Neurophysiological correlates in diagnosis of cognitive disorders in different clinical types of post-concussion syndrome

Abstract

Objective — to identify the most frequent clinical types of post‑concussion syndrome (PCS) with cognitive function disorders; to study changes in cognitive evoked potentials (CEP) P300 neurophysiological indices in this cohort.Methods and subjects. A complex clinical study with CEP P 300 recording was performed with a view to determine the presence and degree/severity of post‑traumatic cognitive disorders in 115 men with PCS after a mine‑blast trauma (MBT) they experienced in 2014 — 2017. The age range of the patients was from 18 to 45; time elapsed after MBT — from 6 months to 3 years. We performed neuropsychological testing according to the Montreal Cognitive Assessment (MoCA), the Hospital Anxiety and Depression Scale (HADS) and Asthenic Assessment Scale; MRI of the head; duplex ultrasound spectroscopy; quantitative EEG and CEP P300.Results. Three main types of PCS were identified in the patients: 1st — with predominance of cognitive disorders — 51 cases (44.3 %); 2nd — with predominant affective disorders — 27 (23.5 %); 3rd — with predominant psychosomatic disorders — 37 (32.2 %). CEP P300 latency statistically significantly depended on the severity of cognitive disorders. A statistically significant correlation of P 300 latency with the attention concentration and operative memory on the MoCA scale and a score in the cognitive cluster of the questionnaire «Cicerone» was found. The P300 method was used to define the type of PCS in long‑term period of mild traumatic brain injury.Conclusions. It is suggested that 3 main types of PCS should be identified depending on the predominance and occurrence of apparent significant cognitive disorders and severity of clinical manifestations. Expediency of CEP P300 method application for detection of the presence and severity of cognitive disorders in patients with PCS was confirmed on the basis of patients complains analysis, manifestations, neuropsychological testing results and examinations.