Evidence map›Paper›PMID 40695203›Full record

ArticleJournal of the neurological sciences2025

Traumatic brain injury, environmental exposures, and subjective cognition in post-9/11 veterans enrolled in the VA Million Veteran Program.

Kelsey M Schilling, Lay Kodama, Kelsey R Thomas, Catherine Chanfreau-Coffinier, VA Million Veteran Program, Victoria C Merritt

Abstract read
In one paragraph

Article in Journal of the neurological sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Kelsey M SchillingVA San Diego Healthcare System (VASDHS), San Diego, CA, United States.
Lay KodamaVA San Diego Healthcare System (VASDHS), San Diego, CA, United States; Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.
Kelsey R ThomasVA San Diego Healthcare System (VASDHS), San Diego, CA, United States; Department of Psychiatry, University of California San Diego, La Jolla, CA, United States; Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, United States.
Catherine Chanfreau-CoffinierVA Greater Los Angeles Health Care System, Los Angeles, CA, United States.
VA Million Veteran Program
Victoria C MerrittVA San Diego Healthcare System (VASDHS), San Diego, CA, United States; Department of Psychiatry, University of California San Diego, La Jolla, CA, United States; Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, United States. Electronic address: victoria.merritt@va.gov.

Funding

CSRD VA IK2 CX001865CSRD VA IK2 CX001952
6 · The paper itself

Abstract

Using data from the VA Million Veteran Program (MVP), this study aimed to (1) examine rates of environmental exposures as a function of traumatic brain injury (TBI) history in post-9/11 veterans and (2) examine the independent and interactive effects of TBI and exposures on subjective cognition. Participants included 6707 MVP-enrolled veterans (78 % male; age: M = 44.66, SD = 10.91) who were deployed in support of the Iraq/Afghanistan-era conflicts, completed MVP surveys, and participated in the VA TBI Screening and Evaluation Program (TBI-SEP). Veterans were classified into three groups based on the results of the TBI-SEP: (1) negative TBI screen; (2) positive TBI screen but no TBI diagnosis; or (3) positive TBI screen and confirmed TBI diagnosis. Environmental exposures were extracted from MVP surveys and included solvents/fuels; pesticides; lead; other metals; combustion products; open-air burn pits; and chemical/biological warfare (CBW) agents. The Medical Outcomes Study Cognitive Functioning-Revised (MOS-Cog-R) scale was used to assess subjective cognition. Chi-square tests showed that exposure rates were highest among veterans screening positive for TBI. The most commonly reported exposure types were combustion products, burn pits, and solvents/fuels. Adjusted linear regressions showed that both TBI and environmental exposures independently contributed to worse subjective cognition, but there were no synergistic effects between TBI and exposures on cognition, except for CBW agents. Our findings emphasize the importance of considering environmental exposures as independent risk factors for subjective cognitive difficulties in post-9/11 veterans and support the use of toxic exposure screenings to connect veterans with appropriate resources and clinical care.

Indexed as

Brain Injuries, TraumaticCognition DisordersEnvironmental ExposureVeteransAdultAfghan Campaign 2001-CognitionFemaleHumansIraq War, 2003-2011MaleMiddle AgedNeuropsychological TestsUnited StatesUnited States Department of Veterans AffairsCognitive functioningConcussionMilitary veteransTBIToxic exposuresToxins

Identifiers

PMID40695203
PMCPMC13536923

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.