Halstead-Reitan Deficit Scores in Assessment of Nonimpact Head Injury

Patients subjected to severe acceleration forces in motor vehicle accidents that met criteria for uncomplicated mild traumatic brain injury (mTBI) in the absence of direct impact to the head were examined neuropsychologically using the Halstead-Reitan Neuropsychological Test Battery. The subjects were litigants and/or insurance claimants for whom there was psychometric evidence of acceptable test effort. The purpose of the study was to provide descriptive neuropsychological data for this particular clinical population. Individual test results were interpreted using inferential methods of level of performance, pathognomonic signs, score patterns, and right-left performance differences. These interpretive strategies yielded group data from which frequencies and percentages of atypical neuropsychological characteristics were calculated. The most salient clinical characteristics involved atypical right-left performance relationships on simple and more complex tests of motor function. Clinical data provided support for the possibility that a minority of nonimpact litigants or insurance claimants that sustain uncomplicated mTBI experience persistent diminishment in some neuropsychological abilities.

Descriptive Halstead-Reitan study of nonimpact mild traumatic brain injury

Sweeney¹

2016

Halstead-Reitan characteristics of nonimpact and impact mTBI litigants and insurance claimants

Sweeney¹,

Johnson

2017

The purpose of this study was to investigate possible neuropsychological differences in Halstead-Reitan characteristics between motor vehicle accident litigants and insurance claimants that sustained uncomplicated mild traumatic brain injury (mTBI) and did or did not sustain direct impact to the head (i.e., Impact vs. Nonimpact mTBI), and to compare these clinical groups with a control group that did not suffer mTBI (No mTBI). The Tactile Form Recognition Test (TFR) was the only level of performance test in the Halstead-Reitan Battery (HRB) that generated statistically significant differences. The TFR resembles a complex reaction time test. TFR response time was significantly longer for Nonimpact mTBI patients than for Impact mTBI and No mTBI participants. Frequency comparisons of abnormal score patterns demonstrated that Nonimpact patients produced significantly more aberrant Impairment Index vs. FSIQ score patterns than Impact and No mTBI participants. Given the components of the score pattern, this finding suggests that Nonimpact patients may experience less recovery from neuropsychological deficits than Impact participants. Complex perceptual reaction times and score patterns comparing sensitive and "hold" test results may represent heuristic avenues of future research in the study of compensation-seeking Nonimpact and Impact mTBI patients.

An index of decline or recovery following nonimpact and impact mTBI

Sweeney¹,

Johnson

2017

This study investigated the degree to which litigants/insurance claimants sustaining Nonimpact mild traumatic brain injury (mTBI) in motor vehicle accidents differed from compensation-seeking motor vehicle accident victims that suffered Impact mTBI in terms of neuropsychological decline/recovery, using as a control litigants/insurance claimants that did not experience mTBI in motor vehicle accidents. A clinical index (C-Voc) was employed as the dependent measure for decline/recovery, consisting of T-score algebraic differences between a highly sensitive neurocognitive measure (Category Test) and a relatively insensitive "hold" measure (Wechsler Adult Intelligence Scale Vocabulary subtest). Nonimpact mTBI subjects showed significantly greater neurocognitive decline than Impact mTBI participants and, interestingly, Impact mTBI individuals did not differ significantly from individuals with no diagnosis of mTBI. These findings suggest that Nonimpact subjects may experience significantly greater persistent neurocognitive residua of mTBI than Impact participants.