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

Published online by Cambridge University Press:  22 September 2010

C. Konrad ,
A. J. Geburek ,
F. Rist ,
H. Blumenroth ,
B. Fischer ,
I. Husstedt ,
V. Arolt ,
H. Schiffbauer  and
H. Lohmann
C. Konrad*
Affiliation:
Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Germany Department of Psychiatry, University of Münster, Germany
A. J. Geburek
Affiliation:
Department of Psychiatry, University of Münster, Germany Department of Psychology, University of Münster, Germany
F. Rist
Affiliation:
Department of Psychology, University of Münster, Germany
H. Blumenroth
Affiliation:
Department of Clinical Radiology, University of Münster, Germany
B. Fischer
Affiliation:
Department of Neurosurgery, University of Münster, Germany
I. Husstedt
Affiliation:
Department of Neurology, University of Münster, Germany
V. Arolt
Affiliation:
Department of Psychiatry, University of Münster, Germany
H. Schiffbauer
Affiliation:
Department of Clinical Radiology, University of Münster, Germany Department of Radiology, University of Bonn, Germany
H. Lohmann
Affiliation:
Department of Neurology, University of Münster, Germany
*
*Address for correspondence: Dr C. Konrad, Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Strasse 8, 35039 Marburg, Germany. (Email: Carsten.Konrad@med.uni-marburg.de)
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Abstract

Background

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.

Method

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).

Results

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.

Conclusions

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.

Keywords

Brain injurycognitiondepression
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 6 , June 2011 , pp. 1197 - 1211
Copyright
Copyright © Cambridge University Press 2010

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