Long-term cognitive and emotional consequences of mild traumatic brain injury

• Published in: Psychological medicine 2011-06, Vol.41 (6), p.1197-1211
• Main Authors: Konrad, C., Geburek, A. J., Rist, F., Blumenroth, H., Fischer, B., Husstedt, I., Arolt, V., Schiffbauer, H., Lohmann, H.
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Affective Symptoms - diagnosis; Affective Symptoms - psychology; Biological and medical sciences; Brain Concussion - diagnosis; Brain Concussion - psychology; Cognition & reasoning; Cognition Disorders - diagnosis; Cognition Disorders - psychology; Compensation; Depression; Emotions; Female; Follow-Up Studies; Gender; Glasgow Coma Scale; Head injuries; Humans; Image Interpretation, Computer-Assisted; Injuries of the nervous system and the skull. Diseases due to physical agents; Magnetic Resonance Imaging; Male; Medical sciences; Memory, Episodic; Middle Aged; Mood disorders; Neuropsychological Tests - statistics & numerical data; Neuropsychology; Organic mental disorders. Neuropsychology; Personality Inventory - statistics & numerical data; Psychology. Psychoanalysis. Psychiatry; Psychometrics; Psychopathology. Psychiatry; Response bias; Traumas. Diseases due to physical agents; Traumatic brain injury; Young Adult
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291710001728

The objective of this study was to investigate long-term cognitive and emotional sequelae of mild traumatic brain injury (mTBI), as previous research has remained inconclusive with respect to their prevalence and extent. Thirty-three individuals who had sustained mTBI on average 6 years prior to the study and 33 healthy control subjects were matched according to age, gender and education. Structural brain damage at time of testing was excluded by magnetic resonance imaging (MRI). A comprehensive neuropsychological test battery was conducted to assess learning, recall, working memory, attention and executive function. Psychiatric symptoms were assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the Beck Depression Inventory (BDI). Possible negative response bias was ruled out by implementing the Word Memory Test (WMT). The mTBI individuals had significant impairments in all cognitive domains compared to the healthy control subjects. Effect sizes of cognitive deficits were medium to large, and could not be accounted for by self-perceived deficits, depression, compensation claims or negative response bias. BDI scores were significantly higher in the patient group, and three patients fulfilled DSM-IV criteria for a mild episode of major depression. Primarily, well-recovered individuals who had sustained a minor trauma more than half a decade ago continue to have long-term cognitive and emotional sequelae relevant for everyday social and professional life. mTBI may lead to a lasting disruption of neurofunctional circuits not detectable by standard structural MRI and needs to be taken seriously in clinical and forensic evaluations.