Imaging studies may increase our understanding regarding neuropsychological test performance in those with mild TBI. For example, Van Boven and colleagues37 suggested that those with mild TBI may require larger areas of cortex to complete tasks. In addition, the impact, of injury on performance

may grow as lifetime injury burden increases. This assertion is supported by the work of Bélanger and colleagues38 who found that a history of multiple self-reported TBI was associated with poorer performance on tests of delayed memory and executive functioning. TBI (moderate and severe) Widespread and enduring cognitive Inhibitors,research,lifescience,medical deficits are often noted in those with moderate to selleck inhibitor severe TBI. ScnthaniRaja and colleagues10 compared the neuropsychological test performance of 112 individuals with complicated mild to severe injuries with matched controls and identified deficits in attention, processing

Inhibitors,research,lifescience,medical speed, visual and verbal memory, executive functioning, and working memory. These significantly worse scores were noted long postinjury. The performance of older Inhibitors,research,lifescience,medical individuals and long-term survivors was worse. Among a cohort that had been referred for rehabilitation, Draper and Ponsford39 evaluated neuropsychological performance 10 years post-injury and found persisting deficits in processing speed, learning, and executive functioning. Level of impairment was associated with injury severity. Finally, Mathias and Wheaton40 conducted a meta-analytic review regarding attention and information processing speed deficits post-severe TBI. Findings suggested large and significant deficits in the areas of information processing speed, attention span, focused/selective attention, sustained attention, and Inhibitors,research,lifescience,medical supervisory attentional control. In reviewing Inhibitors,research,lifescience,medical the literature on functioning post-severe TBI, Van Boven and colleagues37 suggested

that deficits such as those noted above may be related to difficulty adequately recruiting the cortical resources necessary to complete complex cognitive tasks. PTSD In studying Vietnam combat veterans and their n unexposed identical twin brothers, Gilbertson and colleagues26 found that performance on cognitive tasks (ie, intellectual, verbal memory, attention, executive functioning, and visuospatial skills) was more strongly associated with familial factors than PTSD. Patterns of vulnerability in terms of verbal memory and executive else functioning were identified among both exposed and unexposed members of the twin pairs. Further study regarding learning, processing speed, intelligence, and visual recall have supported the theory that pretrauma performance on neuropsychological measures is related to PTSD symptom development.41,42 In a recent publication, Aupperle and colleagues42 summarized investigations regarding executive function and PTSD, and identified subtle impairments in response inhibition and attention regulation among those with PTSD.