Correlation of neuropsychological deficits with findings on MRI AND NEUROPET in patients with MTBI
Keywords:mild traumatic brain injury; neuropsychological test scores; post traumatic symptoms;
Background & Objective: Spectrums of post-traumatic symptoms are frequent among mild traumatic brain injury (MTBI) patients. They account for symptoms in 40-80% of patients during 3-4months and 15-30% of patients 6 months post-injury. There are no studies in India to support the literature of the same. The current prospective study evaluates neuropsychological deficits (NPD) and explores the value of MRI and NEUROPET in patients with MTBI. Methods: Fifteen MTBI patients presenting with initial GCS score of 13-15 were recruited initially 1-2 weeks post injury. All patients were followed up twice, after 1-2 and 6-7months. The patients were evaluated with MRI , Neuropet, neuropsychological test (PGIBBD – PGI brain battery of dysfunction ), post-traumatic symptoms . All test variables were analyzed using repeated measure of analysis with 0.05 significant levels. Results: Sustained-attention was first to improve. Memory and executive domains improved partially until 2months and then after complete recovery. But few facets of learning/memory did not improve even at 6months. The post traumatic symptoms decreased since baseline from 76% to 52% at 3-4months and further to 28% at 6-7 months. The results of present study provide information that MRI lesions found in MTBI patients were predictive of neuropsychological deficits (NPD) if scan was done as early as within 1 week post injury. FDG F18 Neuropet in the present study has demonstrated hypometabolic lesions not seen on MRI and these lesions were correlating to neuropsychological deficits which were persistant 6 mths post injury in respective patients. Interpretations & Conclusion: The study reports course of changes in cognition, traumatic symptoms, since the time of injury till 6-7months. The results summarize that majority of post-traumatic symptoms recovers after MTBI without any intrusions, but residuals are not uncommon. Structural lesions on MRI may not always be present but when present may influence the degree or severity of the symptoms in patients with MTBI. Introduction of FDG PET as an early diagnostic modality in patients with neuropsychological disturbances after MTBI might be beneficial as the patients will be opted for relevant pharmacological and cognitive behavioural interventions.
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Copyright (c) 2022 Ramesh Chandra VV, Mohana Sasank Deevi, BCM Prasad
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