Behavioral scales used in severe and moderate traumatic brain injury

Abstract

Neurobehavioral disorders are common consequences of traumatic brain injury (TBI) that should be objectively assessed in this population.The use of scales allows us to unify terms both in clinical practice and investigative work; it also constitutes a useful guide in clinical interviews and makes it possible to see outcome changes in patients with or without intervention. The aim of this study is to review the most frequently neurobehavioral scales used to measure the non-cognitive disorders of conduct in TBI patients. METHOD: A systematic and descriptive literature review was done in Medline, without time limit, which focused on scales applied to behavioral disorders in moderate and severe TBI patients. RESULTS: Ninety articles were selected for the final review and thirty-seven different scales were identified. Seven of these instruments represent sixty-five percent of all behavioral scales applied in the studies collected and were selected for the present review.There are scales that are more general and include a wide range of neurobehavioral symptoms, like the Neurobehavioral Rating Scale and the Neuropsychiatric Inventory. On the opposite, there are questionnaires that focus on specific symptoms like aggressiveness, agitation and apathy such as the Agitated Behavior Scale or the Apathy Evaluation Scale.The forms for caregiver or staff were the most prevalent in our review. The most representative behavioral scales applied to moderate and severe TBI patients were analyzed using clinical useful, covered domains, item descriptions, administration procedures and psychometric properties.

Inter-rater agreement of the Turkish version of the Neurobehavioral Rating Scale-Revised form

“…As a rating instrument for behavioral disorders, the NBRS scale has considerable importance in the field of rehabilitation. [18] It is accepted that in severe TBI patients' dysfunction usually depends on cognitive deficits rather than emotional disorders or physical impairments, and NBRS-R is an important evaluation tool for identifying neurobehavioral dysfunction for this reason, NBRS-R was selected for the patient population of this study. [19] In our clinics, there is an increasing annual incidence of brain injured patients.…”

“…The participant inclusion criteria for the study were as follows: age between 13-65 years, abnormal computed tomography (CT) findings with any Glasgow Coma Scale (GCS) [13] (i.e., mild, [13][14][15] moderate, [9][10][11][12] and/or severe TBI, [3][4][5][6][7][8] ) Turkish language skills, normal psychomotor development prior to TBI-related hospitalization, and adequate physical, mental and communication capabilities to cooperate and complete the NBRS-R test. Exclusion criteria included GCS score of 3 or under, unreactive pupils, unstable cardiopulmonary findings and previous history of neuropsychiatric disorders due to alcoholism, drug abuse or brain injury.…”

“…These include: The Neurobehavioral Functioning Inventory (NFI), the Neurobehavioral Rating Scale (NBRS), Behavior Rating Inventory of Executive Functions (BRIEF), the Dysexecutive Questionnaire (DEX), the Frontal Behavior Inventory (FBI), the Frontal Systems Behavior Scale (FrSBe), the Iowa Rating Scales of Personality Change (IRSPC) and the Neuropsychiatric Inventory (NPI). [7] The Neurobehavioral Rating Scale-revised (NBRS-R) is a widely-used measurement around the world, which focus specifically on TBI patients. [1,[7][8][9] It appears to be a more sensitive tool for monitoring neurobehavioral disturbances, and can be easily applied by physiatrists in rehabilitation clinics.…”

“…[7] The Neurobehavioral Rating Scale-revised (NBRS-R) is a widely-used measurement around the world, which focus specifically on TBI patients. [1,[7][8][9] It appears to be a more sensitive tool for monitoring neurobehavioral disturbances, and can be easily applied by physiatrists in rehabilitation clinics.…”

Prevalence of neuropsychiatric symptoms and psychotropic drug use in patients with acquired brain injury in long-term care: a systematic review

“…The Neuropsychiatric Inventory Nursing Home version (NPI-NH) was used as template for the NPS (14). The NPI, a structured interview including 12 NPS, is suitable for assessing NPS in ABI and has been used in severe and moderate TBI (15,16). With regard to PDU, the Anatomical Chemical Classification of the World Health Organization was used as template (17).…”