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Correlations between Cognitive Impairments and Employment Status in Patients with Diffuse Axonal Injury

Patients with diffuse axonal injury (DAI) may initially present with prominent physical impairments, but their cognitive dysfunctions are more persistent and are attributable to later unemployment. In this study, we analyzed how the findings of early and delayed neuropsychological assessments correl...

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Autores principales: HIROTA, Shin, INAJI, Motoki, NARIAI, Tadashi, HARA, Mutsuya, TAMAKI, Masashi, MAEHARA, Taketoshi, TOMITA, Hiroki, TONE, Osamu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5341345/
https://www.ncbi.nlm.nih.gov/pubmed/28003570
http://dx.doi.org/10.2176/nmc.oa.2016-0049
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author HIROTA, Shin
INAJI, Motoki
NARIAI, Tadashi
HARA, Mutsuya
TAMAKI, Masashi
MAEHARA, Taketoshi
TOMITA, Hiroki
TONE, Osamu
author_facet HIROTA, Shin
INAJI, Motoki
NARIAI, Tadashi
HARA, Mutsuya
TAMAKI, Masashi
MAEHARA, Taketoshi
TOMITA, Hiroki
TONE, Osamu
author_sort HIROTA, Shin
collection PubMed
description Patients with diffuse axonal injury (DAI) may initially present with prominent physical impairments, but their cognitive dysfunctions are more persistent and are attributable to later unemployment. In this study, we analyzed how the findings of early and delayed neuropsychological assessments correlated with employment outcome of patients with DAI. A total of 56 patients with DAI without motor or visual dysfunction were included in this study. The neuropsychological battery consisted of the Wechsler Adult Intelligent Scale - Revised (WAIS-R), Wechsler Memory Scale - Revised (WMS-R), Trail Making Test (TMT), Wisconsin Card Sorting Test (WCST), and Word Fluency Test (WFT). This battery of tests was administered twice in early stage after injury and in later stage. The results of all of the neuropsychological tests improved significantly (P <0.001) between the early and later assessments. All scores other than TMT part A and B improved to the normal range (Z-score ≥ 2). The patient characteristics (age, gender, initial Glasgow Coma Scale, and duration of posttraumatic amnesia) had no relationship to the outcome. The results of TMT part B, however, were significantly correlated with employment outcome in both the early and later assessments (P = 0.01, 0.04). Given that TMT evaluates visual attention, we surmise that a lack of attention may be the core symptom of the cognitive deficit and cause the re-employment failure in patients with DAI. TMT part B in both early and later assessments has the potential to accurately predict chronic functional outcome.
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spelling pubmed-53413452017-03-24 Correlations between Cognitive Impairments and Employment Status in Patients with Diffuse Axonal Injury HIROTA, Shin INAJI, Motoki NARIAI, Tadashi HARA, Mutsuya TAMAKI, Masashi MAEHARA, Taketoshi TOMITA, Hiroki TONE, Osamu Neurol Med Chir (Tokyo) Original Article Patients with diffuse axonal injury (DAI) may initially present with prominent physical impairments, but their cognitive dysfunctions are more persistent and are attributable to later unemployment. In this study, we analyzed how the findings of early and delayed neuropsychological assessments correlated with employment outcome of patients with DAI. A total of 56 patients with DAI without motor or visual dysfunction were included in this study. The neuropsychological battery consisted of the Wechsler Adult Intelligent Scale - Revised (WAIS-R), Wechsler Memory Scale - Revised (WMS-R), Trail Making Test (TMT), Wisconsin Card Sorting Test (WCST), and Word Fluency Test (WFT). This battery of tests was administered twice in early stage after injury and in later stage. The results of all of the neuropsychological tests improved significantly (P <0.001) between the early and later assessments. All scores other than TMT part A and B improved to the normal range (Z-score ≥ 2). The patient characteristics (age, gender, initial Glasgow Coma Scale, and duration of posttraumatic amnesia) had no relationship to the outcome. The results of TMT part B, however, were significantly correlated with employment outcome in both the early and later assessments (P = 0.01, 0.04). Given that TMT evaluates visual attention, we surmise that a lack of attention may be the core symptom of the cognitive deficit and cause the re-employment failure in patients with DAI. TMT part B in both early and later assessments has the potential to accurately predict chronic functional outcome. The Japan Neurosurgical Society 2017-02 2016-12-22 /pmc/articles/PMC5341345/ /pubmed/28003570 http://dx.doi.org/10.2176/nmc.oa.2016-0049 Text en © 2017 The Japan Neurosurgical Society This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Original Article
HIROTA, Shin
INAJI, Motoki
NARIAI, Tadashi
HARA, Mutsuya
TAMAKI, Masashi
MAEHARA, Taketoshi
TOMITA, Hiroki
TONE, Osamu
Correlations between Cognitive Impairments and Employment Status in Patients with Diffuse Axonal Injury
title Correlations between Cognitive Impairments and Employment Status in Patients with Diffuse Axonal Injury
title_full Correlations between Cognitive Impairments and Employment Status in Patients with Diffuse Axonal Injury
title_fullStr Correlations between Cognitive Impairments and Employment Status in Patients with Diffuse Axonal Injury
title_full_unstemmed Correlations between Cognitive Impairments and Employment Status in Patients with Diffuse Axonal Injury
title_short Correlations between Cognitive Impairments and Employment Status in Patients with Diffuse Axonal Injury
title_sort correlations between cognitive impairments and employment status in patients with diffuse axonal injury
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5341345/
https://www.ncbi.nlm.nih.gov/pubmed/28003570
http://dx.doi.org/10.2176/nmc.oa.2016-0049
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