Long-lasting neurobehavioral disorders after traumatic brain injury: potential predictors and functional outcomes.

BACKGROUND

Traumatic brain injury (TBI) often leads to neurobehavioral disorders (NBDs) that hinder functional recovery. Although demographic (gender, age, years of education) and clinical factors (post-traumatic amnesia duration [PTA], Glasgow Coma Scale severity) have been studied as potential predictors of NBDs, the impact of the levels of cognitive functioning (LCF) and traumatic axonal injury (TAI) has received less attention.

AIM: This study investigates the relationship between the variables and the onset of NBDs following TBI. It also examines the correlation between NBDs and patients' functional outcome and community participation, as measured by the Glasgow Outcome Scale Extended (GOSE) and the Community Integration Questionnaire (CIQ).

DESIGN

Observational, longitudinal study.

SETTING

Inpatient rehabilitation setting.

POPULATION: The study cohort comprised 54 TBI patients (12 females, 42 males; mean age 46.1 years).

METHODS

Patients underwent comprehensive neuropsychological, neurobehavioral, and psychological assessments at 12 months. Clinical variables were collected during the acute/subacute phase, and functional outcomes were measured in the chronic phase (GOSE and CIQ).

RESULTS

The most frequent NBDs observed by caregivers included anger, difficulty controlling temper, impulsivity, and irritability. The findings highlight years of education, PTA duration, LCF score at rehabilitation admission (LCFa) and TAI as the key drivers of long-lasting NBDs (R2≈0.4-0.5). There was a significant moderate negative correlation between NBDs and GOSE (r=-0.67, P<0.001) as well as CIQ (r=-0.71, P<0.001).

CONCLUSIONS

The study highlights that lower education levels, prolonged PTA duration, lower LCFa, and presence of TAI are linked to a higher likelihood of developing persistent NBDs, which negatively impact functional outcomes and community participation.

CLINICAL REHABILITATION IMPACT: Regular monitoring and early intervention for patients with these risk factors - lower education, prolonged PTA, lower LCFa and TAI - could help mitigate the long-term effects of NBDs, improving rehabilitation outcomes through timely and targeted therapeutic approaches.