Cognitive impairment in diffuse axonal injury patients with favorable outcome
Background and purposeTraumatic brain injury (TBI), especially the severe TBI are often followed by persistent cognitive sequalae, including decision-making difficulties, reduced neural processing speed and memory deficits. Diffuse axonal injury (DAI) is classified as one of the severe types of TBI....
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2023.1077858/full |
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| author | Weiliang Chen Chunyu Yao Shengwen Li Hongguang Huang Zujian Zhu Rui Chen Wen Su Xiao Huang Lisheng Xu Kaijie Sun Jiannan Song Rongcai Jiang Guanjun Wang |
| author_facet | Weiliang Chen Chunyu Yao Shengwen Li Hongguang Huang Zujian Zhu Rui Chen Wen Su Xiao Huang Lisheng Xu Kaijie Sun Jiannan Song Rongcai Jiang Guanjun Wang |
| author_sort | Weiliang Chen |
| collection | DOAJ |
| description | Background and purposeTraumatic brain injury (TBI), especially the severe TBI are often followed by persistent cognitive sequalae, including decision-making difficulties, reduced neural processing speed and memory deficits. Diffuse axonal injury (DAI) is classified as one of the severe types of TBI. Part of DAI patients are marginalized from social life due to cognitive impairment, even if they are rated as favorable outcome. The purpose of this study was to elucidate the specific type and severity of cognitive impairment in DAI patients with favorable outcome.MethodsThe neurocognition of 46 DAI patients with favorable outcome was evaluated by the Chinese version of the Montreal Cognitive Assessment Basic (MoCA-BC), and the differences in the domains of cognitive impairment caused by different grades of DAI were analyzed after data conversion of scores of nine cognitive domains of MoCA-BC by Pearson correlation analysis.ResultsAmong the 46 DAI patients with favorable outcome, eight had normal cognitive function (MoCA-BC ≥ 26), and 38 had cognitive impairment (MoCA-BC < 26). The MoCA-BC scores were positively correlated with pupillary light reflex (r = 0.361, p = 0.014), admission Glasgow Coma Scale (GCS) (r = 0.402, p = 0.006), and years of education (r = 0.581, p < 0.001). Return of consciousness (r = −0.753, p < 0.001), Marshall CT (r = −0.328, p = 0.026), age (r = −0.654, p < 0.001), and DAI grade (r = −0.403, p = 0.006) were found to be negatively correlated with the MoCA-BC scores. In patients with DAI grade 1, the actually deducted scores (Ads) of memory (r = 0.838, p < 0.001), abstraction (r = 0.843, p < 0.001), and calculation (r = 0.782, p < 0.001) were most related to the Ads of MoCA-BC. The Ads of nine cognitive domains and MoCA-BC were all proved to be correlated, among patients with DAI grade 2. However, In the DAI grade 3 patients, the highest correlation with the Ads of MoCA-BC were the Ads of memory (r = 0.904, p < 0.001), calculation (r = 0.799, p = 0.006), orientation (r = 0.801, p = 0.005), and executive function (r = 0.869, p = 0.001).ConclusionDAI patients with favorable outcome may still be plagued by cognitive impairment, and different grades of DAI cause different domains of cognitive impairment. |
| first_indexed | 2024-04-10T20:31:52Z |
| format | Article |
| id | doaj.art-8e4e0a4313244ff1b8f56328a106243f |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-04-10T20:31:52Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neuroscience |
| spelling | doaj.art-8e4e0a4313244ff1b8f56328a106243f2023-01-25T05:58:14ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2023-01-011710.3389/fnins.2023.10778581077858Cognitive impairment in diffuse axonal injury patients with favorable outcomeWeiliang Chen0Chunyu Yao1Shengwen Li2Hongguang Huang3Zujian Zhu4Rui Chen5Wen Su6Xiao Huang7Lisheng Xu8Kaijie Sun9Jiannan Song10Rongcai Jiang11Guanjun Wang12Department of Neurosurgery, Haining People’s Hospital, Jiaxing, Zhejiang, ChinaDepartment of Neurosurgery, Haining People’s Hospital, Jiaxing, Zhejiang, ChinaThe Second Department of Orthopaedics, Haining People’s Hospital, Haining, Zhejiang, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Zhejiang University Medical College, Hangzhou, Zhejiang, ChinaDepartment of Neurosurgery, Haining People’s Hospital, Jiaxing, Zhejiang, ChinaDepartment of Neurosurgery, Haining People’s Hospital, Jiaxing, Zhejiang, ChinaDepartment of Neurosurgery, Haining People’s Hospital, Jiaxing, Zhejiang, ChinaDepartment of Neurosurgery, Haining People’s Hospital, Jiaxing, Zhejiang, ChinaDepartment of Neurosurgery, Haining People’s Hospital, Jiaxing, Zhejiang, ChinaDepartment of Neurosurgery, Haining People’s Hospital, Jiaxing, Zhejiang, ChinaDepartment of Neurosurgery, Haining People’s Hospital, Jiaxing, Zhejiang, ChinaDepartment of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Neurosurgery, Haining People’s Hospital, Jiaxing, Zhejiang, ChinaBackground and purposeTraumatic brain injury (TBI), especially the severe TBI are often followed by persistent cognitive sequalae, including decision-making difficulties, reduced neural processing speed and memory deficits. Diffuse axonal injury (DAI) is classified as one of the severe types of TBI. Part of DAI patients are marginalized from social life due to cognitive impairment, even if they are rated as favorable outcome. The purpose of this study was to elucidate the specific type and severity of cognitive impairment in DAI patients with favorable outcome.MethodsThe neurocognition of 46 DAI patients with favorable outcome was evaluated by the Chinese version of the Montreal Cognitive Assessment Basic (MoCA-BC), and the differences in the domains of cognitive impairment caused by different grades of DAI were analyzed after data conversion of scores of nine cognitive domains of MoCA-BC by Pearson correlation analysis.ResultsAmong the 46 DAI patients with favorable outcome, eight had normal cognitive function (MoCA-BC ≥ 26), and 38 had cognitive impairment (MoCA-BC < 26). The MoCA-BC scores were positively correlated with pupillary light reflex (r = 0.361, p = 0.014), admission Glasgow Coma Scale (GCS) (r = 0.402, p = 0.006), and years of education (r = 0.581, p < 0.001). Return of consciousness (r = −0.753, p < 0.001), Marshall CT (r = −0.328, p = 0.026), age (r = −0.654, p < 0.001), and DAI grade (r = −0.403, p = 0.006) were found to be negatively correlated with the MoCA-BC scores. In patients with DAI grade 1, the actually deducted scores (Ads) of memory (r = 0.838, p < 0.001), abstraction (r = 0.843, p < 0.001), and calculation (r = 0.782, p < 0.001) were most related to the Ads of MoCA-BC. The Ads of nine cognitive domains and MoCA-BC were all proved to be correlated, among patients with DAI grade 2. However, In the DAI grade 3 patients, the highest correlation with the Ads of MoCA-BC were the Ads of memory (r = 0.904, p < 0.001), calculation (r = 0.799, p = 0.006), orientation (r = 0.801, p = 0.005), and executive function (r = 0.869, p = 0.001).ConclusionDAI patients with favorable outcome may still be plagued by cognitive impairment, and different grades of DAI cause different domains of cognitive impairment.https://www.frontiersin.org/articles/10.3389/fnins.2023.1077858/fulldiffuse axonal injurycognitive impairmentoutcomeMontreal cognitive assessmentcognitive domain |
| spellingShingle | Weiliang Chen Chunyu Yao Shengwen Li Hongguang Huang Zujian Zhu Rui Chen Wen Su Xiao Huang Lisheng Xu Kaijie Sun Jiannan Song Rongcai Jiang Guanjun Wang Cognitive impairment in diffuse axonal injury patients with favorable outcome Frontiers in Neuroscience diffuse axonal injury cognitive impairment outcome Montreal cognitive assessment cognitive domain |
| title | Cognitive impairment in diffuse axonal injury patients with favorable outcome |
| title_full | Cognitive impairment in diffuse axonal injury patients with favorable outcome |
| title_fullStr | Cognitive impairment in diffuse axonal injury patients with favorable outcome |
| title_full_unstemmed | Cognitive impairment in diffuse axonal injury patients with favorable outcome |
| title_short | Cognitive impairment in diffuse axonal injury patients with favorable outcome |
| title_sort | cognitive impairment in diffuse axonal injury patients with favorable outcome |
| topic | diffuse axonal injury cognitive impairment outcome Montreal cognitive assessment cognitive domain |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2023.1077858/full |
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