Analysis Of Neuropsychological Tests And Neuroimaging Of Cognitive Impairments In Traumatic Brain Injury

Objective Cognitive impairment is one of the common consequences after traumatic brain injury (TBI), the goal of this study is to provide a preliminary description of cognitive portrait of 3 cases with TBIMethods Three patients with TBI dated from Dec 2009 to March 2010 were enrolled. The following data were collected for each patient:age at injury, gender, level of education, injury causes, Glasgow Coma Scale score, duration of alteration of consciousness, duration of loss of consciousness, duration of post-traumatic amnesia, results of brain imaging. The MMSE was administered to the 3 patients, with repeated MMSE and MoCA to the same patients over 6 months. At the same time, the neuroimaging examinations were performed during follow-up period.Results The three cases were all severe TBI. All of them presented with temporal lesions, two of them with frontal lesions, one of them with basal ganglia lesion. Case 1 developed ventricular dilatation and widened sulci 48 months after TBI. Case 2 developed hydrocephalus 12 months after TBI. The results of the first MMSE demonstrated cognitive deficits in every patients (15/30,17/30,24/30), with attention, memory (delayed memory), visuospatial and executive function impaired in each of them. The results of the second MMSE six months later demonstrated that the cognition got better (24/30,25/30,27/30), but the MoCA tests administreatd simultaneously showed that cognitive impairments remained in three patients (18/30,17/30,23/30). The results of the second MMSE and MoCA showed that the score in attention, memory (delayed memory), visuospatial and executive function remained low in three patients.Conclusion The results of MMSE and MoCA in this study revealed that the three severe TBI patients have cognitive deficits, with attention, memory (delayed memory), visuospatial and executive function more commonly impaired than other cognitive domains. Cognitive impairments in TBI may be more unlikely to get worse after the acute phase of injury. Our study demonstrated that the frontal and temporal lobes may be the most vulnerable cortical areas in TBI patients. To evaluate the cognitive impairment of subjects after TBI, MoCA may be more sensitive and reliable than MMSE.