Abstract
This review aimed at providing a brief and comprehensive summary of recent research regarding the use of the Wisconsin Card-Sorting Test (WCST) to assess executive function in patients with traumatic brain injury (TBI). A bibliographical search, performed in PubMed, Web of Science, Scopus, Cochrane Library, and PsycInfo, targeted publications from 2010 to 2020, in English or Spanish. Information regarding the studies’ designs, sample features and use of the WCST scores was recorded. An initial search eliciting 387 citations was reduced to 47 relevant papers. The highest proportion of publications came from the United States of America (34.0%) and included adult patients (95.7%). Observational designs were the most frequent (85.1%), the highest proportion being cross-sectional or case series studies. The average time after the occurrence of the TBI ranged from 4 to 62 years in single case studies, and from 6 weeks up to 23.5 years in the studies with more than one patient. Four studies compared groups of patients with TBI according to the severity (mild, moderate and/or severe), and in two cases, the studies compared TBI patients with healthy controls. Randomized control trials were seven in total. The noncomputerized WCST version including 128 cards was the most frequently used (78.7%). Characterization of the clinical profile of participants was the most frequent purpose (34.0%). The WCST is a common measure of executive function in patients with TBI. Although shorter and/or computerized versions are available, the original WCST with 128 cards is still used most often. The WCST is a useful tool for research and clinical purposes, yet a common practice is to report only one or a few of the possible scores, which prevents further valid comparisons across studies. Results might be useful to professionals in the clinical and research fields to guide them in assessment planning and proper interpretation of the WCST scores.
Highlights
Traumatic brain injury (TBI) is an alteration in normal brain function or any other evidence of brain pathology caused by an impact from external mechanical forces, such as rapid acceleration or deceleration, a bump or jolt to the head or penetration by a projectile
The Wisconsin Card-Sorting Test (WCST) is a useful tool for research and clinical purposes, yet a common practice is to report only one or a few of the possible scores, which prevents further valid comparisons across studies
This review aims at providing a brief and comprehensive summary of recent research making use of the WCST to assess executive function in patients with TBI
Summary
Traumatic brain injury (TBI) is an alteration in normal brain function or any other evidence of brain pathology caused by an impact from external mechanical forces, such as rapid acceleration or deceleration, a bump or jolt to the head or penetration by a projectile. TBI is mild, moderate or severe, depending on the resulting severity and duration of loss of consciousness, post-traumatic amnesia and neuro-radiological evidence of cerebral damage. This classification system is highly reliable for first diagnosis; its prognostic value for long-term neuropsychological outcome is still limited as it rarely takes into account premorbid factors, underlying structural damage and the impact of non-neurological factors [2]. The main outcomes following TBI include mortality, functional disability, health-related quality of life, and cognitive, psychiatric and social complications [3]. Other symptoms might be so intrusive that they can affect negatively the patient’s daily activities, emotional wellbeing and social interactions
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