Neuropsychological and behavioral disorders and their correlations with the severity of the traumatic brain injury.

OBJECTIVE: The goal of this study was to evaluate the different neuropsychological and behavioral disorders of patients with traumatic brain injury (TBI) and to study their correlations with the epidemiological and neurotraumatic characteristics.

MATERIAL/PATIENTS AND METHODS: It was a cross-sectional study including 30 patients with TBI conducted in the physical medicine and rehabilitation department. The analysis of memory impairment was performed by the (MMS) and the (GOAT) tests. The psychological profile was evaluated by the HAD scale. Behavioral disorders were tested by the agitated behavior scale. Otherwise, the executive functions were evaluated by the DEX scale. The global social-functional evolution was measured by the GOS scale.

RESULTS: The mean age was 32.19±12.37years with a sex-ratio of 3,5. The mean follow-up period was 3,9±2.24years. Fifteen patients (55.6%) had severe TBI. Memory disorders were observed in 9 patients (36%) when evaluated by the MMS scale and in 5 patients (18.5%) by the GOAT scale. Depressive symptoms were found in 17 patients (70.4%); Moreover, anxiety was noted in 15 patients (55.6%). Behavioral troubles, such as aggressiveness and agitation were noted respectively in 17 (63%) and 6 patients (22.2%). Severe agitation level was found in one patient (3.7%). Abnormal executive functions were noted in 17 patients (76.7%) with an average. Dex score of 23.68±22.8. The most affected dimensions were intentionality and negative affect. Dex score of 23.68±22.8. The most affected dimensions were intentionality and negative affect. We have found correlations between cognitive impairment and the education level (P<0.01), between aggression and male sex (P<0.01) and between abnormal executive functions and the initial GSC score (P=0.04, r=-0.43). The lack of overall improvement (GOS scale) was correlated to the degree of abnormal executive function (P=0.02).

DISCUSSION-CONCLUSION: The executive function disorders, depressed mood and the memory disorders seemed to be the most frequent among neuropsychological disorders in TBI. We noted that it is so important to evaluate neuropsychological disorders in TBI because they were underestimated. We have started this experience despite the lack of means in our department. The evaluation of the executive function in addition to the classic neurospsychological assessment is essential to propose efficient means of rehabilitation.