Traumatic brain injury

Our recommended test battery for traumatic brain injury (TBI) is sensitive to cognitive dysfunction across the spread of TBI severities, from mild¹ through to severe².

The tests within this battery assess the key cognitive domains often impaired in patients, as well as domains likely to be affected by medication. The test battery has shown sensitivity to the beneficial effects of the cholinesterase inhibitor rivastigmine in TBI patients with memory impairment^3,4.

These tests are biologically relevant, with performance on these tests correlating with structural brain damage in individuals with TBI⁵ and changes in task performance over time correlate with changes in brain structure in such patients⁶. 

Measures

• Episodic memory
• Executive function
• Processing speed
• Multitasking
• Planning

CANTAB Tests

• Paired Associates Learning (PAL): 8 minutes
• Reaction Time (RTI): 3 minutes
• Spatial Working Memory (SWM): 4 minutes
• Multitasking Test (MTT): 8 minutes
• One Touch Stockings of Cambridge (OTS): 10 minutes

Research 

_{Abbreviated from Egerhazi et al., 2007; Progress in Neuro-Psychopharmacology & Biological Psychiatry and adapted from Salmond et al., 2005; Brain}

Key References

Diaz-Arrastia R, Kochanek PM, Bergold P, Kenney K, Marx CE, Grimes CJ, Loh LT, Adam LT, Oskvig D, Curley KC, Salzer W. Pharmacotherapy of traumatic brain injury: state of the science and the road forward: report of the Department of Defense Neurotrauma Pharmacology Workgroup. J Neurotrauma. 2014 Jan 15;31(2):135-58.

Salmond CH, Chatfield DA, Menon DK, Pickard JD, Sahakian BJ. Cognitive sequelae of head injury: involvement of basal forebrain and associated structures. Brain. 2005 Jan;128(Pt 1):189-200.

Newcombe VF, Outtrim JG, Chatfield DA, Manktelow A, Hutchinson PJ, Coles JP, Williams GB, Sahakian BJ, Menon DK.  Parcellating the neuroanatomical basis of impaired decision-making in traumatic brain injury. Brain. 2011 Mar;134(Pt 3):759-68.

Sterr A, Herron KA, Hayward C, Montaldi D. Are mild head injuries as mild as we think? Neurobehavioral concomitants of chronic post-concussion syndrome. BMC Neurol. 2006 Feb 6;6:7.

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1. _{Sterr A, Herron KA, Hayward C, Montaldi D. Are mild head injuries as mild as we think? Neurobehavioral concomitants of chronic post-concussion syndrome. BMC Neurol. 2006 Feb 6;6:7.}
2. _{Salmond CH, Chatfield DA, Menon DK, Pickard JD, Sahakian BJ. Cognitive sequelae of head injury: involvement of basal forebrain and associated structures. Brain. 2005 Jan;128(Pt 1):189-200.}
3. _{Silver JM, Koumaras B, Chen M, Mirski D, Potkin SG, Reyes P, Warden D, Harvey PD, Arciniegas D, Katz DI, Gunay I. Effects of rivastigmine on cognitive function in patients with traumatic brain injury. Neurology. 2006 Sep 12;67(5):748-55.}
4. _{Silver JM, Koumaras B, Meng X, Potkin SG, Reyes PF, Harvey PD, Katz DI, Gunay I, Arciniegas DB. Long-term effects of rivastigmine capsules in patients with traumatic brain injury. Brain Inj. 2009 Feb;23(2):123-32.}
5. _{Newcombe VF, Outtrim JG, Chatfield DA, Manktelow A, Hutchinson PJ, Coles JP, Williams GB, Sahakian BJ, Menon DK.  Parcellating the neuroanatomical basis of impaired decision-making in traumatic brain injury. Brain. 2011 Mar;134(Pt 3):759-68.}
6. _{Newcombe VF, Correia MM, Ledig C, Abate MG, Outtrim JG, Chatfield D, et al. Dynamic changes in white matter abnormalities correlate with late improvement and deterioration following TBI: a diffusion tensor imaging study. Neurorehabil Neural Repair (2016) 30(1):49–62.10.1177/1545968315584004}