Neurological and neuropsychological characteristics of postconcussion syndrome following blast mild traumatic brain injury
Bibliographic record
Abstract
A common complication of blast mild traumatic brain injury (mTBI) is postconcussion syndrome (PCS), the diagnostic criteria of which are based on the patient's subjective complaints. Creation of reliable tools for clinical signs of blast mild TBI objectification is of great priority. Objective: using a comprehensive neurological and neuropsychological examination to determine the characteristics of clinical signs of blast mild TBI in the long-term period to assess the correlation with the data of neurophysiological and radiological studies. Materials and methods. The study involved 115 male participants of hostilities in the East of Ukraine (main group) with a diagnosis of " PCS after previous blast mTBI " and 30 healthy individuals (control group). Patients were in the long-term period of injury (from 6 months to 3 years). After collecting complaints and medical history data, the neurological status and the state of cognitive functions were examined. The latter were studied using the questionnaire "Cicerone". Neuropsychological testing according to the Montreal Cognitive Assessment score (MoCA) was carried out. The Hospital Anxiety and Depression Scale (HADS) was also used, and to objectify asthenic disorders - the Asthenic State Scale (ASS). Results. Assessment of the severity of cognitive impairment using the questionnaire "Cicerone" allowed identifying three clinical variants of PCS: 1) with cognitive impairment in combination with affective disorders (44,3 ± 9,1) % of patients), 2) with a predominance of affective disorders (23,5 ± 7,7) % of patients), 3) moderate and mild disorders of the cognitive and affective spectrum in combination with moderate autonomic disorders ((32,2 ± 8,5) % of patients). In 43,5% of cases, according to the MoCA scale, a decrease in cognitive impairment was found for memorization (memory), attention, delayed recall, total score. According to the HADS scale, the distribution of patients was as follows: clinically significant anxiety was noted in (9,6%) patients, depression - in (11,3%) patients, combination of clinically significant anxiety with depression - in (5,2%) patients, subclinical symptoms of anxiety of various severity - in (55,7%) patients. The phenomena of asthenia due to fatigue with mood swings, loss of the ability to concentrate for a long time on mental and physical tasks occurred in all patients with PCS. Factors with a probably higher risk of cognitive impairment were identified: 1) complaints of extreme fatigue and headache, 2) neurological signs in the form of pyramidal insufficiency, brisk tendon reflexes, 3) anxiety level according to the HADS scale. They can be considered as predictors of detection of cognitive deficit in patients with PCS as a result of blast mild TBI. Conclusions. Comprehensive neurological and neuropsychological examination is an effective tool for diagnosing cognitive changes in PCS as a result of blast mild TBI.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".