Brain Injury review

The purpose of this study was to determine if there is a dose-response relationship between potential monetary compensation and failure on psychological indicators of malingering in traumatic brain injury. 332 traumatic brain injury patients were divided into three groups based on incentive to perform poorly on neuropsychological testing: no incentive; limited incentive as provided by State law; high incentive as provided by Federal law. The rate of failure on five well-validated malingering indicators across these groups was examined. Cases handled under Federal workers compensation laws showed considerably higher rates of failure and diagnosable malingering than cases handled under State law. The findings indicate that monetary compensation associated with workers compensation claims is a major motive for exaggeration and malingering of problems attributed to work-related brain injuries. The clinician’s index of suspicion regarding exaggeration and malingering of symptoms and deficits should be much higher in the context of Federal workers compensation claims, particularly in patients who have suffered only mild traumatic brain injury.

Oubmed id is 16980265

This abstract comes from A McInire and colleagues from the P van Donkelaar lab at the university of Oregon in the USA.

The purpose of this study was to examine whether the temporal dynamics of attention was deficient in participants who have recently experienced mild traumatic brain injury. For this purpose the rapid serial visual presentation task was used and the performance of participants with mild traumatic brain injurywas compared to that of controls matched for age, gender, education, and activity type. In the rapid serial visual presentation task a stream of rapidly presented letters is displayed with target and probe letters separated by varying durations. The participant is required to identify the target letter and determine whether the probe letter was present or not. Previous research has shown that healthy participants display an attentional blink: they fail to detect the probe letter when it appears within approximately 500 ms of the target letter.

We found that participants with mild traumatic brain injury had a normal attentional blink-it was neither greater in magnitude nor longer in duration than that displayed by the control participants. However, the participants with mild traumatic brain injury did show evidence of attentional competition-making more errors in identifying the target letter when the probe letter was presented-that was not present in the control participants. Taken together, these results suggest that the temporal constraints of attention are subtly but systematically affected by mild traumatic brain injury.

The full text can be found by using the pubmed identifier 16676168. It is in the May 2006 edition of Experimental Brain Research.

This abstract comes from the european journal of pediatrician., and is by E Javouhey and colleagues from the chiron Lab at UMRASTTE in France.

OBJECTIVE The aim of the study was to determine the risk factors of a severe outcome for children severely injured [killed or with an Injury Severity Score >/=16] in a road accident.

MATERIALS AND METHODS Casualties that occurred between 1996 and 2001 which involved children under 14 years of age were assessed in a population-based study based on data included in a French road trauma Registry. A severe traumatic brain injury was defined as a head injury with an Abbreviated Injury Scale (AIS) severity score >/=3. A multivariate logistic regression was performed to quantify the risk of a “severe outcome” defined as death or an expected serious impairment 1 year later.

RESULTS The annual incidence of an ISS of 16+ was 7.7 per 100,000 children. Among the 126 severely injured children included in this study, 40 died (including 16 immediate deaths), and a severe outcome was expected for 54 of the 86 survivors. Children with an “isolated severe traumatic brain injury ” and those with “multiple injuries including traumatic brain injury ” were more likely to have a severe outcome than those who had an “isolated severe injury without traumatic brain injury ” (OR: 7.91; 95%CI: 1.43-43.77 and OR: 8.37; 95%CI: 1.52-46.13, respectively). Age was inversely linked to a severe outcome. The unprotected motor vehicle occupants (MVO) had an odds ratio of 7.56 (95%CI: 1.07-53.56) compared to the protected MVO. Only 30% of children who survived a severe TBI were admitted to rehabilitation.

CONCLUSION The mechanism of the injury, an injury pattern involving the head and a young age were associated with a severe outcome following a road accident. A majority of children severely injured were not referred to inpatient rehabilitation.

This article is availabe from pubmed the identifier is 16649025 and it is from April 2006