Citation

Spikman JM, van der Naalt J. J. Neurotrauma 2010; 27(7): 1195-1202.

Affiliation

University Medical Centre Groningen, Neuropsychology, Hanzeplein 1, 9713 GZ Groningen, Groningen, Netherlands, 9713 GZ, 0031503611422; j.m.spikman@rug.nl.

Copyright

(Copyright © 2010, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2010.1277

PMID

20380551

Abstract

In patients with moderate to severe traumatic brain injury (TBI), impairments of self-awareness are frequently found and associated with worse functional outcome and poor compliance with rehabilitation. The aim of this study was to investigate whether indications of impaired self-awareness could be found in TBI patients with frontal lesions and executive function deficits. Twenty-two TBI patients with focal frontal injuries were compared to 29 TBI patients without focal frontal injuries visible on neuroimaging. No differences were found on several outcome measures; the GOS-E (Extended Glasgow Outcome Scale), DOS (Differential Outcome Scale) and return to work (RTW), although the Frontal patients were more severely injured indicated by the GCS and PTA-duration and had impaired performance on a neuropsychological test for executive functioning. Even more so, the Frontal group had a significantly lower score on the Sickness Impact Profile (SIP), indicating that they had less complaints than the Nonfrontals, and scored significantly higher on the Percentage of Recovery score (PoR), which expresses the extent of recovery in a percentage of their previous functioning. In contrast to the Nonfrontal group, these PoR scores were not related to RTW, reflecting an erroneous perception of the actual working status. The positive results on these different outcome measures, which are partly or entirely self-reported, were conceived as an indication for an impaired self-evaluative ability in the Frontal patients. To determine outcome in patients with frontal injuries and executive dysfunction, judgment of several different relevant others' (partners, therapists, employers) of the patients' daily life functioning should be taken into account. Key words: TBI, outcome, frontal lesions, impaired self-awareness, executive functions.

Language: en