Ocena wpływu urazów mózgu na funkcje poznawcze i ryzyko rozwoju epilepsji pourazowej
Evaluating Cognitive Impact of Traumatic Brain Injury and Risk for Post-Traumatic Epilepsy
W skrócie
[Preprint - wstępne wyniki] Badanie wykazało, że pacjenci z urazem mózgu, u których rozwinęła się epilepsja pourazowa, mają większe trudności z pamięcią, uwagą i myśleniem niż ci, u których epilepsja się nie rozwinęła. Obserwowano, że szybkość przetwarzania informacji i pamięć pracująca poprawiały się u pacjentów z samym urazem w ciągu 18 miesięcy, ale pozostały deficytowe u tych, którzy zachorovali na epilepsję. Badacze sugerują, że brak poprawy w tych obszarach funkcji poznawczych może być wskaźnikiem podwyższonego ryzyka rozwoju epilepsji pourazowej.
Oryginalny abstract (angielski)
Abstract: Objective: Post-traumatic epilepsy (PTE) is a common sequela of traumatic brain injury (TBI). Research indicates that individuals with PTE tend to experience greater cognitive difficulties compared to those with TBI alone. However, it is plausible that a distinct cognitive profile exists that distinguishes between TBI cases with and without PTE. We aimed to identify longitudinal changes in cognitive measures among TBI patients to better assess the changes associated with developing PTE. Setting: Outpatient. Participants: Prospective subjects who had suffered TBI within 6 months post-injury (TBI-6M, n=32), retrospective subjects with pre-existing PTE diagnoses (PTE, n=20), and healthy control subjects (HC, n=41). Design: We examined cognitive performance for TBI patients within 6 months post-injury, then again within 12 months (TBI-12M, n=26), and within 18-months (TBI-18M, n=25), and compared this with cognitive performance among HC and PTE. Main Measures: Cognitive tests administered yielded 15 test components for analysis. We utilized linear mixed effects modeling to examine cohort-level differences cognitive function. Results: 11/15 tests showed a significant performance deficit in the PTE subjects compared to HC. TBI-6M was not significantly different from the PTE subjects; with time, 9/15 tests showed some degree of recovery in TBI subjects. Tests for information processing speed/working memory and executive function showed strong recovery (TBI-6M vs. TBI-18M, SDMT written: p Conclusions: Information processing speed/working memory are strong indicators for TBI recovery, while auditory learning/memory shows chronic impairment. The stagnation of recovery in cognitive domains typically characterized by robust recovery may correlate with an elevated risk of developing PTE.