DOI QR코드

DOI QR Code

Neurocognitive Function Differentiation from the Effect of Psychopathologic Symptoms in the Disability Evaluation of Patients with Mild Traumatic Brain Injury

  • Kim, Jin-Sung (Department of Psychiatry, College of Medicine, Yeungnam University) ;
  • Kim, Oh-Lyong (Department of Neurosurgery, College of Medicine, Yeungnam University) ;
  • Koo, Bon-Hoon (Department of Psychiatry, College of Medicine, Yeungnam University) ;
  • Kim, Min-Su (Department of Neurosurgery, College of Medicine, Yeungnam University) ;
  • Kim, Soon-Sub (Department of Psychiatry, College of Medicine, Yeungnam University) ;
  • Cheon, Eun-Jin (Department of Psychiatry, College of Medicine, Yeungnam University)
  • Received : 2012.09.13
  • Accepted : 2013.11.14
  • Published : 2013.11.28

Abstract

Objective : We determined whether the relationship between the neuropsychological performance of patients with mild traumatic brain injury (TBI) and their psychopathological characteristics measured by disability evaluation are interrelated. In addition, we assessed which psychopathological variable was most influential on neuropsychological performance via statistical clustering of the same characteristics of mild TBI. Methods : A total of 219 disability evaluation participants with mild brain injury were selected. All participants were classified into three groups, based on their psychopathological characteristics, via a two-step cluster analysis using validity and clinical scales from the Minnesota Multiphasic Personality Inventory (MMPI) and Symptom Checklist-90-revised (SCL-90-R). The Korean Wechsler Adult Intelligence Scale (K-WAIS), Korean Memory Assessment Scale (K-MAS) and the Korean Boston Naming Test (K-BNT) were used to evaluate the neurocognitive functions of mild TBI patients. Results : Over a quarter (26.9%) experienced severe psychopathological symptoms and 43.4% experienced mild or moderate psychopathological symptoms, and all of the mild TBI patients showed a significant relationship between neurocognitive functions and subjective and/or objective psychopathic symptoms, but the degree of this relationship was moderate. Variances of neurocognitive function were explained by neurotic and psychotic symptoms, but the role of these factors were different to each other and participants did not show intelligence and other cognitive domain decrement except for global memory abilities compared to the non-psychopathology group. Conclusion : Certain patients with mild TBI showed psychopathological symptoms, but these were not directly related to cognitive decrement. Psychopathology and cognitive decrement are discrete aspects in patients with mild TBI. Furthermore, the neurotic symptoms of mild TBI patients made positive complements to decrements or impairments of neurocognitive functions, but the psychotic symptoms had a negative effect on neurocognitive functions.

Keywords

References

  1. Arciniegas DB, Anderson CA, Topkoff J, McAllister TW : Mild traumatic brain injury : a neuropsychiatric approach to diagnosis, evaluation, and treatment. Neuropsychiatr Dis Treat 1 : 311-327, 2005
  2. Borod JC, Goodglass H, Kaplan E : Normative data on the Boston Diagnostic Aphasia Examination, Parietal Lobe and the Boston Naming Test. J Clin Neuropsychol 2 : 209-215, 1980 https://doi.org/10.1080/01688638008403793
  3. Bryant RA, O'Donnell ML, Creamer M, McFarlane AC, Clark CR, Silove D : The psychiatric sequelae of traumatic injury. Am J Psychiatry 167 : 312-320, 2010 https://doi.org/10.1176/appi.ajp.2009.09050617
  4. Derogatis LR, Lipman RS, Covi L : SCL-90 : an outpatient psychiatric rating scale--preliminary report. Psychopharmacol Bull 9 : 13-28, 1973
  5. Jeon IC, Kim OL, Kim MS, Kim SH, Chang CH, Bai DS : The effect of premorbid demographic factors on the recovery of neurocognitive function in traumatic brain injury patients. J Korean Neurosurg Soc 44 : 295-302, 2008 https://doi.org/10.3340/jkns.2008.44.5.295
  6. Kay T, Harrington DE, Adams R, Anderson T, Berrol S, Cicerone K, et al. : Definition of mild traumatic brain injury. J Head Trauma Rehabil 8 : 86-87, 1993 https://doi.org/10.1097/00001199-199309000-00010
  7. Kim GI, Kim JH, Won HT : Symptom Checklist-90-Revised. Seoul : Jungangjeokseong Press, 1984
  8. Kim HH, Na DR : The Korean version Boston Naming Test. Seoul : Hakjisa, 1997
  9. Kim YH, Kim JH, Kim JS, Rho ML, Yeon TH, Oh SW : The Korean version Minnesota Multiphasic Personality Inventory. Seoul : Korean Guidance, 1989
  10. Lee HS, Park BG, Ahn CI, Kim MLH, Jeung IG : Korean version of memory assessment scales. Seoul : Korean Guidance, 2001
  11. Levin HS : Memory deficit after closed head injury. J Clin Exp Neuropsychol 12 : 129-153, 1990 https://doi.org/10.1080/01688639008400960
  12. Lezak MD, Howieson DB, Loring DW, Hannay HJ, Fisher JS : Neuropsychological assessment, ed 4. New York : Oxford University Press, 2004, pp157-285
  13. Mittenberg W, Aguila-Puentes G, Patton C, Canyock EM, Heilbronner RL : Neuropsychologcial profiling of symptom exaggeration and malingering in Hom J, Denney RL (eds) : Detection of response bias in forensic neuropsychology. New York : The Haworth Medical Press, 2002, pp227-240
  14. Mittenberg W, DiGiulio DV, Perrin S, Bass AE : Symptoms following mild head injury : expectation as aetiology. J Neurol Neurosurg Psychiatry 55 : 200-204, 1992 https://doi.org/10.1136/jnnp.55.3.200
  15. Norusis MJ : IBM SPSS Statistics 19 Guide to Data Analysis. New Jersey : Pearson Education, 2011, pp361-391
  16. Patch PC, Hartlage LC : Behavioral change following traumatic brain injury, in Horton MN, ropsychology. New York : Springer Publishing Company, Inc., 2003, pp215-235
  17. Rapaport D, Gill MM, Schafer R : Diagnostic Psychological Testing. New York : International University Press, 1968, pp1-562
  18. Rees PM : Contemporary issues in mild traumatic brain injury. Arch Phys Med Rehabil 84 : 1885-1894, 2003 https://doi.org/10.1016/j.apmr.2003.03.001
  19. Rogers JM, Read CA : Psychiatric comorbidity following traumatic brain injury. Brain Inj 21 : 1321-1333, 2007 https://doi.org/10.1080/02699050701765700
  20. Ruff RM, Camenzuli L, Mueller J : Miserable minority : emotional risk factors that influence the outcome of a mild traumatic brain injury. Brain Inj 10 : 551-565, 1996 https://doi.org/10.1080/026990596124124
  21. Ruff RM, Richardson AM : Mild traumatic brain injury, in Sweet JJ (eds) : Forensic Neuropsychology : Fundamentals and Practice. New York : Psychology Press, 2005, pp315-337
  22. Shin TH, Gong CB, Kim MS, Kim JS, Bai DS, Kim OL : Development of a cognitive level explanation model in brain injury : comparisons between disability and non-disability evaluation groups. J Korean Neurosurg Soc 48 : 506-517, 2010 https://doi.org/10.3340/jkns.2010.48.6.506
  23. Slick DJ, Sherman EM, Iverson GL : Diagnostic criteria for malingered neurocognitive dysfunction : proposed standards for clinical practice and research. Clin Neuropsychol 13 : 545-561, 1999 https://doi.org/10.1076/1385-4046(199911)13:04;1-Y;FT545
  24. Teasdale G, Jennett B : Assessment of coma and impaired consciousness. A practical scale. Lancet 2 : 81-84, 1974
  25. Wechsler D : Wechsler adult intelligence scale-revised. New York : The Psychological Corporation, 1981
  26. Williams JM : Memory Assessment Scales. Odessa, FL : Psychological Assessment Resources, 1991Wilson BA, Vizor A, Bryant T : Predicting severity of cognitive impairment after severe head injury. Brain Inj 5 : 189-197, 1991 https://doi.org/10.3109/02699059109008089
  27. Williams WH, Potter S, Ryland H : Mild traumatic brain injury and Postconcussion Syndrome : a neuropsychological perspective. J Neurol Neurosurg Psychiatry 81 : 1116-1122, 2010 https://doi.org/10.1136/jnnp.2008.171298
  28. Yeom TH, Park YS, Oh KJ, Lee YH : Korean version Wechsler adult intelligence scale. Seoul : Korean Guidance, 1992