Gauthier Sandra, LeBlanc Joanne, Seresova Alena, Laberge-Poirier Andréanne, A Correa José, Alturki Abdulrahman Y, Marcoux Judith, Maleki Mohammed, Feyz Mitra, de Guise Elaine
Department of Psychology, Université de Montréal, Montréal, Canada; Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal, Canada.
Traumatic Brain Injury Program-McGill University Health Center, Montréal, Canada.
J Commun Disord. 2018 May-Jun;73:77-90. doi: 10.1016/j.jcomdis.2018.04.003. Epub 2018 Apr 14.
Communication impairment following a traumatic brain injury (TBI) has been well documented, yet information regarding communication skills in the acute period following the injury is limited in the literature. Also, little is known about the influence of TBI severity (mild, moderate or severe) on cognitive-communication impairments and how these impairments are related to short-term functional outcome. The goal of this study was to assess the performance of adults with mild, moderate and severe TBI on different language tests and to determine how this performance is related to functional capacity. We also aimed to explore which variables among age, sex, education, TBI severity and site of cerebral damage would predict initial language impairments.
Several language tests were administered to a sample of 145 adult patients with TBI of a range of severities admitted to an acute care service and to 113 healthy participants from the community.
TBI patients of a range of severities performed poorly on all language tests in comparison to the healthy controls. In addition, patients with mild TBI performed better than the moderate and severe groups, except on the reading test and on the semantic naming test. In addition, their performance on verbal fluency, conversational discourse and procedural discourse tasks predicted acute functional outcome. Finally, age, education and TBI severity and site of lesion predicted some language performance. A left temporal lesion was associated with poorer performance in conversational discourse and auditory comprehension tasks, a left frontal lesion with a decrease in the verbal fluency results and a right parietal lesion with decreased auditory comprehension and reasoning skills.
Health care professionals working in the acute care setting should be aware of the possible presence of cognitive-communication impairments in patients with TBI, even for those with mild TBI. These deficits can lead to functional communication problems and assistance may be required for tasks frequently encountered in acute care requiring intact comprehension and expression.
创伤性脑损伤（TBI）后的沟通障碍已有充分记录，但关于损伤急性期沟通技能的文献资料有限。此外，对于TBI严重程度（轻度、中度或重度）对认知沟通障碍的影响以及这些障碍与短期功能结局之间的关系知之甚少。本研究的目的是评估轻度、中度和重度TBI成人在不同语言测试中的表现，并确定这种表现与功能能力之间的关系。我们还旨在探讨年龄、性别、教育程度、TBI严重程度和脑损伤部位等变量中哪些能够预测初始语言障碍。
对145名入住急性护理机构的不同严重程度的成年TBI患者样本以及113名社区健康参与者进行了多项语言测试。
与健康对照组相比，不同严重程度的TBI患者在所有语言测试中表现均较差。此外，轻度TBI患者的表现优于中度和重度组，但在阅读测试和语义命名测试中除外。此外，他们在言语流畅性、对话语篇和程序性语篇任务上的表现可预测急性功能结局。最后，年龄、教育程度、TBI严重程度和病变部位可预测一些语言表现。左侧颞叶病变与对话语篇和听觉理解任务的较差表现相关，左侧额叶病变与言语流畅性结果下降相关，右侧顶叶病变与听觉理解和推理技能下降相关。
在急性护理环境中工作的医疗保健专业人员应意识到TBI患者可能存在认知沟通障碍，即使是轻度TBI患者。这些缺陷可能导致功能性沟通问题，对于急性护理中经常遇到的需要完整理解和表达的任务可能需要提供帮助。
