Cognitive evoked potentials in the diagnosis of post-concussion syndrome due to blast mild traumatic brain injury
DOI:
https://doi.org/10.25305/unj.236138Keywords:
blast mild traumatic brain injury, post-concussion syndrome, cognitive impairment, cognitive evoked potentials, P300Abstract
Hostilities in the East of Ukraine are characterized by the use of new weapons, including rocket artillery, rocket-propelled grenades and landmines. This has led to an increase in the number of victims with blast mild traumatic brain injury (BMTBI) and the need to provide them with effective assistance and rehabilitation. An important task is to improve the BMTBI diagnosis by specifying the objective criteria for structural and functional disorders of the central nervous system. This will improve the prognosis of the course of BMTBI in the injured and the treatment program, including personalized, to prevent the development of persistent neurological deficit.
Objective: to investigate the possibilities of the cognitive evoked potentials (CEP) method for the objective diagnosis of cognitive disorders in post-concussion syndrome (PCS) BMTBI.
Materials and methods. The study involved 115 men with PCS (main group) and 30 healthy individuals (control group). The cognitive functions of the study participants were studied using the questionnaire "Cicerone". The neurophysiological method for assessing the functional state of the brain involved the registration of CEP, event-related (P300 CEP).
Results. The selection of a subgroup of patients with PCS, characterized by a predominance of cognitive impairments, allowed us to trace the relationship between the results of neurophysiological studies with the cognitive indicators of patients with BMTBI. P300 latency indices are inversely proportional to cognitive assessment the questionnaire "Cicerone" and statistically significantly depend on the severity of cognitive impairment.
Conclusions. The CEP P300 method can be an effective means of objectifying the degree of cognitive impairment in patients with PCS due to BMTBI.
References
Kobeissy F, Mondello S, Tümer N, Toklu HZ, Whidden MA, Kirichenko N, Zhang Z, Prima V, Yassin W, Anagli J, Chandra N, Svetlov S, Wang KK. Assessing neuro-systemic & behavioral components in the pathophysiology of blast-related brain injury. Front Neurol. 2013 Nov 21;4:186. doi: 10.3389/fneur.2013.00186
Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. Soldiers returning from Iraq. N Engl J Med. 2008 Jan 31;358(5):453-63. doi: 10.1056/NEJMoa072972
Owens BD, Kragh JF Jr, Wenke JC, Macaitis J, Wade CE, Holcomb JB. Combat wounds in operation Iraqi Freedom and operation Enduring Freedom. J Trauma. 2008 Feb;64(2):295-9. doi: 10.1097/TA.0b013e318163b875
Elder GA. Update on TBI and Cognitive Impairment in Military Veterans. Curr Neurol Neurosci Rep. 2015 Oct;15(10):68. doi: 10.1007/s11910-015-0591-8
Phipps H, Mondello S, Wilson A, Dittmer T, Rohde NN, Schroeder PJ, Nichols J, McGirt C, Hoffman J, Tanksley K, Chohan M, Heiderman A, Abou Abbass H, Kobeissy F, Hinds S. Characteristics and Impact of U.S. Military Blast-Related Mild Traumatic Brain Injury: A Systematic Review. Front Neurol. 2020 Nov 2;11:559318. doi: 10.3389/fneur.2020.559318
Sirko A, Pilipenko G, Romanukha D, Skrypnik A. Mortality and Functional Outcome Predictors in Combat-Related Penetrating Brain Injury Treatment in a Specialty Civilian Medical Facility. Mil Med. 2020 Jun 8;185(5-6):e774-e780. doi: 10.1093/milmed/usz431
Kucherov Y, Hubler GK, DePalma RG. Blast induced mild traumatic brain injury/concussion: a physical analysis. Journal of Applied Physics. 2012 Nov 15;112(10):104701. doi: 10.1063/1.4765727
Benzinger TL, Brody D, Cardin S, Curley KC, Mintun MA, Mun SK, Wong KH, Wrathall JR. Blast-related brain injury: imaging for clinical and research applications: report of the 2008 st. Louis workshop. J Neurotrauma. 2009 Dec;26(12):2127-44. doi: 10.1089/neu.2009.0885
Veitch DP, Friedl KE, Weiner MW. Military risk factors for cognitive decline, dementia and Alzheimer's disease. Curr Alzheimer Res. 2013 Nov;10(9):907-30. doi: 10.2174/15672050113109990142
Karr JE, Areshenkoff CN, Duggan EC, Garcia-Barrera MA. Blast-related mild traumatic brain injury: a Bayesian random-effects meta-analysis on the cognitive outcomes of concussion among military personnel. Neuropsychol Rev. 2014 Dec;24(4):428-44. doi: 10.1007/s11065-014-9271-8
Dwyer B, Katz DI. Postconcussion syndrome. Handb Clin Neurol. 2018;158:163-178. doi: 10.1016/B978-0-444-63954-7.00017-3
Elder GA, Mitsis EM, Ahlers ST, Cristian A. Blast-induced mild traumatic brain injury. Psychiatr Clin North Am. 2010 Dec;33(4):757-81. doi: 10.1016/j.psc.2010.08.001
Cicerone KD, Kalmar K. Persistent postconcussion syndrome: the structure of subjective complaints after mild traumatic brain injury. The Journal of head trauma rehabilitation. 1995;10(3):1–17. doi: 10.1097/00001199-199510030-00002
Zakharov VV. [Neuro-psychiatric disorders: diagnostic tests]. Moscow: MEDpress-inform. 2013. Russian.
Solovyova AP, Goryachev DV, Arkhipov VV. [Criteria for assessment of cognitive impairment in clinical trials]. The Bulletin of the Scientific Centre for Expert Evaluation of Medicinal Products. 2018 Nov 22;8(4):218-30. doi:10.30895/1991-2919-2018-8-4-218-230.
Kropotov YD. [Quantitative EEG, event related potentials and neurotherapy]. Donetsk: Publisher Zaslavsky AY. 2010. Russian.
Gnezditskiy VV, Korepina OS, Chatskaya AV, Klochkova OI. [Memory, Cognition and the Endogenous Evoked Potentials of the Brain: the Estimation of the Disturbance of Cognitive Functions and Capacity of Working Memory Without the Psychological Testing]. Uspekhi fiziologicheskikh nauk. 2017 Jan 1;48(1):3-23. Russian.
Chebotariova LL, Solonovych OS, Kadzhaya MV, Tretiakova AI, Solonovych AS, Pronoza-Stebliuk KV, Stebliuk VV. [Risk factors of cognitive impairment in patients with blast-related mild traumatic brain injury]. Ukrainian Neurosurgical Journal. 2019;25(4):16-24. Ukrainian. doi: 10.25305/unj.174610
Chebotariova LL, Tretiakova AI, Solonovych AS, Sulii LM, Zol’nikova AY. Post-concussion syndrome after a mine blast injury: neuropsychological consequences and changes of the cognitive evoked potentials (P 300). Neurophysiology. 2020 Jul;52(4):289-97. doi: 10.1007/s11062-021-09884-7
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Y. V. Zavaliy, O. S. Solonovych, V. V. Biloshitsky, Trеtiakova A. I., L. L. . Chebotariova, L. M. Suliy,
This work is licensed under a Creative Commons Attribution 4.0 International License.
Ukrainian Neurosurgical Journal abides by the CREATIVE COMMONS copyright rights and permissions for open access journals.
Authors, who are published in this Journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the Journal under the terms of Creative Commons Attribution License, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this Journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form of which it has been published by the Journal (for example, to upload the work to the online storage of the Journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this Journal is included.
