B-144: Neuropsychological Impact of Complicated Mild Traumatic Brain Injury

Abstract

Objective: Mild traumatic brain injury (mTBI) varies from complicated mild traumatic brain injury (cmTBI) in that it is characterized by neuroimaging abnormalities often resulting in cognitive and emotional impairments that sometimes resemble a moderate TBI. This review will aim to identify the pattern and profile of scores in cmTBI to inform better diagnostic practices and assist with more targeted interventions. Method/Data Selection: Literature searches, conducted in November 2025, used ProQuest, Web of Science, and PubMed, targeting peer-reviewed articles in English. This review included articles published within the last ten years with search terms including "complicated" AND "mild traumatic brain injury" AND "cognitive deficits" AND "concussion" AND "post-concussive symptoms." The paper focuses on the adult population. Studies including children under the age of 18 and moderate to severe TBI were excluded. Twelve studies met inclusion criteria, encompassing 1,482 participants. Results/Data Synthesis: Findings indicated that cmTBI is associated with inefficiencies in processing speed, higher-order attention and working memory, executive functioning, and verbal learning efficiency, with visuospatial functioning, and core language abilities generally being preserved. Psychological distress emerged as a critical moderator of cognitive outcomes, underscoring the importance of emotional assessment in the differential diagnosis and management of cmTBI. Conclusions: Given the cognitive profile observed across the literature, neuropsychological evaluation of individuals with cmTBI should prioritize assessment of processing speed, attention and working memory, higher-order executive functioning, and verbal learning and memory, while also incorporating measures of premorbid functioning, emotional and behavioral functioning, and performance and symptom validity. There should not be an emphasis on intellectual functioning, as crystalized intelligence and related intelligence quotient (IQ) scores are spared.