BRIEF RESEARCH REPORT article
Front. Neurol.
Sec. Cognitive and Behavioral Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1594748
This article is part of the Research TopicInnovations in the assessment and treatment of TBI and co-occurring conditions in military connected populationsView all 9 articles
Effects of a Modular Telehealth Intervention on Comorbid Conditions in Service Members with Mild Traumatic Brain Injury
Provisionally accepted
Jesse R Fann1*
Tessa Hart2Kathleen R Bell3Wesley Cole4Sonia Jain5Rema Raman6Jason Barber1Sureyya Dikmen1John Richardson7Murray B Stein5
Nancy Temkin1- 1University of Washington, Seattle, United States
- 2Moss Rehabilitation Research Institute (MRRI), Philadelphia, Pennsylvania, United States
- 3University of Texas Southwestern Medical Center, Dallas, Texas, United States
- 4University of North Carolina at Charlotte, Charlotte, North Carolina, United States
- 5University of California, San Diego, La Jolla, California, United States
- 6University of Southern California, Los Angeles, California, United States
- 7Stop Soldier Suicide, Durham, North Carolina, United States
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: Many active duty service members with mild traumatic brain injury (mTBI) report comorbidities such as depression, anxiety, PTSD, insomnia, and pain. We analyzed data from a prior randomized controlled trial (RCT) to examine the effects of evidence-based treatment modules, delivered by telephone, on the number and symptom burden of five common comorbidities. Setting and Participants: 356 service members from two military medical centers who had sustained deployment-related mTBI in the preceding 2 years.Design: Secondary analysis of RCT comparing 6 months of telephone-delivered problem-solving treatment (PST) with comorbidity-specific modules to education only (EO). Main Measures: Comorbidity burden measured by Patient Health Questionnaire-9, Brief Symptom Inventory-Anxiety, PTSD Checklist, Pittsburgh Sleep Quality Inventory, Rivermead Postconcussion Symptoms Questionnaire (headache item) assessed at baseline and 6 and 12 months. Results: 47% of service members endorsed ≥ 3 comorbidities at baseline. At 6 months, the PST group had significantly fewer comorbidities, greater improvement in depression, anxiety, PTSD, and sleep, but not headache, and higher response/remission rates for depression and sleep, compared to EO. There were no significant group differences at 12 months. Conclusions: Telephone-delivered PST with comorbidity-specific modules reduces burden of comorbidities after deployment-related mTBI. Research is needed on how to maintain improvements over time.
Keywords: Traumatic Brain Injury, concussion, Comorbidity, telehealth, Clinical Trial
Received: 16 Mar 2025; Accepted: 23 Jun 2025.
Copyright: © 2025 Fann, Hart, Bell, Cole, Jain, Raman, Barber, Dikmen, Richardson, Stein and Temkin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jesse R Fann, University of Washington, Seattle, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.