Clinical Trials Logo

Clinical Trial Summary

The purpose of this study is to examine differences in post-concussive (PC) symptom endorsement among four groups of Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) Veterans: those with a history of target, service-related, mild traumatic brain injury (mTBI) and co-occurring posttraumatic stress disorder (PTSD) (Group 1); those with a history of target, service-related, mTBI only (Group 2); those with PTSD only (Group 3); and those with no history of target, service-related, mTBI or PTSD (Group 4) by examining scores on the Neurobehavioral Symptom Inventory (NSI). Support for this study is provided by previous research highlighting the complex relationship between mTBI, PTSD and subsequent PC symptom endorsement (Brenner et al. 2010; Terrio et al, 2009).

HYPOTHESES ARE AS FOLLOWS:

1. Individuals with a history of target, service-related, mTBI only (Group 2) and individuals with PTSD only (Group 3) each will report significantly more PC symptoms, as measured by NSI total scores, when compared to those with no history of service-related mTBI or PTSD (Group 4).

2. Individuals with co-occurring target, service-related, mTBI history and PTSD (Group 1) will report significantly more PC symptoms, as measured by total NSI scores, than either those with target, service-related, mTBI only (Group 2) or those with PTSD only (Group 3).


Clinical Trial Description

Archival data will be collected from all OEF/OIF Veterans who were seen in the VA ECHCS TBI Clinic by Nancy Cutter, M.D. and her team between January 1, 2009 and December 31, 2010. Electronic Medical Record (EMR) progress note titles "OEF/OIF TBI 2nd Level Evaluation Consult Report" and "TBI Consult Report" will be used to identify potential subjects.

Power is based on the primary hypothesis that those with PTSD only (Group 3) and those with target, service-related mTBI only (Group 2) will have significantly more PC symptom reporting than those with no history of target, service-related mTBI or PTSD (Group 4). Belanger et al. (2010) reported a standard deviation of 15.3 on the NSI total score in a sample of 134 mTBI subjects. Assuming variability similar to the Belanger study, a significance level of 0.025 to correct for the two comparisons and 80% power, 180 subjects per group will detect a clinically significant difference of 5 points. For simplicity, this was calculated using a two-sided, two-sample t-test. Given that we are modeling all four groups together, pooled standard error estimates will be used, which will result in slightly higher power.

All analyses will assume a two-sided test of hypothesis with an overall significance level of 0.05, unless otherwise noted, and will be performed in either Statistical Analysis Software (SAS) v9.2 or above (SAS Institute, Inc., Cary, NC).

Demographic characteristics will be reported as means and standard deviations; medians and ranges; and proportions, as appropriate. Likewise, characteristics will be compared between the four aforementioned subject groups using Analysis of Variance (ANOVA), chi-square tests and/or nonparametric tests as appropriate.

Hypothesis 1: An ANOVA with reference cell coding will be utilized to model NSI total score as a function of the four groups (Group 1: Individuals with co-occurring target, service-related, mTBI and PTSD; Group 2: those with target, service-related, mTBI only; Group 3: those with PTSD only; and Group 4: those with no history of target, service-related, mTBI or PTSD). Potential confounders will then be assessed individually by adding them to the model with the groups. If any of the group parameter estimates changes by more than 10% with the inclusion of the potential confounder, the variable will be utilized in the final model. Once the final model is determined, a contrast will be set up within the model to test (1) PTSD only vs. Neither and (2) target, service-related, mTBI only vs. Neither, a Bonferroni correction will be employed such that the significance level will be adjusted to 0.025 for these two primary tests. Estimated mean differences will be reported with 95% CIs. Potential confounding variables to be considered are: age; gender; total number of deployments; time since last deployment; time since earliest documented mTBI; time since target, service-related, mTBI; and total number of mTBIs.

Hypothesis 2: Within the same final model above, a contrast will be used to test (1) those with co-occurring target, service-related, mTBI and PTSD vs. PTSD only and (2) those with co-occurring target, service-related, mTBI and PTSD vs. target, service-related, mTBI only. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT01502839
Study type Observational
Source VA Eastern Colorado Health Care System
Contact
Status Terminated
Phase N/A
Start date March 2011
Completion date May 2015

See also
  Status Clinical Trial Phase
Terminated NCT03052712 - Validation and Standardization of a Battery Evaluation of the Socio-emotional Functions in Various Neurological Pathologies N/A
Recruiting NCT05503316 - The Roll of Balance Confidence in Gait Rehabilitation in Persons With a Lesion of the Central Nervous System N/A
Completed NCT04356963 - Adjunct VR Pain Management in Acute Brain Injury N/A
Completed NCT03418129 - Neuromodulatory Treatments for Pain Management in TBI N/A
Terminated NCT03698747 - Myelin Imaging in Concussed High School Football Players
Recruiting NCT05130658 - Study to Improve Ambulation in Individuals With TBI Using Virtual Reality -Based Treadmill Training N/A
Recruiting NCT04560946 - Personalized, Augmented Cognitive Training (PACT) for Service Members and Veterans With a History of TBI N/A
Completed NCT05160194 - Gaining Real-Life Skills Over the Web N/A
Recruiting NCT02059941 - Managing Severe Traumatic Brain Injury (TBI) Without Intracranial Pressure Monitoring (ICP) Monitoring Guidelines N/A
Recruiting NCT03940443 - Differences in Mortality and Morbidity in Patients Suffering a Time-critical Condition Between GEMS and HEMS
Recruiting NCT03937947 - Traumatic Brain Injury Associated Radiological DVT Incidence and Significance Study
Completed NCT04465019 - Exoskeleton Rehabilitation on TBI
Recruiting NCT04530955 - Transitioning to a Valve-Gated Intrathecal Drug Delivery System (IDDS) N/A
Recruiting NCT03899532 - Remote Ischemic Conditioning in Traumatic Brain Injury N/A
Suspended NCT04244058 - Changes in Glutamatergic Neurotransmission of Severe TBI Patients Early Phase 1
Completed NCT03307070 - Adapted Cognitive Behavioral Treatment for Depression in Patients With Moderate to Severe Traumatic Brain Injury N/A
Recruiting NCT04274777 - The Relationship Between Lipid Peroxidation Products From Traumatic Brain Injury and Secondary Coagulation Disorders
Withdrawn NCT05062148 - Fundamental and Applied Concussion Recovery Modality Research and Development: Applications for the Enhanced Recovery N/A
Withdrawn NCT04199130 - Cognitive Rehabilitation and Brain Activity of Attention-Control Impairment in TBI N/A
Withdrawn NCT03626727 - Evaluation of the Efficacy of Sodium Oxybate (Xyrem®) in Treatment of Post-traumatic Narcolepsy and Post-traumatic Hypersomnia Early Phase 1