TY - JOUR
T1 - Selective cognitive dysfunction is related to a specific pattern of cerebral damage in persons with severe traumatic brain injury
AU - Paola, Margherita Di
AU - Phillips, Owen
AU - Costa, Alberto
AU - Ciurli, Paola
AU - Bivona, Umberto
AU - Catani, Sheila
AU - Formisano, Rita
AU - Caltagirone, Carlo
AU - Carlesimo, Giovanni Augusto
PY - 2015/11/3
Y1 - 2015/11/3
N2 - Objective: Cognitive dysfunction is a common sequela of traumatic brain injury (TBI); indeed, patients show a heterogeneous pattern of cognitive deficits. This study was aimed at investigating whether patients who show selective cognitive dysfunction after TBI present a selective pattern of cerebral damage. Setting: Post-Coma Unit, IRCCS Santa Lucia Foundation, Rome, Italy. Participants: We collected data from 8 TBI patients with episodic memory disorder and without executive deficits, 7 patients with executive function impairment and preserved episodic memory capacities, and 16 healthy controls. Design: We used 2 complementary analyses: (1) an exploratory and qualitative approach in which we investigated the distribution of lesions in the TBI groups, and (2) a hypothesisdriven and quantitative approach in which we calculated the volume of hippocampi of individuals in the TBI and control groups. Main Measures: Neuropsychological scores and hippocampal volumes. Results: We found that patients with TBI and executive functions impairment presented focal lesions involving the frontal lobes, whereas patients with TBI and episodic memory disorders showed atrophic changes of the mesial temporal structure (hippocampus). Conclusion: The complexity of TBI is due to several heterogeneous factors. Indeed, studying patients with TBI and selective cognitive dysfunction should lead to a better understanding of correlations with specific brain impairment and damage, better follow-up of long-term outcome scenarios, and better planning of selective and focused rehabilitation programs.
AB - Objective: Cognitive dysfunction is a common sequela of traumatic brain injury (TBI); indeed, patients show a heterogeneous pattern of cognitive deficits. This study was aimed at investigating whether patients who show selective cognitive dysfunction after TBI present a selective pattern of cerebral damage. Setting: Post-Coma Unit, IRCCS Santa Lucia Foundation, Rome, Italy. Participants: We collected data from 8 TBI patients with episodic memory disorder and without executive deficits, 7 patients with executive function impairment and preserved episodic memory capacities, and 16 healthy controls. Design: We used 2 complementary analyses: (1) an exploratory and qualitative approach in which we investigated the distribution of lesions in the TBI groups, and (2) a hypothesisdriven and quantitative approach in which we calculated the volume of hippocampi of individuals in the TBI and control groups. Main Measures: Neuropsychological scores and hippocampal volumes. Results: We found that patients with TBI and executive functions impairment presented focal lesions involving the frontal lobes, whereas patients with TBI and episodic memory disorders showed atrophic changes of the mesial temporal structure (hippocampus). Conclusion: The complexity of TBI is due to several heterogeneous factors. Indeed, studying patients with TBI and selective cognitive dysfunction should lead to a better understanding of correlations with specific brain impairment and damage, better follow-up of long-term outcome scenarios, and better planning of selective and focused rehabilitation programs.
KW - Executive function
KW - Frontal lobe
KW - Hippocampus
KW - Memory function
KW - Structural MRI
KW - TBI
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U2 - 10.1097/HTR.0000000000000063
DO - 10.1097/HTR.0000000000000063
M3 - Article
C2 - 24901328
AN - SCOPUS:84947025514
VL - 30
SP - 402
EP - 410
JO - Journal of Head Trauma Rehabilitation
JF - Journal of Head Trauma Rehabilitation
SN - 0885-9701
IS - 6
ER -