A review of mild head trauma. part I: Meta-analytic review of neuropsychological studies

Abstract

We conducted a meta-analytic review of neuropsychological studies of mild head trauma (MHT). Studies were included if they met these criteria: patients studied at least 3 months after MHT; patients selected because of a history of MHT rather than because they were symptomatic; and attrition rate of less than 50% for longitudinal studies. Studies of children were not considered. We found a total of 8 published papers with 11 samples that met these criteria. Using the g statistics, the overall effect size of 0.07 was nonsignificant, but the d statistic yielded an effect size of 0.12, p < .03. Measurers of attention had the largest effect, g = 0.17. p < .02 and d = 0.20, p < .006. Severity of injury accounted for far more variance than did specific neuropsychological domain, however. The small effect size suggests that the maximum prevalence of persistent neuropsychological deficit is likely to be small and neuropsychological assessment is likely to have positive predictive value of less than 50%. Consequently, clinicians will more likely be correct when not diagnosing brain injury than when diagnosing a brain injury in cases with chronic disability after MHT.

Neuropsychology and clinical neuroscience of persistent post-concussive syndrome

“…Belanger et al (2005) perPersistent post-concussive syndromeformed a meta-analysis of 39 studies involving 1463 cases of mTBI assessing clinical neuropsychological test findings. Their findings were similar to what has also been described by Binder et al (1997), Frencham et al (2005), and Schretlen & Shapiro (2003), implicating short-term, but not necessarily long-term neuropsychological effects, except for those cases who were in litigation, where either "stable or worsening of cognitive functioning over time (p. 215) was observed." Mooney et al (2005), in a university based rehabilitation service, examined those with "disappointing recoveries" and observed that "in cases of poor recovery after mTBI where compensation or litigation may be a factor, most of the variance in recovery seems to be explained by depression, pain, and symptom invalidity (p. 975) ."…”

Neuropsychological Sequelae of PTSD and TBI Following War Deployment among OEF/OIF Veterans

“…Evidence clearly suggests that, for most people, the cognitive effects of mTBI resolve within days to three months post-injury (for meta-analyses see: Belanger et al, 2005;Frenchman et al, 2005;Schretlen & Shapiro, 2003). Yet, despite generally good long-term prognosis for individuals who experience a mTBI, a subset report the subjective experience of chronic cognitive deficits, especially in attention and memory (e.g., Dikmen, Machamer, Fann, & Temkin, 2010;Hartlage, Durant-Wilson, & Patch, 2001;Binder, Rohling, & Larrabee, 1997;Rimel, Giordani, Barth, Boll, & Jane, 1981).…”

Neuropsychological and information processing deficits following mild traumatic brain injury

“…Although deficits have been found in speed of information processing, memory, attention and executive functions, both the clinical significance and the etiology of these deficits have been questioned (Binder, 1997;Binder et al, 1997).…”