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To the Editor: The study on the neuropsychological outcomes of combat duty in Iraq by Dr Vasterling and colleagues¹ is an important contribution that used strong methods, with predeployment and postdeployment measures, a nondeployed control comparison, and a battery of objective outcomes. However, the data suggest to me a different interpretation than that reached by the authors.

Their principal conclusion was that soldiers who deployed to Iraq experienced an increased risk of neuropsychological compromise in the area of attention and memory, independent of other potential causes, such as posttraumatic stress disorder or head injury. Of the entire battery of 16 objective neurocognitive tests in Table 5 in the article, only 3 showed a significant difference in the direction of less proficiency for those who deployed to Iraq compared with nondeployers.

Moreover, results of 2 of these 3 tests actually improved among those who deployed to Iraq (Tables 4 and 6 . . . [Full Text of this Article]

Charles W. Hoge, MD
charles.hoge@na.amedd.army.mil
Division of Psychiatry and Neuroscience
Walter Reed Army Institute of Research
Silver Spring, Md

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Deployment to the Iraq War and Neuropsychological Sequelae
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Deployment to the Iraq War and Neuropsychological Sequelae—Reply
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