Traumatic Brain Injury and the Relationship to Aggression on Tests of Executive Functioning

Abstract Objective This study aimed to determine the relationship between symptom self-report accuracy and objective cognitive functioning in multiple cognitive domains for varying neurocognitive impairment (NCI) subsequent to Traumatic Brain Injury (TBI). Specifically, the discrepancy between self-report and objective findings among participants with mild, moderate, and severe NCI was examined within the cognitive domains of Attention, Executive Functioning, Learning/Memory, and Speech/Language. Method The sample included archival data consisting of neuropsychological scores and self-reported Ruff Neurobehavioral Inventory (RNBI) results of 135 adult TBI patients with mild, moderate, or severe NCI who received neuropsychological assessment at a private practice. Patients were grouped based on level of impairment using Halstead Impairment Index criteria. Results No main effect was found for Attention. Patients with severe NCI had greater discrepancies in Executive Functioning (p = 0.015), Learning/Memory (p = 0.015), and Speech/Language (p < 0.001) function, when compared to those with mild NCI. Additionally, patients with severe NCI demonstrated greater discrepancies in Speech/Language (p < 0.001) function when compared to those with moderate NCI. Conclusion These findings indicate as severity of neurocognitive impairment increases for TBI patients, self-reported cognitive symptomatology—specifically executive functioning, learning/memory, and speech/language—will become less accurate. Clinically, these findings suggest that when working with patients who have severe neurocognitive deficits subsequent to TBI, it is important to consider objective testing as self-reporting may not be accurate. Understanding patient’s genuine deficits will foster patient awareness and acceptance of TBI-related cognitive deficits with increased investment in treatment and improved neurorehabilitation outcomes.

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The relationship between brain tissue oxygen partial pressure thresholds and microdialysis markers of ischaemia in traumatic brain injury

Journal of Cerebral Blood Flow & Metabolism ◽

10.1038/sj.jcbfm.9591524.0561 ◽

2005 ◽

Vol 25 (1_suppl) ◽

pp. S561-S561

Author(s):

Jurgens Nortje ◽

Peter J Hutchinson ◽

David A Zygun ◽

Pippa G Al-Rawi ◽

Mark T O'Connell ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Oxygen Partial Pressure ◽

Partial Pressure ◽

Brain Tissue ◽

Tissue Oxygen ◽

Brain Tissue Oxygen ◽

The Relationship ◽

Tissue Oxygen Partial Pressure

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NEUROPSYCHOLOGICAL CHANGES IN PATIENTS WITH A CONSEQUENCE OF TRAUMATIC BRAIN INJURY

JOURNAL OF NEUROLOGY AND NEUROSURGICAL RESEARCH ◽

10.26739/2181-0982-2020-3-9 ◽

2020 ◽

Vol 3 (1) ◽

pp. 44-46

Author(s):

Istatillo Shodjalilov ◽

◽

Saoda Igamova ◽

Aziza Djurabekova

Keyword(s):

Traumatic Brain Injury ◽

Cognitive Impairment ◽

Brain Injury ◽

Neuropsychological Testing ◽

Anxiety And Depression ◽

Psychopathological Symptoms ◽

Neuropsychological Changes ◽

The Relationship

The incidence of cognitive impairment in TBI is high, depending on the severity. At the same time, psychopathological symptoms in the form of asthenia, increased anxiety and depression are encountered among patients with TBI. The work studied the relationship between cognitive and psychopathological symptoms in patients with TBI using neuropsychological testing on scales.

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Intracranial Pressure during External Ventricular Drainage Weaning Is an Outcome Predictor of Traumatic Brain Injury

BioMed Research International ◽

10.1155/2020/8379134 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Jia-cheng Gu ◽

Hong Wu ◽

Xing-zhao Chen ◽

Jun-feng Feng ◽

Guo-yi Gao ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Intracranial Pressure ◽

External Ventricular Drainage ◽

Unfavorable Outcome ◽

Ventricular Drainage ◽

Outcome Group ◽

Significant Difference ◽

The Mean ◽

The Relationship

External ventricular drainage (EVD) is widely used in patients with a traumatic brain injury (TBI). However, the EVD weaning trial protocol varies and insufficient studies focus on the intracranial pressure (ICP) during the weaning trial. We aimed to establish the relationship between ICP during an EVD weaning trial and the outcomes of TBI. We enrolled 37 patients with a TBI with an EVD from July 2018 to September 2019. Among them, 26 were allocated to the favorable outcome group and 11 to the unfavorable outcome group (death, post-traumatic hydrocephalus, persistent vegetative state, and severe disability). Groups were well matched for sex, pupil reactivity, admission Glasgow Coma Scale score, Marshall computed tomography score, modified Fisher score, intraventricular hemorrhage, EVD days, cerebrospinal fluid output before the weaning trial, and the complications. Before and during the weaning trial, we recorded the ICP at 1-hour intervals to calculate the mean ICP, delta ICP, and ICP burden, which was defined as the area under the ICP curve. There were significant between-group differences in the age, surgery types, and intensive care unit days (p=0.045, p=0.028, and p=0.004, respectively). During the weaning trial, 28 (75.7%) patients had an increased ICP. Although there was no significant difference in the mean ICP before and during the weaning trial, the delta ICP was higher in the unfavorable outcome group (p=0.001). Moreover, patients who experienced death and hydrocephalus had a higher ICP burden, which was above 20 mmHg (p=0.016). Receiver operating characteristic analyses demonstrated the predictive ability of these variables (area under the curve AUC=0.818 [p=0.002] for delta ICP and AUC=0.758 [p=0.038] for ICP burden>20 mmHg). ICP elevation is common during EVD weaning trials in patients with TBI. ICP-related parameters, including delta ICP and ICP burden, are significant outcome predictors. There is a need for larger prospective studies to further explore the relationship between ICP during EVD weaning trials and TBI outcomes.

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THE RELATIONSHIP BETWEEN EARLY BLOOD PRESSURE VARIABILITY AND SHORT-TERM PROGNOSIS IN SEVERE TRAUMATIC BRAIN INJURY PATIENTS

Heart ◽

10.1136/heartjnl-2012-302920r.15 ◽

2012 ◽

Vol 98 (Suppl 2) ◽

pp. E255.4-E256

Author(s):

Chen Hui ◽

Wu Xiaoying ◽

Chen Hui

Keyword(s):

Blood Pressure ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

Blood Pressure Variability ◽

Short Term ◽

The Relationship

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Self- and Informant Ratings of Executive Functioning After Mild Traumatic Brain Injury

Journal of Head Trauma Rehabilitation ◽

10.1097/htr.0000000000000120 ◽

2015 ◽

Vol 30 (6) ◽

pp. E30-E39 ◽

Cited By ~ 15

Author(s):

Jacobus Donders ◽

Ye In Oh ◽

Jessica Gable

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Executive Functioning ◽

Mild Traumatic Brain Injury ◽

Informant Ratings

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Does Apolipoprotein e4 Status Moderate the Association of Family Environment with Long-Term Child Functioning following Early Moderate to Severe Traumatic Brain Injury? A Preliminary Study

Journal of the International Neuropsychological Society ◽

10.1017/s1355617716000631 ◽

2016 ◽

Vol 22 (8) ◽

pp. 859-864 ◽

Cited By ~ 8

Author(s):

Amery Treble-Barna ◽

Huaiyu Zang ◽

Nanhua Zhang ◽

Lisa J. Martin ◽

Keith Owen Yeates ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Executive Functioning ◽

Parenting Style ◽

Family Environment ◽

Adaptive Functioning ◽

Behavioral Adjustment ◽

Child Functioning ◽

E4 Allele

AbstractObjectives:To examine whether apolipoprotein e4 (APOE) status moderates the association of family environment with child functioning following early traumatic brain injury (TBI).Methods:Sixty-five children with moderate to severe TBI and 70 children with orthopedic injury (OI) completed assessments 6, 12, 18 months, and 3.5 and 6.8 years post injury. DNA was extracted from saliva samples and genotyped for APOE e4 status. Linear mixed models examined moderating effects of APOE e4 status on associations between two family environment factors (parenting style, home environment) and three child outcomes (executive functioning, behavioral adjustment, adaptive functioning).Results:Children with TBI who were carriers of the e4 allele showed poorer adaptive functioning relative to non-carriers with TBI and children with OI in the context of low authoritarianism. At high levels of authoritarianism, non-carriers with TBI showed the poorest adaptive functioning among groups. There were no main effects or interactions involving APOE and executive functioning or behavioral adjustment.Conclusions:The APOE e4 allele was detrimental for long-term adaptive functioning in the context of positive parenting, whereas in less optimal parenting contexts, being a non-carrier was detrimental. We provide preliminary evidence for an interaction of APOE e4 status and parenting style in predicting long-term outcomes following early TBI. (JINS, 2016,22, 859–864)

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