany L, Rubovitch V, Zhang Y, Becker KG, Perez E, et al. Changes in mouse cognition and hippocampal gene expression observed in a mild physical- and blast-traumatic brain injury. Neurobiol Dis. 2013;54:1–11. doi:10.1016/j.nbd.2013.02.006. Examined changes in the mouse hippocampal transcriptome following a weight drop injury or exposure to a low-level blast. While a common set of up regulated or down regulated RNAs were found, most changes between the two models differed. A functional pathway analysis found that genes up regulated or down regulated in AD were regulated in similar directions by non-blast TBI but in the opposite direction after blast.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  72. Bower JH, Maraganore DM, Peterson BJ, McDonnell SK, Ahlskog JE, Rocca WA. Head trauma preceding PD: a case-control study. Neurology. 2003;60(10):1610–5.

    Article  CAS  PubMed  Google Scholar 

  73. Chen H, Richard M, Sandler DP, Umbach DM, Kamel F. Head injury and amyotrophic lateral sclerosis. Am J Epidemiol. 2007;166(7):810–6. doi:10.1093/aje/kwm153.

    Article  PubMed Central  PubMed  Google Scholar 

  74. Schmidt S, Kwee LC, Allen KD, Oddone EZ. Association of ALS with head injury, cigarette smoking and APOE genotypes. J Neurol Sci. 2010;291(1-2):22–9. doi:10.1016/j.jns.2010.01.011.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  75. Strickland D, Smith SA, Dolliff G, Goldman L, Roelofs RI. Physical activity, trauma, and ALS: a case-control study. Acta Neurol Scand. 1996;94(1):45–50.

    Article  CAS  PubMed  Google Scholar 

  76. IOM (Institute of Medicine). Amyotrophic Lateral Sclerosis in Veterans: Review of the Scientific Literature. Washington DC 2006.

  77. Department of Veterans Affairs. Presumption of Service Connection for Amyotrophic Lateral Sclerosis. Federal Registry 2009. p. 57072.

  78. Faden AI, Loane DJ. Chronic neurodegeneration after traumatic brain injury: Alzheimer disease, chronic traumatic encephalopathy, or persistent neuroinflammation? Neurotherapeutics. 2015;12(1):143–50. doi:10.1007/s13311-014-0319-5. Reviews the evidence for inflammation playing a role in chronic neurodegeneration after TBI.

    Article  CAS  PubMed  Google Scholar 

  79. Johnson VE, Stewart JE, Begbie FD, Trojanowski JQ, Smith DH, Stewart W. Inflammation and white matter degeneration persist for years after a single traumatic brain injury. Brain. 2013;136(Pt 1):28–42. doi:10.1093/brain/aws322.

    Article  PubMed Central  PubMed  Google Scholar 

  80. Ramlackhansingh AF, Brooks DJ, Greenwood RJ, Bose SK, Turkheimer FE, Kinnunen KM, et al. Inflammation after trauma: microglial activation and traumatic brain injury. Ann Neurol. 2011;70(3):374–83. doi:10.1002/ana.22455.

    Article  PubMed  Google Scholar 

  81. Muller N. Immunology of major depression. Neuroimmunomodulation. 2014;21(2-3):123–30. doi:10.1159/000356540.

    PubMed  Google Scholar 

  82. Wieck A, Grassi-Oliveira R, Hartmann do Prado C, Teixeira AL, Bauer ME. Neuroimmunoendocrine interactions in post-traumatic stress disorder: focus on long-term implications of childhood maltreatment. Neuroimmunomodulation. 2014;21(2-3):145–51. doi:10.1159/000356552.

    CAS  PubMed  Google Scholar 

  83. Yaffe K, Vittinghoff E, Lindquist K, Barnes D, Covinsky KE, Neylan T, et al. Posttraumatic stress disorder and risk of dementia among US veterans. Arch Gen Psychiatry. 2010;67(6):608–13. doi:10.1001/archgenpsychiatry.2010.61.

    Article  PubMed Central  PubMed  Google Scholar 

  84. Qureshi SU, Kimbrell T, Pyne JM, Magruder KM, Hudson TJ, Petersen NJ, et al. Greater prevalence and incidence of dementia in older veterans with posttraumatic stress disorder. J Am Geriatr Soc. 2010;58(9):1627–33. doi:10.1111/j.1532-5415.2010.02977.x.

    Article  PubMed  Google Scholar 

  85. Weiner MW, Friedl KE, Pacifico A, Chapman JC, Jaffee MS, Little DM, et al. Military risk factors for Alzheimer’s disease. Alzheimers Dement. 2013;9(4):445–51. doi:10.1016/j.jalz.2013.03.005.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The author has received research support from the Department of Veterans Affairs, Veterans Health Administration, Rehabilitation Research and Development Service Awards 1I01RX000179-01 and 1I01RX000996-01.

Compliance with Ethics Guidelines

ᅟ

Conflict of Interest

Gregory A. Elder has received research grants from the Veterans Administration.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. James J. Peters Department of Veterans Affairs Medical Center, Neurology Service, 130 West Kingsbridge Road, Bronx, NY, 10468, USA

    Gregory A. Elder

  2. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY, 10029, USA

    Gregory A. Elder

  3. Department of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY, 10029, USA

    Gregory A. Elder

  4. Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY, 10029, USA

    Gregory A. Elder

Authors
  1. Gregory A. Elder
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gregory A. Elder.

Additional information

This article is part of the Topical Collection on Dementia

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Elder, G.A. Update on TBI and Cognitive Impairment in Military Veterans. Curr Neurol Neurosci Rep 15, 68 (2015). https://doi.org/10.1007/s11910-015-0591-8

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11910-015-0591-8

Keywords

Search

Navigation