Abstract
Psychophysiological investigations of traumatic brain injury (TBI) are being conducted for several reasons, including the objective of learning more about the underlying physiological mechanisms of the pathological processes that can be initiated by a head injury. Additional goals include the development of objective physiologically based measures that can be used to monitor the response to treatment and to identify minimally symptomatic individuals who are at risk of delayed-onset neuropsychiatric disorders following injury. Research programs studying TBI search for relationships between psychophysiological measures, particularly ERP (event-related potential) component properties (e.g., timing, amplitude, scalp distribution), and a participant’s clinical condition. Moreover, the complex relationships between brain injury and psychiatric disorders are receiving increased research attention, and ERP technologies are making contributions to this effort. This review has two objectives supporting such research efforts. The first is to review evidence indicating that TBI is a significant risk factor for post-injury neuropsychiatric disorders. The second objective is to introduce ERP researchers who are not familiar with neuropsychiatric assessment to the instruments that are available for characterizing TBI, post-concussion syndrome, and psychiatric disorders. Specific recommendations within this very large literature are made. We have proceeded on the assumption that, as is typically the case in an ERP laboratory, the investigators are not clinically qualified and that they will not have access to participant medical records.
Highlights
The assessment of mild traumatic brain injury (TBI) presents significant challenges
Investigators have a responsibility to respond if a participant discloses thoughts of injury to self or others
The form of this response will vary according to the qualifications of the investigators and the location of the study
Summary
The assessment of mild TBI presents significant challenges. This is true in those cases where the patient is asymptomatic or minimally symptomatic in the immediate post-injury period and subsequently presents a serious neuropsychiatric disorder. As part of the effort to construct psychophysiological characterization of TBI, it is necessary to identify relations between experimentally induced factor effects on candidate assessment measures like ERPs and clinically observable manifestations of injury This is important in longitudinal studies where the ability of ERPs to provide indices of the responses to treatment or the progression of disease is being investigated. The identification of systematic relations between well-delineated clinical symptoms and precisely controlled experimental factor effects would be accomplished by a review of the patient’s clinical history in which all medical records obtained in the post-injury period including neuroradiological studies are obtained. Frontiers in Neurology | Neurotrauma that has the longest application history and the largest validating population
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