Verbal Recall After Mild Traumatic Brain Injury: Sensitivity of the Rapid Screen of Concussion

2003 ◽  
Vol 4 (2) ◽  
pp. 155-167 ◽  
Author(s):  
Karleigh Jayne Kwapil ◽  
Gina Geffen ◽  
Ken McFarland ◽  
Veronica Eileen DeMonte

AbstractThe present study aimed to determine whether including a sensitive test of immediate and delayed recall would improve the diagnostic validity of the Rapid Screen of Concussion (RSC) in mild Traumatic Brain Injury (mTBI) versus orthopaedic clinical samples. Two studies were undertaken. In Study 1, the performance of 156 mTBI and 145 orthopaedic participants was analysed to identify the number of individuals who performed at ceiling on the verbal memory subtest of the RSC, as this test required immediate and delayed recall of only five words. A second aim was to determine the sensitivity and specificity levels of the RSC. Study 2 aimed to examine whether replacement of the verbal memory subtest with the 12-word Hopkins Verbal Learning Test (HVLT) could improve the sensitivity of the RSC in a new sample of 26 mTBI and 30 orthopaedic participants. Both studies showed that orthopaedic participants outperformed mTBI participants on each of the selected measures. Study 1 showed that 14% of mTBI participants performed at ceiling on the immediate and 21.2% on delayed recall test. Performance on the original battery yielded a sensitivity of 82%, specificity of 80% and overall correct classification of 81.5% participants. In Study 2, inclusion of the HVLT improved sensitivity to a level of 88.5%, decreased specificity to a level of 70% and resulted in an overall classification rate of 80%. It was concluded that although inclusion of the five-word subtest in the RSC can successfully distinguish concussed from non-concussed individuals, use of the HVLT in this protocol yields a more sensitive measure of subtle cognitive deficits following mTBI.

2015 ◽  
Vol 26 (1) ◽  
pp. 35-50 ◽  
Author(s):  
Sara C. Schroeder ◽  
Ronald M. Ruff ◽  
Lutz Jäncke

The aim of this study was to examine the effect of posttraumatic stress disorder (PTSD) on (a) neuropsychological test performance and (b) self-reported emotional complaints within individuals suffering from postconcussional disorder (PCD) after a mild traumatic brain injury (MTBI). A two-group comparative research design was employed. Two MTBI samples with and without PTSD were assessed with a neuropsychological test battery and the Ruff Neurobehavioral Inventory (RNBI). On the neurocognitive test performances no significant between group differences were found, but the MTBI group with PTSD endorsed a significantly greater number of emotional complaints, especially in the RNBI subscales of anxiety and depression. The patients with PTSD also endorsed a significantly greater number of premorbid sequelae in the RNBI emotional composite scale as well as the RNBI premorbid subscales of pain, anxiety and abuse. In sum, PTSD has a negative impact on emotional but not cognitive functioning within individuals suffering from PCD after a mild TBI.


2019 ◽  
Vol 34 (6) ◽  
pp. 999-999
Author(s):  
S Sorg ◽  
M Walsh ◽  
M Werhane ◽  
K Holiday ◽  
A Clark ◽  
...  

Abstract Objective We investigated whether clock-checking frequency during a prospective memory (PM) task differed between Veterans with reported histories of blast-related mild traumatic brain injury (mTBI) and Veteran Controls (VCs) without a history mTBI. We hypothesized that, compared to controls, the mTBI group would less frequently clock check. Additionally, we expected that reduced clock-checking would contribute to poorer time-based PM performance in the mTBI group. Method Twenty-seven Veterans (9 mTBI and 18 VC) with sufficient effort testing completed a structured TBI history interview, the Post-Traumatic Stress Disorder Checklist (PCL) and the Memory for Intentions Test (MIST) as a PM task. During MIST administration, examiners recorded clock-checking behavior each time a participant physically turned a digital clock to observe the current time. Results Compared to VCs, the mTBI group performed worse on the Time subscale of the MIST [Mean (SD) VC = 6.7 (1.1), mTBI = 5.7 (1.1), p < .05], and demonstrated significantly fewer clock-checks over the duration of the test [VC = 14.2(4.7), mTBI = 10.2 (3.4), p < .05]. Clock-checking significantly correlated with MIST Time subscale performance (r = .38, p < .05). Groups did not significantly differ in PCL scores, and PCL scores did not significantly correlate with clock-checking counts. Conclusion Our preliminary results are the first to show that clock-checking behavior may contribute to reduced performance on time-based PM tasks in Veterans with histories of mTBI. Specifically, our findings demonstrate that participants with mTBI employ an inefficient time monitoring strategy wherein infrequent clock checking contributes to poorer test performance. These findings suggest that strategies to improve clock checking may improve PM performance.


2016 ◽  
Vol 47 (2) ◽  
pp. 171-183 ◽  
Author(s):  
Noorjehan Joosub ◽  
Nafisa Cassimjee ◽  
Annelies Cramer

Traumatic brain injury is a multi-faceted condition that affects individuals on physical, cognitive, and emotional levels. The study investigated the relationship between depression and neuropsychological performance in a group with traumatic brain injury. A retrospective review was conducted on 75 participants who completed neuropsychological assessments. Information on clinical characteristics, sociodemographic information, neuropsychological outcomes, and Beck Depression Inventory scores were included in the analysis. Results indicated that 36% of the participants reported experiencing severe symptoms of depression, 28% moderate symptoms of depression, and 36% mild/minimal symptoms of depression. Performance on the Rey Auditory Verbal Learning Test indicated inverse relationships with depression scores suggesting that traumatic brain injury patients with lower depression scores perform better on verbal memory tasks. Similarly, findings for the written and oral versions of the Symbol Digit Modalities Test reflected inverse correlations with depression scores, indicating that lower depression scores are correlated with increased processing speed and capacity. A significant positive association between the time taken to complete the Trail Making Test Trail A and Trail B and depression scores was found, suggesting that higher depression scores in this sample were related to slower performance speed and lower executive performance. When specific clinical and sociodemographic variables were included as covariates in a partial correlational analysis, neuropsychological performance indicators and depression scores remained significant for Symbol Digit Modalities Test (oral and written), the Rey Auditory Verbal Learning Test Retrieval and Recognition trials, and Trail Making Test (Trail B). This study indicates that in a traumatic brain injury cohort, depression levels are significantly associated with specific neuropsychological performance measures. The findings of this study have implications for psychosocial treatment planning after a traumatic brain injury and contribute to our understandings of the inter-relationship between cognition and emotion.


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