title: Cognitive impact of traumatic axonal injury (TAI) and return to work.
abstract: OBJECTIVE
  Axonal injury (AI) after traumatic brain injury (TBI) is often overlooked as an explanation for cognitive complaints when no damage is detected by computed tomography. The purpose was to assess cognition during the 12 months following a TBI and suspected traumatic axonal injury (TAI).
  
  
  METHODS
  The sample included 17 patients younger than 65 years old, however one died. In the acute phase and at 6 and 12 months, cognition, reaction time, psychomotor performance and finger tapping speed were assessed. Working memory and work status were added at 12 months. Acute MRI findings were recorded.
  
  
  RESULTS
  After 1 year, all patients still showed cognitive dysfunction. A recovery had been noted at 6 months, but a cognitive decline was indicated for the majority at 12 months. The sick-listed patients had TAI located in the corpus callosum and the brainstem. They were cognitively more impaired and in more areas than the four patients who had returned to work.
  
  
  CONCLUSIONS
  Cognitive screening can identify the long-term impact of TAI identified by conventional MRI, used as a routine clinical technique. For rehabilitation and for insurance-related matters, these injuries must be taken seriously, as a deterioration over time might occur. Further research is needed.
authors.affiliation: Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden. eva.esbjornsson@neuro.gu.se
authors.forename: Eva
authors.initials: E
authors.lastname: Esbjörnsson
authors.forename: Thomas
authors.initials: T
authors.lastname: Skoglund
authors.forename: Marios-Konstantinos
authors.initials: MK
authors.lastname: Mitsis
authors.forename: Caisa
authors.initials: C
authors.lastname: Hofgren
authors.forename: Jerry
authors.initials: J
authors.lastname: Larsson
authors.forename: Katharina S
authors.initials: KS
authors.lastname: Sunnerhagen
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation; D020833:Diffuse Axonal Injury / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation; D018450:Disease Progression; D056344:Executive Function; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D020127:Recovery of Function; D062707:Return to Work; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D014057:Tomography, X-Ray Computed