ABSTRACT
OBJECTIVES: To assess the effectiveness of interventions for mild traumatic brain injury (MTBI) in adults as found in the literature. RESEARCH DESIGN: Systematic review of the literature. METHODS: Six electronic databases and 18 journals within the brain injury field were manually searched between the years 1980-2003. References from articles were scanned for further literature. Studies that met broad inclusion criteria were subjected to a formal test of relevance. Those found to be relevant were qualitatively tested for their methodological soundness. RESULTS: One thousand and fifty-five studies were initially identified and 163 were assessed using the relevance tool, yielding 20 studies for review. Four categories of interventions were identified: Pharmacotherapy, Cognitive Rehabilitation, Patient Education and Other. The majority of studies were weak, however there is evidence to support the effectiveness of patient education interventions. CONCLUSIONS: There are few rigorous studies evaluating treatment of MTBI. Limitations of the current literature are presented.
Subject(s)
Brain Injuries/therapy , Adult , Brain Injuries/etiology , Brain Injuries/psychology , Cognition Disorders/etiology , Cognition Disorders/rehabilitation , Female , Humans , Male , Middle Aged , Patient Education as Topic/methods , Research Design , Trauma Severity IndicesABSTRACT
The relationship of the Trail Making Test (TMT) to the frontal lobes was tested by comparing patients with damage to the frontal and nonfrontal regions to control participants. Although the analysis of time measurements, both raw and transformed, showed notable slowing of frontal groups, error analysis proved to be a more useful method of categorizing performance. Analysis of errors on Part B indicated that all patients who made more than 1 error had frontal lesions. Dividing the frontal damaged patients into subgroups on the basis of the number of errors yielded specificity of brain-behavior relations within the frontal lobes. Patients with damage in dorsolateral frontal areas were most impaired. Those with inferior medial damage to the frontal lobes were not significantly affected in TMT Part B performance.
