Post-Concussion Syndrome after a Mine Blast Injury: Neuropsychological Consequences and Changes of the Cognitive Evoked Potentials (P 300)

Abstract

In 115 male patients with the post-concussion syndrome (PCS) after a mine blast injury (MBI) and 30 control healthy subjects, complex clinical and instrumental diagnostics were performed. The age of the patients varied from 18 to 45 years, the post-traumatic MBI interval was 0.5 to 3 years, and the MBIs were accompanied by an acoustic (AT) or combined acoustic/barotrauma in 92% of the cases. The standard examination procedure included MRI of the brain, recording of EEG and of auditory cognitive evoked potentials (CEP) (elicited within the oddball paradigm, with special attention to the cognitive component, wave P 300) using the Cicerone and Kalmar NSI questionnaire [7], and neurological and neuropsychological examination using the MoCA, HADS, and asthenic disorder (AD) scales. It was found that, despite a mild intensity of traumatic brain ingury (mTBI) and a rather long duration of post-traumatic period, neuropsychological consequences of the trauma are not fully compensated in a majority of the patients. Up to 90% of persons with PCS demonstrated abnormally high anxiety and depression estimates, psychasthenic disorders, and a more or less expressed decrease in the working ability (WA). These patients were characterized by noticeably longer latencies and much lower amplitudes of P 300 wave at application of the target stimuli than control subjects. Such differences in the parameters of P 300 were clearly associated with the presence of cognitive impairment, severe asthenia, depression, and drop in the WA. It was found that such associations were most intense (statistically significant) in the cases where increments in the P300 latency exceeded the upper limits of age normatives calculated for the population. As is concluded, it is expedient to use recording and analysis of CEP P 300 in the complex diagnostics of cognitive disorders in patients with PCS.