title: Selective Cognitive Dysfunction Is Related to a Specific Pattern of Cerebral Damage in Persons With Severe Traumatic Brain Injury.
abstract: OBJECTIVE
  Cognitive dysfunction is a common sequela of traumatic brain injury (TBI); indeed, patients show a heterogeneous pattern of cognitive deficits. This study was aimed at investigating whether patients who show selective cognitive dysfunction after TBI present a selective pattern of cerebral damage.
  
  
  METHODS
  Post-Coma Unit, IRCCS Santa Lucia Foundation, Rome, Italy.
  
  
  METHODS
  We collected data from 8 TBI patients with episodic memory disorder and without executive deficits, 7 patients with executive function impairment and preserved episodic memory capacities, and 16 healthy controls.
  
  
  METHODS
  We used 2 complementary analyses: (1) an exploratory and qualitative approach in which we investigated the distribution of lesions in the TBI groups, and (2) a hypothesis-driven and quantitative approach in which we calculated the volume of hippocampi of individuals in the TBI and control groups.
  
  
  METHODS
  Neuropsychological scores and hippocampal volumes.
  
  
  RESULTS
  We found that patients with TBI and executive functions impairment presented focal lesions involving the frontal lobes, whereas patients with TBI and episodic memory disorders showed atrophic changes of the mesial temporal structure (hippocampus).
  
  
  CONCLUSIONS
  The complexity of TBI is due to several heterogeneous factors. Indeed, studying patients with TBI and selective cognitive dysfunction should lead to a better understanding of correlations with specific brain impairment and damage, better follow-up of long-term outcome scenarios, and better planning of selective and focused rehabilitation programs.
authors.affiliation: Clinical and Behavioural Neurology Department (Drs Di Paola, Costa, Caltagirone, and Carlesimo and Mr Phillips), Post-Coma Unit (Drs Bivona, Catani, and Formisano), and Neuropsychological Diagnosis and Rehabilitation Unit (Dr Ciurli), IRCCS Santa Lucia Foundation, Rome, Italy; MeSVA Department, University of L'Aquila, L'Aquila, Italy (Dr Paola); and Neuroscience Department, University of Rome "Tor Vergata," Rome, Italy (Drs Caltagirone and Carlesimo).
authors.forename: Margherita
authors.initials: M
authors.lastname: Di Paola
authors.forename: Owen
authors.initials: O
authors.lastname: Phillips
authors.forename: Alberto
authors.initials: A
authors.lastname: Costa
authors.forename: Paola
authors.initials: P
authors.lastname: Ciurli
authors.forename: Umberto
authors.initials: U
authors.lastname: Bivona
authors.forename: Sheila
authors.initials: S
authors.lastname: Catani
authors.forename: Rita
authors.initials: R
authors.lastname: Formisano
authors.forename: Carlo
authors.initials: C
authors.lastname: Caltagirone
authors.forename: Giovanni Augusto
authors.initials: GA
authors.lastname: Carlesimo
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001930:Brain Injuries / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000209:etiology* / Q000503:physiopathology; D056344:Executive Function / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000473:pathology*; D015600:Glasgow Coma Scale; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D015601:Injury Severity Score; D007558:Italy; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008569:Memory Disorders / Q000209:etiology* / Q000503:physiopathology; D009483:Neuropsychological Tests; D011594:Psychometrics; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D055815:Young Adult