Executive Functions Deficits After Severe Traumatic Brain Injury: The GREFEX Study

被引：30

作者：

Azouvi, Philippe ^{[1
,2
]}

Vallat-Azouvi, Claire ^{[2
,3
]}

Joseph, Pierre-Alain ^{[4
]}

Meulemans, Thierry ^{[5
]}

Bertola, Celine ^{[6
]}

Le Gall, Didier ^{[7
,8
,9
]}

Bellmann, Anne ^{[10
]}

Roussel, Martine ^{[11
,12
]}

Coyette, Francoise ^{[13
]}

Krier, Marianne ^{[14
]}

Franconie, Catherine ^{[15
]}

Bindschadler, Claire ^{[16
]}

Diouf, Momar ^{[17
]}

Godefroy, Olivier ^{[11
,12
]}

机构：

[1] Hop Raymond Poincare, AP HP, Serv Med Phys & Readaptat, Garches, France

[2] Univ Versailles St Quentin, EA HANDIReSP 4047, Garches, France

[3] Hop Raymond Poincare, UGECAMIDF, Antenne UEROS & SAMSAH92, Garches, France

[4] Univ Bordeaux, EA 4136, Liege, Belgium

[5] Univ Liege, Neuropsychol Unit, Liege, Belgium

[6] Fdn Hopale, CRF Calve, Berck Sur Mer, France

[7] CHU, EA 4638, LPPL, Angers, France

[8] CHU, Unite Neuropsychol, Angers, France

[9] Univ Angers, Angers, France

[10] Clin Romande Readaptat, Sion, Switzerland

[11] Univ Hosp Amiens, Dept Neurol, Amiens, France

[12] Univ Hosp Amiens, Lab Funct Neurosci, EA 4559, Amiens, France

[13] St Luc Univ, Hosp Bruxelles, Brussels, Belgium

[14] Inst Reg Med Phys & Readaptat, Nancy, France

[15] Univ Hosp, Nimes, France

[16] Univ Lausanne Hosp, Lausanne, Switzerland

[17] Univ Hosp Amiens, Dept Biostat, Amiens, France

来源：

JOURNAL OF HEAD TRAUMA REHABILITATION | 2016年 / 31卷 / 03期

关键词：

assessment; behavior; cognition; executive functions; rehabilitation; traumatic brain injury; CLOSED-HEAD INJURY; DYSEXECUTIVE SYNDROME; ALZHEIMERS-DISEASE; DIAGNOSTIC-CRITERIA; DIVIDED ATTENTION; WORKING-MEMORY; NORMATIVE DATA; REHABILITATION; DYSFUNCTION; COMA;

D O I：

10.1097/HTR.0000000000000169

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: To assess the sensitivity of traditional neuropsychological tests and of a behavioral inventory of executive disorders in a large sample of patients with chronic severe traumatic brain injury. Methods: A total of 112 patients were compared with 780 healthy controls from a larger database. The GREFEX battery included 7 widely used tests and the Behavioral Dysexecutive Syndrome Inventory (proxy rating). A previously described statistical methodology was used, controlling for age, education, and gender. Summary scores were computed and performance was dichotomized on the basis of 5th percentile cutoffs from controls' z scores. Results: The frequency of cognitive impairment was high (55.4%) but lower than that of behavioral changes (81.5%). Double dissociations were observed between cognitive and behavioral assessments. Behavioral changes exhibited larger effect-sizes as compared with cognitive impairments. Logistic regression analysis showed that 3 cognitive tests (verbal fluency, Stroop reading, and Trail Making Test-B) and 3 behavior z scores (hypoactivity, anticipation, and hyperactivity) best discriminated patients from controls. Conclusion: Behavioral changes were more frequent and severe than cognitive deficits, at least as assessed with traditional testing. The present results also suggest that a shortened battery may provide a rapid screening method with reasonable sensitivity to detect deficits of executive functions in patients with severe traumatic brain injury.

引用

页码：E10 / E20

页数：11