title: Association Between Traumatic Brain Injury-Related Brain Lesions and Long-term Caregiver Burden.
abstract: OBJECTIVE
  To investigate the association between traumatic brain injury (TBI)-related brain lesions and long-term caregiver burden in relation to dysexecutive syndrome.
  
  
  METHODS
  National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.
  
  
  METHODS
  A total of 256 participants: 105 combat veterans with TBI, 23 healthy control combat veterans (HCv), and 128 caregivers.
  
  
  METHODS
  Caregiver burden assessed by the Zarit Burden Interview at 40 years postinjury.
  
  
  METHODS
  Participants with penetrating TBI were compared with HCv on perceived caregiver burden and neuropsychological assessment measures. Data of computed tomographic scans (overlay lesion maps of participants with a penetrating TBI whose caregivers have a significantly high burden) and behavioral statistical analyses were combined to identify brain lesions associated with caregiver burden.
  
  
  RESULTS
  Burden was greater in caregivers of veterans with TBI than in caregivers of HCv. Caregivers of participants with lesions affecting cognitive and behavioral indicators of dysexecutive syndrome (ie, left dorsolateral prefrontal cortex and dorsal anterior cingulate cortex) showed greater long-term burden than caregivers of participants with lesions elsewhere in the brain.
  
  
  CONCLUSIONS
  The TBI-related brain lesions have a lasting effect on long-term caregiver burden due to cognitive and behavioral factors associated with dysexecutive syndrome.
authors.affiliation: Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD (Mss Guevara, Polejaeva, and Knutson, and Dr Wassermann); Faculty of Biology and Medicine, University of Lausanne (Ms Guevara), and Leenaards Memory Center at CHUV, Lausanne University (Ms Guevara and Dr Demonet), Lausanne, VD, Switzerland; Brain Injury Research, Cognitive Neuroscience Laboratory, Rehabilitation Institute of Chicago, Department of Physical Medicine and Rehabilitation, Psychiatry and Behavioral Sciences & Cognitive Neurology (Alzheimer Disease Center), Northwestern University Medical School, Department of Psychology, Northwestern University, Chicago, Illinois (Dr Grafman); and Molecular Neuroscience Department and Department of Psychology, George Mason University, Fairfax, Virginia (Dr Krueger). Conflicts of interest and source of funding: none declared.
authors.forename: Andrea Brioschi
authors.initials: AB
authors.lastname: Guevara
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Demonet
authors.forename: Elena
authors.initials: E
authors.lastname: Polejaeva
authors.forename: Kristine M
authors.initials: KM
authors.lastname: Knutson
authors.forename: Eric M
authors.initials: EM
authors.lastname: Wassermann
authors.forename: Jordan
authors.initials: J
authors.lastname: Grafman
authors.forename: Frank
authors.initials: F
authors.lastname: Krueger
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000000981:diagnostic imaging / Q000523:psychology / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D016022:Case-Control Studies; D017281:Cost of Illness; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D013997:Time Factors; D014728:Veterans