Demographic and cognitive predictors of long-term psychosocial outcome following traumatic brain injury

Author(s):  
RODGER LL. WOOD ◽  
NEIL A. RUTTERFORD
2021 ◽  
Vol 268 (11) ◽  
pp. 4404-4405
Author(s):  
Daan P. J. Verberne ◽  
Rudolf W. H. M. Ponds ◽  
Mariëlle E. A. L. Kroese ◽  
Melloney L. M. Wijenberg ◽  
Dennis G. Barten ◽  
...  

Author(s):  
Daan P. J. Verberne ◽  
Rudolf W. H. M. Ponds ◽  
Mariëlle E. A. L. Kroese ◽  
Melloney L. M. Wijenberg ◽  
Dennis G. Barten ◽  
...  

Abstract Background and purpose Research suggests comparable long-term psychosocial outcomes following mild traumatic brain injury (mTBI) and minor stroke, but no direct comparison has been made. This study aimed to directly compare psychosocial outcome over time in persons with mTBI and minor stroke. Methods In this multicenter, prospective longitudinal cohort study, community-dwelling persons with mTBI (n = 182) and minor stroke (n = 48) were assessed at 6 weeks, 3, 6 and 12 months post-injury. Outcome measures included anxiety and depression symptoms (Hospital Anxiety and Depression Scale—HADS), cognitive problems in daily life (Checklist for Cognitive and Emotional Consequences of Stroke—CLCE-24) and quality of life (EuroQol-5D-5L—EQ-5D-5L). Multilevel growth curve modeling, controlled for demographic variables, was used to determine outcomes over time between groups. Proportions of persons reporting persistent psychosocial symptoms at 6 months post-injury were compared using Pearson’s Chi-squared tests. Results Improvements in outcomes were observed in the first 6 months and effects stabilized to 12 months post-injury in both groups. Minor stroke cases reported significantly higher levels of HADS anxiety and a significantly reduced increase in EQ-5D-5L utility scores than mTBI cases, but differences were small in absolute numbers. No significant differences were observed between groups regarding HADS depression and CLCE-24 cognition scores. Proportions of persons reporting persistent psychosocial symptoms were equal between groups. Conclusions Psychosocial outcome is largely comparable following mTBI and minor stroke. Specific attention should be paid to anxiety symptoms and cognitive problems in daily life for which uniform aftercare seems appropriate.


Author(s):  
Oscar D. Guillamondegui

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.


Author(s):  
Billy Irwin

Abstract Purpose: This article discusses impaired prosody production subsequent to traumatic brain injury (TBI). Prosody may affect naturalness and intelligibility of speech significantly, often for the long term, and TBI may result in a variety of impairments. Method: Intonation, rate, and stress production are discussed in terms of the perceptual, physiological, and acoustic characteristics associated with TBI. Results and Conclusions: All aspects of prosodic production are susceptible to the effects of damage resulting from TBI. There are commonly associated prosodic impairments; however, individual variations in specific aspects of prosody require detailed analysis.


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