Executive Functioning in OEF/OIF Veterans with Traumatic Brain Injury

描述（由申请人提供）： 创伤性脑损伤是一个重大的健康问题，在大量的军事人员从伊拉克和阿富汗返回。不幸的是，许多因暴露于爆炸或其他事故而造成轻度创伤性脑损伤的人由于其损伤的微妙性质而没有得到适当的评估和治疗。此外，与轻度创伤性脑损伤相关的脑变化通常无法通过标准脑成像检测到。其他问题，如共存的情绪障碍，可能的精神残疾的耻辱，他们的年轻，以及缺乏对这种认知变化的认识，都可能影响结果并使康复进一步复杂化。目前的研究建议对轻度创伤性脑损伤的退伍军人进行一系列全面的测试，以记录认知技能的障碍，如推理和解决问题。这些能力对于我们的退伍军人患者试图重返工作和学校至关重要。此外，我们将使用最近开发的MRI脑成像形式，称为扩散张量成像，它可以识别标准MRI扫描无法检测到的细微大脑变化。通过这种方式，我们将能够确定认知缺陷及其与该患者组脑损伤的关系。这项研究将帮助我们理清其他共存症状（如情绪障碍）引起的困难，以及直接来自大脑创伤的问题。我们迫切需要改善对创伤性脑损伤退伍军人患者的诊断和治疗。本研究的数据将提供关于轻度创伤性脑损伤患者特征性认知特征的重要信息，并为VA系统内的正确诊断和治疗程序提供指导。此外，这项研究的结果将阐明这一患者群体认知缺陷的大脑基础。

DESCRIPTION (provided by applicant): Project Summary/Abstract Traumatic brain injury is a significant health problem in a large number of military personnel returning from Iraq and Afghanistan. Unfortunately, many individuals with mild traumatic brain injuries stemming from exposure to blasts or other accidents do not get properly evaluated and treated, due to the subtle nature of their injuries. Moreover, the brain changes associated with mild traumatic brain injury often go undetected with standard brain imaging. Other issues, such as coexisting emotional disorders, the stigma of a possible mental disability, their young age, and the lack of awareness of such cognitive changes, can each affect outcome and further complicate recovery. The current study proposes to conduct a comprehensive battery of tests in returning veterans with mild traumatic brain injury in order to document impairments in cognitive skills, such as reasoning and problem solving. Such abilities are critical as our veteran patients attempt to return to work and school. In addition, we will use a recently developed form of MRI brain imaging, known as diffusion tensor imaging, which can identify subtle brain changes that are not detected with standard MRI scans. In this way, we will be able to identify cognitive deficits and their relationship to brain injury in this patient group. This study will help us to disentangle difficulties stemming from other co-existing symptoms, such as emotional disorders, versus those problems stemming directly from trauma to the brain. Improved diagnostics and treatment for our veteran patients with traumatic brain injury is critically needed. Data from this study will provide important information regarding the characteristic cognitive profile of patients with mild traumatic brain injury and provide direction for proper diagnostic and treatment procedures within the VA system. Moreover, findings from this study will clarify the brain basis of cognitive deficits in this patient group.