Di Paola Margherita, Phillips Owen, Costa Alberto, Ciurli Paola, Bivona Umberto, Catani Sheila, Formisano Rita, Caltagirone Carlo, Carlesimo Giovanni Augusto
Clinical and Behavioural Neurology Department (Drs Di Paola, Costa, Caltagirone, and Carlesimo and Mr Phillips), Post-Coma Unit (Drs Bivona, Catani, and Formisano), and Neuropsychological Diagnosis and Rehabilitation Unit (Dr Ciurli), IRCCS Santa Lucia Foundation, Rome, Italy; MeSVA Department, University of L'Aquila, L'Aquila, Italy (Dr Paola); and Neuroscience Department, University of Rome "Tor Vergata," Rome, Italy (Drs Caltagirone and Carlesimo).
J Head Trauma Rehabil. 2015 Nov-Dec;30(6):402-10. doi: 10.1097/HTR.0000000000000063.
Cognitive dysfunction is a common sequela of traumatic brain injury (TBI); indeed, patients show a heterogeneous pattern of cognitive deficits. This study was aimed at investigating whether patients who show selective cognitive dysfunction after TBI present a selective pattern of cerebral damage.
Post-Coma Unit, IRCCS Santa Lucia Foundation, Rome, Italy.
We collected data from 8 TBI patients with episodic memory disorder and without executive deficits, 7 patients with executive function impairment and preserved episodic memory capacities, and 16 healthy controls.
We used 2 complementary analyses: (1) an exploratory and qualitative approach in which we investigated the distribution of lesions in the TBI groups, and (2) a hypothesis-driven and quantitative approach in which we calculated the volume of hippocampi of individuals in the TBI and control groups.
Neuropsychological scores and hippocampal volumes.
We found that patients with TBI and executive functions impairment presented focal lesions involving the frontal lobes, whereas patients with TBI and episodic memory disorders showed atrophic changes of the mesial temporal structure (hippocampus).
The complexity of TBI is due to several heterogeneous factors. Indeed, studying patients with TBI and selective cognitive dysfunction should lead to a better understanding of correlations with specific brain impairment and damage, better follow-up of long-term outcome scenarios, and better planning of selective and focused rehabilitation programs.
认知功能障碍是创伤性脑损伤（TBI）常见的后遗症；事实上，患者表现出异质性的认知缺陷模式。本研究旨在调查TBI后出现选择性认知功能障碍的患者是否呈现出选择性的脑损伤模式。
意大利罗马圣卢西亚基金会IRCCS昏迷后治疗单元。
我们收集了8例患有情景记忆障碍且无执行功能缺陷的TBI患者、7例执行功能受损但情景记忆能力保留的患者以及16名健康对照者的数据。
我们采用了两种互补分析方法：（1）一种探索性和定性的方法，我们在其中研究TBI组病变的分布，（2）一种假设驱动和定量的方法，我们在其中计算TBI组和对照组个体海马体的体积。
神经心理学评分和海马体体积。
我们发现，TBI伴执行功能受损的患者出现累及额叶的局灶性病变，而TBI伴情景记忆障碍的患者表现为内侧颞叶结构（海马体）萎缩性改变。
TBI的复杂性归因于几个异质性因素。事实上，研究TBI伴选择性认知功能障碍的患者应有助于更好地理解与特定脑损伤的相关性，更好地跟踪长期预后情况，并更好地规划选择性和针对性的康复计划节目。
