A-94 Characterization of Million Veteran Program (MVP) Enrollees with Comprehensive TBI Evaluation (CTBIE) Data: An Analysis of Neurobehavioral Symptoms

Abstract

Abstract Objective Using a large sample of U.S. Veterans enrolled in the Million Veteran Program (MVP), we sought to evaluate neurobehavioral symptoms obtained from the Veterans Health Administration’s Comprehensive Traumatic Brain Injury Evaluation (CTBIE). Method Eligible participants (N = 12,144) included MVP-enrolled Veterans who completed the CTBIE, a clinician-administered interview that assesses for historical, deployment-related TBIs and evaluates current symptoms using the Neurobehavioral Symptom Inventory (NSI). Clinicians completing the CTBIE made clinical determinations about each participant’s TBI diagnostic status (n = 7631 CTBIE+, n = 4513 CTBIE-) as well as likely symptom etiology (TBI: n = 612, Behavioral Health: n = 4965, Combination TBI and Behavioral Health [Comorbid]: n = 2773, Symptom Resolution; n = 750; and Other: n = 1282). We evaluated the association of TBI diagnostic group and symptom etiology group with neurobehavioral symptoms using ANCOVAs adjusted for sociodemographic characteristics. Results Results showed a significant effect of TBI on the NSI total score (p < 0.001, ηp2 = 0.02), with CTBIE+ Veterans endorsing greater symptoms than CTBIE- Veterans. There was also a significant association of symptom etiology group with the NSI total score (p < 0.001, ηp2 = 0.07). Post-hoc analyses showed that the Behavioral Health and Comorbid groups endorsed significantly greater symptoms compared to the TBI, Symptom Resolution, and Other groups. A similar pattern of results was found for all NSI symptom domain scores (vestibular, somatic, cognitive, and affective) and symptom breadth scores. Conclusions Findings from this large epidemiologic MVP study bolster prior work suggesting that behavioral health (e.g., depression, PTSD) greatly contributes to post-concussive symptom endorsement in chronic TBI. Results further highlight the importance of prioritizing mental health treatment in this vulnerable population.