Neuropsychological assessment of a long-term (LT) outcome after severe traumatic brain injury (TBI)

Introduction/Background Neuropsychological assessment of a LT outcome after severe TBI, in correlation with daily life disability. Material and method Severe TBI patients admitted in the Intensive Care Unit in Pitie-Salpetriere hospital (France) from 2005 to 2012 were included. MRI, clinical PRM and neuropsychological assessments were performed. Neuropsychological performances were measured by 10 composite scores (CS) representing the main cognitive functions. The Glasgow Outcome Scale Extended (GOSE) assessed the global functional outcome. Use of self and relatives’ assessment questionnaires allowed evaluation of cognitive complaints in everyday life (Dysexecutive questionnaire–DEX; Working Memory Questionnaire - WMQ; Brain Injury Complaint Questionnaire - BICoQ). Results 101 patients (84.16% men; mean age 38.55 ± 16.03 [19–73]) were included. They presented with initial severity of TBI: GSC median ± 3.6 [3–15]; coma duration 19.01 days ± 18.22 [0–120]; PTA duration 97.8% > 1 day. Assessments were performed at a mean delay of 5 years and 2 months after BI. This cohort had a mean moderate disability according to GOSE (Median  ± 1.32 [3–8]). Neuropsychological evaluation emphasized high prevalence of different cognitive deficits: attention (sustained attention deficit in 63.04% of subjects, tonic alertness 24.75%, divided attention 43.56%), executive functions (EF) (planning 55.56%, mental flexibility 24.75%, generation of new information 20.79%), working memory (WM) (46%) and update (46.88%), anterograde episodic memory (AEM) (46%). Surprisingly inhibition was not noticeable in this cohort (1%). GOSE was significantly related to EF, WM (0.0047*), AEM ( Conclusion Five years after TBI, patients and their relatives are still affected by cognitive disorders. Relatives complaints are clearly informative of participation restrictions. This study emphasizes the importance of LT assessment and follow up in TBI patients and their relatives.