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Impaired cognitive functions in mild traumatic brain injury patients with normal and pathologic magnetic resonance imaging

  • Head and Neck Radiology
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Abstract

Introduction

Mild traumatic brain injury (MTBI) is a common neurological (neurotraumatological) diagnosis. As well as different subjective symptoms, many patients develop neuropsychological dysfunction with objective impairment of attention, memory and certain executive functions. Magnetic resonance imaging (MRI) is not routinely used in MTBI patients despite its proven greater sensitivity and specificity in comparison with computed tomography (CT).

Methods

The patient group consisted of 30 persons with MTBI and the control group consisted of 30 sex- and age-matched healthy volunteers. Both groups underwent neurological examination, neuropsychological testing (including the Postconcussion Symptoms Scale questionnaire, PCSS) and brain MRI (the patient group within 96 h after injury).

Results

The analyzed groups did not differ significantly in terms of sex, age, or level or duration of education. MRI pathological findings (traumatic and nonspecific) were present in nine patients. Traumatic lesions were found in seven patients. Nonspecific white matter lesions were found in five healthy controls. There were significant differences between MTBI patients and controls in terms of subjective symptoms (PCSS) and selected neuropsychological tests. Statistically significant neuropsychological differences were found between MTBI patients with true traumatic lesions and MTBI patients with nonspecific lesions.

Conclusion

There is evidence that MTBI patients with true traumatic MRI lesions are neuropsychologically different from MTBI patients with nonspecific MRI lesions or normal brain MRI. These results support the hypothesis that some acute MTBI signs and symptoms have a real organic basis which can be detected by selected new MRI modalities.

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References

  1. Grindel SH, Lovell MR, Collins MW (2001) The assessment of sport-related concussion: the evidence behind neuropsychological testing and management. Clin J Sport Med 11(3):134–143

    Article  PubMed  CAS  Google Scholar 

  2. Bleiberg J, Cernich AN, Cameron K, Sun W, Peck K, Ecklund PJ, Reeves D, Uhorchak J, Sparling MB, Warden DL (2004) Duration of cognitive impairment after sports concussion. Neurosurgery 54(5):1073–1080

    Article  PubMed  Google Scholar 

  3. Vos PE, Battistin L, Birbamer G, Gerstenbrand F, Potapov A, Prevec T, Stepan ChA, Traubner P, Twijnstra A, Vecsei L, von Wild K (2002) EFNS guideline on mild traumatic brain injury: report of an EFNS task force. Eur J Neurol 9(3):207–219

    Article  PubMed  CAS  Google Scholar 

  4. Carroll LJ, Cassidy JD, Holm L, Kraus J, Coronado VG (2004) Methodological issues and research recommendations for mild traumatic brain injury: the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J Rehabil Med (43 Suppl):113–125

    Article  PubMed  Google Scholar 

  5. Mittl RL, Grossman RI, Hiehle JF, Hurst RW, Kauder DR, Gennarelli TA, Alburger GW (1994) Prevalence of MR evidence of diffuse axonal injury in patients with mild head injury and normal head CT findings. AJNR Am J Neuroradiol 15(8):1583–1589

    PubMed  CAS  Google Scholar 

  6. Paterakis K, Karantanas AH, Komnos A, Volikas Z (2000) Outcome of patients with diffuse axonal injury: the significance and prognostic value of MRI in the acute phase. J Trauma 49(6):1071–1075

    Article  PubMed  CAS  Google Scholar 

  7. Ashikaga R, Araki Y, Ishida O (1997) MRI of head injury using FLAIR. Neuroradiology 39(4):239–242

    Article  PubMed  CAS  Google Scholar 

  8. Yanagawa Y, Tsushima Y, Tokumaru A, Un-no Y, Sakamoto T, Okada Y, Nawashiro H, Shima K (2000) A quantitative analysis of head injury using T2*-weighted gradient-echo imaging. J Trauma 49(2):272–277

    PubMed  CAS  Google Scholar 

  9. Moritani T, Ekholm S, Westesson PL (2004) Diffusion-weighted MR imaging of the brain. Springer, Berlin Heidelberg New York

    Google Scholar 

  10. Aubry M, Cantu R, Dvorak J, Graf-Baumann T, Johnston K, Kelly J, Lovell M, McCrory P, Meeuwisse W, Schamasch P (2002) Summary and agreement statement of the First International Conference on Concussion in Sport, Vienna 2001. Recommendations for the improvement of safety and health of athletes who may suffer concussive injuries. Br J Sports Med 36(1):6–10

    Article  PubMed  CAS  Google Scholar 

  11. Wechsler D (1999) Wechsler Memory Scale, 3rd edn (WMS-III, Slovak version). Psychodiagnostika, Bratislava

  12. Vonkomer J (1992) Disjunkèný reakèný èas. Psychodiagnostika, Bratislava

  13. Kuèera M (1980) Test koncentrace pozornosti. Psychodiagnostické a didaktické testy, Bratislava

  14. Schaefer PW, Huisman TA, Sorensen AG, Gonzalez RG, Schwamm LH (2004) Diffusion-weighted MR imaging in closed head injury: high correlation with initial Glasgow coma scale score and score on modified Rankin scale at discharge. Radiology 233(1):58–66

    Article  PubMed  Google Scholar 

  15. Huisman TA, Sorensen AG, Hergan K, Gonzalez RG, Schaefer PW (2003) Diffusion-weighted imaging for the evaluation of diffuse axonal injury in closed head injury. J Comput Assist Tomogr 27(1):5–11

    Article  PubMed  Google Scholar 

  16. Gentry LR, Godersky JC, Thompson B (1998) MR imaging of head trauma: review of the distribution and radiopathologic features of traumatic lesions. AJR Am J Roentgenol 150(3):663–672

    Google Scholar 

  17. Wahlund LO, Barkhof F, Fazekas F, Bronge L, Augustin M, Sjogren M, Wallin A, Ader H, Leys D, Pantoni L, Pasquier F, Erkinjuntti T, Scheltens P (2001) A new rating scale for age-related white matter changes applicable to MRI and CT. Stroke 32(6):1318–1322

    PubMed  CAS  Google Scholar 

  18. Hughes DG, Jackson A, Mason DL, Berry E, Hollis S, Yates DW (2004) Abnormalities on magnetic resonance imaging seen acutely following mild traumatic brain injury: correlation with neuropsychological tests and delayed recovery. Neuroradiology 46(7):550–558

    Article  PubMed  Google Scholar 

  19. Hofman PA, Stapert SZ, van Kroonenburgh MJ, Jolles J, de Kruijk J, Wilmink JT (2001) MR imaging, single-photon emission CT, and neurocognitive performance after mild traumatic brain injury. AJNR Am J Neuroradiol 22(3):441–449

    PubMed  CAS  Google Scholar 

  20. Voller B, Benke T, Benedetto K, Schnider P, Auff E, Aichner F (1999) Neuropsychological, MRI and EEG findings after very mild traumatic brain injury. Brain Inj 13(10):821–827

    Article  PubMed  CAS  Google Scholar 

  21. Uchino Y, Okimura Y, Tanaka M, Saeki N, Yamaura A (2001) Computed tomography and magnetic resonance imaging of mild head injury – is it appropriate to classify patients with Glasgow Coma Scale score of 13 to 15 as “mild injury”? Acta Neurochir (Wien) 143(10):1031–1037

    Article  CAS  Google Scholar 

  22. Johnston KM, McCrory P, Mohtadi NG, Meeuwisse W (2001) Evidence-based review of sport-related concussion: clinical science. Clin J Sport Med 11(3):150–159

    Article  PubMed  CAS  Google Scholar 

  23. Levin HS, Williams D, Crofford MJ, High WM Jr, Eisenberg HM, Amparo EG, Guinto FC Jr, Kalisky Z, Handel SF, Goldman AM (1988) Relationship of depth of brain lesions to consciousness and outcome after closed head injury. J Neurosurg 69(6):861–866

    Article  PubMed  CAS  Google Scholar 

  24. Godersky JC, Gentry LR, Tranel D, Dyste GN, Danks KR (1990) Magnetic resonance imaging and neurobehavioural outcome in traumatic brain injury. Acta Neurochir Suppl (Wien) 51:311–314

    CAS  Google Scholar 

  25. Tong KA, Ashwal S, Holshouser BA, Nickerson JP, Wall CJ, Shutter LA, Osterdock RJ, Haacke EM, Kido D (2004) Diffuse axonal injury in children: clinical correlation with hemorrhagic lesions. Ann Neurol 56(1):36–50

    Article  PubMed  Google Scholar 

  26. Sternberg RJ (2002) Kognitívní psychologie. Portál, Praha

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We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Clinic of Neurology, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic

    E. Kurča & Š. Sivák

  2. 1st Clinic of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic

    P. Kučera

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  1. E. Kurča
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  2. Š. Sivák
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  3. P. Kučera
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Correspondence to E. Kurča.

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Kurča, E., Sivák, Š. & Kučera, P. Impaired cognitive functions in mild traumatic brain injury patients with normal and pathologic magnetic resonance imaging. Neuroradiology 48, 661–669 (2006). https://doi.org/10.1007/s00234-006-0109-9

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  • DOI: https://doi.org/10.1007/s00234-006-0109-9

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