Bivona U, Costa A, Contrada M, Silvestro D, Azicnuda E, Aloisi M, Catania G, Ciurli P, Guariglia C, Caltagirone C, Formisano R, Prigatano G P
a IRCCS, Santa Lucia Foundation , Rome , Italy.
b Unicusano University , Rome , Italy.
Brain Inj. 2019;33(9):1245-1256. doi: 10.1080/02699052.2019.1641225. Epub 2019 Jul 14.
: The primary aim of this study was to determine the frequency of severe impaired self-awareness (ISA) in patients with severe traumatic brain injury (TBI) and the correlates of selected clinical, neuropsychiatric and cognitive variables. The secondary aim of the study was to assess depression and apathy on the basis of their level of self-awareness. : Thirty patients with severe TBI and 30 demographically matched healthy control subjects (HCs) were compared on measures of ISA, depression, anxiety, alexithymia, neuropsychiatric symptoms and cognitive flexibility. : Twenty percent of the patients demonstrated severe ISA. Severe post-acute ISA was associated with more severe cognitive inflexibility, despite the absence of differences in TBI severity, as evidenced by a Glasgow Coma Scale (GCS) score lower than 9 in all cases in the acute phase. Patients with severe ISA showed lower levels of depression and anxiety but tended to show more apathy and to have greater difficulty describing their emotional state than patients with severe TBI who showed minimal or no disturbance in self-awareness. : These findings support the general hypothesis that severe ISA following severe TBI is typically not associated with depression and anxiety, but rather with apathy and cognitive inflexibility.
本研究的主要目的是确定重度创伤性脑损伤（TBI）患者中严重自我意识受损（ISA）的发生率以及所选临床、神经精神和认知变量的相关性。该研究的次要目的是根据自我意识水平评估抑郁和冷漠。：对30例重度TBI患者和30例人口统计学匹配的健康对照者（HCs）进行了ISA、抑郁、焦虑、述情障碍、神经精神症状和认知灵活性的测量比较。：20%的患者表现出严重ISA。尽管急性期所有病例的格拉斯哥昏迷量表（GCS）评分均低于9，但严重的急性后期ISA与更严重的认知不灵活性有关，但TBI严重程度并无差异。与自我意识极少或无紊乱的重度TBI患者相比，严重ISA患者的抑郁和焦虑水平较低，但往往表现出更多的冷漠，且在描述自己的情绪状态时更困难。：这些发现支持了一般假设，即重度TBI后的严重ISA通常与抑郁和焦虑无关，而是与冷漠和认知不灵活性有关。
