Neuropsychological assessment

Neuropsychology

Cognition

Psychiatry

Developmental psychology

Traumatic brain injury

Executive functions

Executive dysfunction

Amnesia

Psychology

Medicine

Clinical psychology

Audiology

Journal of the International Neuropsychological Society

Objectives: Individuals with moderate–severe traumatic brain injury (TBI) experience a transitory state of impaired consciousness and confusion often called posttraumatic confusional state (PTCS). This study examined the neuropsychological profile of PTCS. Methods: Neuropsychometric profiles of 349 individuals in the TBI Model Systems National Database were examined 4 weeks post-TBI (±2 weeks). The PTCS group was subdivided into Low ( n =46) and High Performing PTCS ( n =45) via median split on an orientation/amnesia measure, and compared to participants who had emerged from PTCS ( n =258). Neuropsychological patterns were examined using multivariate analyses of variance and mixed model analyses of covariance. Results: All groups were globally impaired, but severity differed across groups ( F (40,506)=3.44; p &lt;.001; ŋ p 2 =.206). Rate of forgetting (memory consolidation) was impaired in all groups, but failed to differentiate them ( F (4,684)=0.46; p =.762). In contrast, executive memory control was significantly more impaired in PTCS groups than the emerged group: Intrusion errors: F (2,343)=8.78; p &lt;.001; ŋ p 2 =.049; False positive recognition errors: F (2,343)=3.70; p &lt;.05; ŋ p 2 =.021. However, non-memory executive control and other executive memory processes did not differentiate those in versus emerged from PTCS. Conclusions: Executive memory control deficits in the context of globally impaired cognition characterize PTCS. This pattern differentiates individuals in and emerged from PTCS during the acute recovery period following TBI. ( JINS , 2019, 25 , 302–313)

Neuropsychological Characteristics of the Confusional State Following Traumatic Brain Injury