Challenges also exist, in terms of using experimental findings to guide clinical practice. Research studies frequently discuss significant differences in test scores among those with and without PTSD; however, lower scores do not equal impairment, (a score that is two standard deviations

below the mean of the general population). McNally32 highlights this point by suggesting that above-average intelligence be considered a protective factor Inhibitors,research,lifescience,medical against, PTSD versus lower IQ being a risk factor for developing the disorder. A clinician evaluating an individual’s performance on objective measures of functioning must note whether scores are actually impaired, or simply below personal expectations or previous levels of functioning. Inhibitors,research,lifescience,medical Making this determination can be particularly difficult if the premorbid data available for review is limited and/or anecdotal in nature. Cognitive functioning Cognitive deficits associated with TBI, particularly mild TBI, generally diminish over time. Alternately, PTSD has been associated with enduring cognitive disturbances. Although the etiology of deficits differs between individuals with each

of these conditions, significant areas of overlap exist both in terms of subjective complaints and objective findings (eg, attention). Below, the reader will be provided with summarized information regarding neuropsychological findings, Inhibitors,research,lifescience,medical clinical and experimental, among those with TBI (mild/moderate and severe) and PTSD. To augment this material readers are encouraged to review Table IV, the neuropsychological findings often discussed Inhibitors,research,lifescience,medical among those with TBI or PTSD. Table IV. Neuropsychological findings often discussed among those with traumatic brain injury or post-traumatic stress disorder. TBI (mild) Although there Inhibitors,research,lifescience,medical appears to be general consensus regarding the presence of acute cognitive dysfunction in those with mild TBI,33,34 findings regarding the overall effect of mild TBI on long-term neuropsychological test, performance have been mixed. Frencham

and colleagues35 published a meta-analysis of neuropsychological studies post-mild TBI and found that measures of processing speed, working memory, attention, memory, and executive functioning were most impacted immediately postinjury.35 Overall, their findings indicated that, the effect, of mild TBI on neuropsychological test performance was small, and that problems decreased as time since PDK4 injury increased.36 This assertion is supported by a recent study by Brenner and colleagues,28 in which 45 AP24534 nmr soldiers post-mild TBI completed neuropsychological measures. Twenty-seven had enduring PCS, including cognitive complaints, and 18 did not. Mean time since injury was approximately 41 weeks. Presence of mild TBI symptoms did not impact test performance, and mean participant scores were overwhelmingly unimpaired.