Iverson GL, Lange RT, Franzen MD. Effects of mild traumatic brain injury cannot be differentiated from substance abuse.
Brain Inj 2009;
19:11-8. [PMID:
15762097 DOI:
10.1080/02699050410001720068]
[Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PRIMARY OBJECTIVE
Patients involved in litigation relating to mild traumatic brain injury (MTBI) typically undergo a forensic neuropsychological evaluation. However, if cognitive problems are identified, it is difficult to know whether these are related to the MTBI or other factors such as pre- and/or post-injury substance abuse. The purpose of this study was to compare the neuropsychological test performances of 73 patients with acute, uncomplicated MTBIs to a sample of 73 patients from an inpatient substance abuse programme.
METHODS AND PROCEDURES
Patients were perfectly matched on age, education and gender. Ten cognitive measures were used that included the Trail Making Test (TMT) and selected sub-tests from the Wechsler Memory Scale-Revised.
MAIN OUTCOMES AND RESULTS
Patients with MTBI demonstrated poorer performances on Digits Backwards (p < 0.028) and TMTA (p < 0.032). There were no significant differences between the two groups on the remaining cognitive measures. The clinical usefulness of these measures to differentiate between the groups, using discriminant function analysis, was very poor.
CONCLUSIONS
Patients with uncomplicated MTBIs could not be reliably differentiated from patients with substance abuse problems on these measures of concentration, memory and processing speed.
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