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Quantitative EEG with topographic mapping in traumatic brain injury
Abstracts from the 19th Annual Meeting
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profile of scores. It was also hypothesized that TBI patients would show greater deficits in delayed than immediate recall. Contrary to the first hypothesis, it was found that TBI patients did not have a greater incidence of selective memory deficits. In fact, a significantly greater percentage of control subjects than TBI patients demonstrated the amnesic profile. This was true when either immediate recall or delayed recall measures were employed. In support of the second hypothesis, results indicated that TBI patients showed greater deficits (relative to intelligence scores) on delayed recall than immediate recall. The usefulness of this model for facilitating understanding of cognitive sequelae of TBI is discussed.
Wong, K. H. Quantitative EEG with Topographic Mapping in Traumatic Brain Injury. Quantitative E E G (QEEG) with topographic mapping records of 100 consecutive patients (ages 4-65) with referral diagnosis of traumatic brain injury were reviewed. Each included EEG, spectral, long-latency visual evoked response (VER) and auditory evoked response (AER) data, with each modality classified according to a five-point Likert-type interval scale (Normal, Possibly Normal, Borderline, Possibly Abnormal, Abnormal) as the neurologist/electroencephalographer read and analyzed the record; an overall classification summarized the whole record. The records were examined by sorting them into three groups (Levels of Abnormality, Present or Absence of Epilepsy/ Seizure, Types of Traumatic Brain Injury). Based on the Overall classification, 52 were abnormal, 22 borderline, and 26 normal. Collapsing across levels of abnormality, 27 had epilepsy or seizure, 73 did not; similarly, when viewed from the types of traumatic brain injury, 13 reported skull fracture, 22 concussion, with 65 moderate/severe. Each patient's five classifications were assigned weight (Normal = 0, Abnormal -- 4). Within each group, the average weighted scores were analyzed and plotted accordingly. Results showed that long-latency VER is most sensitive when the overall Q E E G abnormality is borderline. Based on the types of reported traumatic brain injury, VER stands out consistently except in skull fracture, which resulted in highly elevated Overall and EEG abnormality. The 5-point scale is effective with added information. Gandhi, P. V., Wilde, E., Bigler, E. D., Ryser, D. K., & Blatter, D. D. QMRI Correlates with Neuropsychological Indicators of General Impairment in TBI Patients. Numerous studies in neuropsychological literature have concluded that Trail Making Test Part B and the Digit Symbol subtests of the Wechsler Intelligence scales are two of the best measures of general cortical integrity. Indeed, this is evidenced by many neuropsychologists who include these two tests as primary tools in short-form screens when addressing the possibility of organic involvement in differential diagnosis. Quantitative MRI has yielded promising gains in better understanding structural changes in the brain following insult, injury, and illness. However, to date, there has been little investigation of the relationship between anatomical changes as measured by QMRI and patient functioning as measured by neuropsychological testing in long-term follow-up studies. Previous studies indicate that the best measures of general atrophy are a decrease in brain volume, increase in cerebral spinal fluid (CSF), and changes in ventricle to brain ratio (VBR). This study investigates the correlational relationship between these neuropsychological tests and the neuroanatomical indicators of atrophic change in the traumatically injured brain as measured by computer-aided quantitative analysis of magnetic resonance imaging (QMRI). Forty-one participants were selected from the BYU/LDSH TBI database who had traumatic brain injury as their primary diagnosis and had MR
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profile of scores. It was also hypothesized that TBI patients would show greater deficits in delayed than immediate recall. Contrary to the first hypothesis, it was found that TBI patients did not have a greater incidence of selective memory deficits. In fact, a significantly greater percentage of control subjects than TBI patients demonstrated the amnesic profile. This was true when either immediate recall or delayed recall measures were employed. In support of the second hypothesis, results indicated that TBI patients showed greater deficits (relative to intelligence scores) on delayed recall than immediate recall. The usefulness of this model for facilitating understanding of cognitive sequelae of TBI is discussed.
Wong, K. H. Quantitative EEG with Topographic Mapping in Traumatic Brain Injury. Quantitative E E G (QEEG) with topographic mapping records of 100 consecutive patients (ages 4-65) with referral diagnosis of traumatic brain injury were reviewed. Each included EEG, spectral, long-latency visual evoked response (VER) and auditory evoked response (AER) data, with each modality classified according to a five-point Likert-type interval scale (Normal, Possibly Normal, Borderline, Possibly Abnormal, Abnormal) as the neurologist/electroencephalographer read and analyzed the record; an overall classification summarized the whole record. The records were examined by sorting them into three groups (Levels of Abnormality, Present or Absence of Epilepsy/ Seizure, Types of Traumatic Brain Injury). Based on the Overall classification, 52 were abnormal, 22 borderline, and 26 normal. Collapsing across levels of abnormality, 27 had epilepsy or seizure, 73 did not; similarly, when viewed from the types of traumatic brain injury, 13 reported skull fracture, 22 concussion, with 65 moderate/severe. Each patient's five classifications were assigned weight (Normal = 0, Abnormal -- 4). Within each group, the average weighted scores were analyzed and plotted accordingly. Results showed that long-latency VER is most sensitive when the overall Q E E G abnormality is borderline. Based on the types of reported traumatic brain injury, VER stands out consistently except in skull fracture, which resulted in highly elevated Overall and EEG abnormality. The 5-point scale is effective with added information. Gandhi, P. V., Wilde, E., Bigler, E. D., Ryser, D. K., & Blatter, D. D. QMRI Correlates with Neuropsychological Indicators of General Impairment in TBI Patients. Numerous studies in neuropsychological literature have concluded that Trail Making Test Part B and the Digit Symbol subtests of the Wechsler Intelligence scales are two of the best measures of general cortical integrity. Indeed, this is evidenced by many neuropsychologists who include these two tests as primary tools in short-form screens when addressing the possibility of organic involvement in differential diagnosis. Quantitative MRI has yielded promising gains in better understanding structural changes in the brain following insult, injury, and illness. However, to date, there has been little investigation of the relationship between anatomical changes as measured by QMRI and patient functioning as measured by neuropsychological testing in long-term follow-up studies. Previous studies indicate that the best measures of general atrophy are a decrease in brain volume, increase in cerebral spinal fluid (CSF), and changes in ventricle to brain ratio (VBR). This study investigates the correlational relationship between these neuropsychological tests and the neuroanatomical indicators of atrophic change in the traumatically injured brain as measured by computer-aided quantitative analysis of magnetic resonance imaging (QMRI). Forty-one participants were selected from the BYU/LDSH TBI database who had traumatic brain injury as their primary diagnosis and had MR