Neuropsychological evaluation of mild head injury.

Gentilini, Massimo; Nichelli, Paolo Frigio; Schoenhuber, R; Bortolotti, P; Tonelli, L; Falasca, A; Merli, Giulia

doi:10.1136/jnnp.48.2.137

Cited by 159 publications

(59 citation statements)

References 13 publications

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“…The finding that mild TBI participants showed deficits in selective and sustained attention is consistent with a number of studies that have reported problems with attention (e.g., Gentilini et al, 1985Gentilini et al, , 1989Mclean et al, 1983;Stuss et al, 1989). The poorer verbal memory of the mild TBI group also confirms the findings of previous studies undertaken with mild TBI patients (e.g., Dikmen et al, 1986;Stuss et al, 1985).…”

Section: Discussionsupporting

confidence: 82%

“…However, objective assessments of memory have provided mixed findings. Whereas Gentilini et al (1985), Levin et al (1987), and Mathias and Coats (1999) found no evidence to indicate visual or verbal memory problems at 1 month post injury, other studies have shown significantly poorer working memory (Newcombe et al, 1994) and delayed recall (Dikmen et al, 1986) at similar post-injury intervals. Prob-lems with verbal learning (Leininger et al, 1990) and delayed recall (Stuss et al, 1985) have additionally been reported in chronically affected mild TBI patients at 3 and 5 months post injury, respectively.…”

Section: Introductionmentioning

confidence: 83%

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Neuropsychological and information processing deficits following mild traumatic brain injury

Mathias

Beall

Bigler

2004

J Int Neuropsychol Soc

121

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Neuroradiological and neuropathological investigations have found evidence of diffuse brain damage in the frontal and temporal lobes, corpus callosum, and fornices in patients who have sustained a mild traumatic brain injury (TBI). However, neuropsychological assessments of these patients do not typically target many of the subtle information processing deficits that may arise from diffuse damage involving the frontotemporal regions of the brain as well as white matter pathology, including the corpus callosum. Consequently, we have a limited understanding of the deficits that may be attributable to temporary or permanent disruptions to these functional pathways. This study assessed a group of mild TBI patients (N 5 40) and a matched control group (N 5 40) on a number of standard neuropsychological tests of selective and sustained attention, verbal and non-verbal fluency, and verbal memory. In addition, reaction time (RT) tasks, requiring both the inter-and intra-hemispheric processing of visual and tactile information, were used to assess the functional integrity of the tracts that are likely to be affected by diffuse damage. In the 1st month after sustaining their injury, the mild TBI group demonstrated deficits in attention, non-verbal fluency, and verbal memory. They also demonstrated slower visual and tactile RTs, with the visual RTs of mild TBI patients being more affected by increased task difficulty and the need to transfer information across the corpus callosum, than did their matched controls. (JINS, 2004, 10, 286-297.)

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 83%

Neuropsychological and information processing deficits following mild traumatic brain injury

Mathias

Beall

Bigler

2004

J Int Neuropsychol Soc

121

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“…For example, mild injuries show an early rapid change followed by a decelerating rate of improvement over the 1st or 2nd months post injury (Gronwall, 1977(Gronwall, , 1989Gronwall & Wrightson, 1974). Recovery periods ranging from 1 to 3 months have been reported for some attentional skills (Gentilini, Nichelli, Schoenhuber, Bortolotti, Tonelli, Falasca & Merli, 1985;Hugenholtz, Stuss, Stethem & Richard, 1988;Levin, Mattis, Ru, Eisenberg, Marshall, Tabadoor, High & Frankowski, 1987).…”

Section: Introductionmentioning

confidence: 95%

Rehabilitation of executive deficits in closed head injury and anterior communicating artery aneurysm patients

Stablum¹,

Umiltà²,

Mogentale³

et al. 2000

Psychological Research

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This paper reports a study that was aimed to rehabilitate executive functions in closed head injury (CHI) and anterior communicating artery (ACoA) aneurysm patients. The groups tested comprised 10 CHI patients, 9 ACoA aneurysm patients and 19 controls. We employed a dual-task paradigm that is known to tap the ability to co-ordinate two actions. The treatment consisted of five experimental sessions, in which the dual-task paradigm was used. In the CHI study, the dual-task cost was measured before the treatment (assessment), immediately after the treatment (retest), and 3 months after the treatment (follow-up). In the ACoA aneurysm study, the dual-task cost was also assessed 12 months after the treatment. A significant reduction of the dual-task cost from assessment to retest was found. This reduction remained stable in the follow-up sessions. The results are discussed with reference to the absence of spontaneous recovery of this specific executive function and to the possibility that the beneficial effect of the treatment generalises to other executive functions and/or daily living activities.

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“…Persons with severe TBI are more likely to suffer cognitive and physical impairment compared with those with mild TBI (Dikmen et al, 1986(Dikmen et al, , 1995Gentilini et al, 1985;Gronwall and Wrightson, 1974). Multidisciplinary teams commonly provide coordinated care for those with severe TBI (Brasure, 2012;Sander and Constantinidou, 2008;Wertheimer et al, 2008).…”

Section: Types Of Tbi Rehabilitation Servicesmentioning

confidence: 99%

Prospective study of myelin water fraction changes after mild traumatic brain injury in collegiate contact sports

Spader

Dean

LaFrance

et al. 2019

Journal of Neurosurgery

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OBJECTIVEMild traumatic brain injury (mTBI) in athletes, including concussion, is increasingly being found to have long-term sequelae. Current imaging techniques have not been able to identify early damage caused by mTBI that is predictive of long-term symptoms or chronic traumatic encephalopathy. In this preliminary feasibility study, the authors investigated the use of an emerging magnetic resonance imaging (MRI) technique, multicomponent driven equilibrium single pulse observation of T1 and T2 (mcDESPOT), in visualizing acute and chronic white matter changes after mTBI in collegiate football and rugby players.METHODSThis study was a nonrandomized, nonblinded prospective trial designed to quantify changes in the myelin water fraction (MWF), used as a surrogate MRI measure of myelin content, in a group of male collegiate football and rugby players, classified here as a contact sport player (CSP) cohort, at the time of mTBI diagnosis and 3 months after injury when the acute symptoms of the injury had resolved. In addition, differences in the MWF between the CSP cohort and a control cohort of noncontact sport players (NCSPs) were quantified. T-tests and a threshold-free cluster enhancement (TFCE) statistical analysis technique were used to identify brain structures with significant changes in the MWF between the CSP and NCSP cohorts and between immediately postinjury and follow-up images obtained in the CSP cohort.RESULTSBrain MR images of 12 right-handed male CSPs were analyzed and compared with brain images of 10 right-handed male NCSPs from the same institution. A comparison of CSP and NCSP baseline images using TFCE showed significantly higher MWFs in the bilateral basal ganglia, anterior and posterior corpora callosa, left corticospinal tract, and left anterior and superior temporal lobe (p < 0.05). At the 3-month follow-up examination, images from the CSP cohort still showed significantly higher MWFs than those identified on baseline images from the NCSP cohort in the bilateral basal ganglia, anterior and posterior corpora callosa, and left anterior temporal lobe, and also in the bilateral corticospinal tracts, parahippocampal gyrus, and bilateral juxtapositional (previously known as supplemental motor) areas (p < 0.05). In the CSP cohort, a t-test comparing the MWF at the time of injury and 3 months later showed a significant increase in the overall MWF at follow-up (p < 0.005). These increases were greatest in the bilateral basal ganglia and deep white matter. MWF decreases were seen in more superficial white matter (p < 0.005).CONCLUSIONSIn this preliminary study, MWF was found to be increased in the brains of CSPs compared with the brains of controls, suggesting acute/chronic MWF alterations in CSPs from previous injuries. Increases in the MWF were also demonstrated in the brains of CSPs 3 months after the players sustained an mTBI. The full clinical significance of an increased MWF and whether this reflects axon neuropathology or disorderly remyelination leading to hypermyelination has yet to be determined.

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Neuropsychological evaluation of mild head injury.

Cited by 159 publications

References 13 publications

Neuropsychological and information processing deficits following mild traumatic brain injury

Neuropsychological and information processing deficits following mild traumatic brain injury

Rehabilitation of executive deficits in closed head injury and anterior communicating artery aneurysm patients

Prospective study of myelin water fraction changes after mild traumatic brain injury in collegiate contact sports

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