Can Mild Traumatic Brain Injury Alter Cognition Chronically? A LIMBIC-CENC Multicenter Study

William C. Walker, Maya E. O’Neil, Zhining Ou, Terri K. Pogoda, Heather G. Belanger, Randall S. Scheibel, Angela P. Presson, Shannon R. Miles, Elisabeth A. Wilde, David F. Tate, Maya Troyanskaya, Mary Jo Pugh, Amy Jak, David X. Cifu

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objective: While outcome from mild traumatic brain injury (mTBI) is generally favorable, concern remains over potential negative long-term effects, including impaired cognition. This study examined the link between cognitive performance and remote mTBIs within the Long-term Impact of Military-relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) multicenter, observational study of Veterans and service members (SMs) with combat exposure. Method: Baseline data of the participants passing all cognitive performance validity tests (n = 1,310) were used to conduct a crosssectional analysis. Using multivariable regression models that adjusted for covariates, including age and estimated preexposure intellectual function, positive mTBI history groups, 1–2 lifetime mTBIs (nonrepetitive, n = 614), and 3+ lifetime mTBIs (repetitive; n = 440) were compared to TBI negative controls (n = 256) on each of the seven cognitive domains computed by averaging Z scores of prespecified component tests. Significance levels were adjusted for multiple comparisons. Results: Neither of the mTBI positive groups differed from the mTBI negative control group on any of the cognitive domains in multivariable analyses. Findings were also consistently negative across sensitivity analyses (e.g., mTBIs as a continuous variable, number of blast-related mTBIs, or years since the first and last mTBI). Conclusions: Our findings demonstrate that the average veteran orSMwho experienced one or more mTBIs does not have postacute objective cognitive deficits due to mTBIs alone. A holistic health care approach including comorbidity assessment is indicated for patients reporting chronic cognitive difficulties after mTBI(s), and strategies for addressing misattribution may be beneficial.

Original languageEnglish (US)
Pages (from-to)1-19
Number of pages19
Issue number1
StatePublished - Sep 29 2022


  • Cognition
  • Concussion
  • Military
  • Neuropsychological testing
  • Traumatic brain injury

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology


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