Executive functioning of complicated-mild to moderate traumatic brain injury patients with frontal contusions

Abstract

Executive dysfunctions are among the most prevalent neurobehavioral sequelae of traumatic brain injuries (TBIs). Using culturally validated tests from the Delis-Kaplan Executive Function System (D-KEFS: Trail Making, Verbal Fluency, Design Fluency, Sorting, Twenty Questions, and Tower) and the Behavioural Assessment of the Dysexecutive Syndrome (BADS: Rule Shift Cards, Key Search, and Modified Six Elements), the current study was the first to examine executive functioning in a group of Iranian TBI patients with focal frontal contusions. Compared with a demographically matched normative sample, the frontal contusion patients showed substantial impairments, with very large effect sizes (p ≤ .003, 1.56 < d < 3.12), on all the executive measures. Controlling for respective lower-level/fundamental conditions, the differences on the highest-level executive (cognitive switching) conditions were still significant. The frontal patients also committed more errors. Patients with lateral prefrontal (LPFC) contusions were qualitatively worst. For example, only the LPFC patients committed perseverative repetition errors. Altogether, our results support the notion that the frontal lobes, specifically the lateral prefrontal regions, play a critical role in cognitive executive functioning, over and above the contributions of respective lower-level cognitive abilities. The results provide clinical evidence for validity of the cross-culturally adapted versions of the tests.

Altered cortical activation and connectivity patterns for visual attention processing in young adults post‐traumatic brain injury: A functional near infrared spectroscopy study

“…A large number of clinical studies have reported TBI‐induced attention deficits in affected individuals. A recent study in adult patients with lateral prefrontal contusions reported significantly reduced attention capacities as compared to the patients with contusions located in other frontal areas and normal controls using culturally validated tests from the Delis‐Kaplan Executive Function System (Trail Making, Verbal Fluency, Design Fluency, Sorting, Twenty Questions, and Tower) . Significantly poorer attention capacity and slower information processing speed were observed in TBI patients who showed poorer outcomes (evaluated using the Glasgow Outcome Scale) compared to those who showed better outcomes .…”

The Role of HMGB1 in Traumatic Brain Injury—Bridging the Gap Between the Laboratory and Clinical Studies

“…Traumatic brain injury (TBI) is a global public health problem, causing significant mortality and morbidity worldwide [1]. Despite improvements in mortality rates achieved by ongoing advancements in healthcare, many survivors of TBI suffer with longstanding neuro-cognitive deficits that heavily impair their ability to function independently [2][3][4][5][6][7]. There is an unmet need for therapeutic interventions given that several pharmacological approaches to improve outcomes have remained unsuccessful to date [8].…”

Glycyrrhizin Blocks the Detrimental Effects of HMGB1 on Cortical Neurogenesis after Traumatic Neuronal Injury

“…Traumatic brain injury (TBI) is a global public health problem; predicted by the World Health Organisation (WHO) to become one of the leading causes of death and disability by the end of this year [ 1 , 2 ]. The best available medical and neurosurgical interventions reduce mortality rates after severe TBI, but a significant number of survivors are left with life changing moderate-to-severe disabilities [ 3 ]; the negative effects are largely related to sensory-motor, neuro-cognitive, behavioural and memory deficits [ 4 , 5 , 6 , 7 , 8 , 9 ]. From a pathophysiological standpoint, TBI causes significant neuronal cell death primarily in the cerebral cortex [ 10 ], largely evident during the secondary stages of host response to injury [ 11 ].…”