TBI TBI Cognitive & Behavioral Outcomes 2 — Questions and Answers
Question 1: What is 'executive dysfunction' in the context of TBI, and which brain region is most associated with it?
- Sensory processing deficits; parietal lobe
- Impaired planning, problem-solving, cognitive flexibility, and initiation; prefrontal cortex (Correct answer)
- Language deficits; temporal lobe
- Visual processing; occipital lobe
Correct answer: Impaired planning, problem-solving, cognitive flexibility, and initiation; prefrontal cortex
Executive dysfunction involves impaired higher-order cognitive control functions and is primarily linked to prefrontal cortex damage in TBI.
Question 2: Which behavioral syndrome after TBI is characterized by reduced initiation, flat affect, reduced spontaneous movement, and apathy despite intact cognition?
- Korsakoff syndrome
- Akinetic mutism (Correct answer)
- Wernicke's aphasia
- Anton syndrome
Correct answer: Akinetic mutism
Akinetic mutism is a severe disorder of motivation and initiation seen after bilateral frontal or anterior cingulate damage in TBI.
Question 3: Post-traumatic stress disorder (PTSD) can co-occur with TBI; which symptom overlap makes dual diagnosis challenging?
- Motor deficits
- Sleep disturbance, concentration problems, and irritability appear in both conditions (Correct answer)
- Seizure activity
- Spasticity
Correct answer: Sleep disturbance, concentration problems, and irritability appear in both conditions
Many symptoms (insomnia, poor concentration, irritability, hyperarousal) are shared between TBI sequelae and PTSD, complicating differential diagnosis.
Question 4: Which cognitive rehabilitation strategy is most effective for memory deficits after moderate-to-severe TBI?
- Passive listening exercises
- Compensatory strategy training using external aids (notebooks, calendars, alarms) (Correct answer)
- Pharmacological memory enhancement alone
- Sensory stimulation therapy
Correct answer: Compensatory strategy training using external aids (notebooks, calendars, alarms)
Compensatory strategies using external memory aids are the most evidence-based approach for memory dysfunction in TBI rehabilitation.
Question 5: Sleep disturbance after TBI most commonly manifests as which pattern?
- Hypersomnia only
- Insomnia, fragmented sleep, fatigue, and excessive daytime sleepiness (Correct answer)
- Narcolepsy with cataplexy
- Circadian phase advance disorder exclusively
Correct answer: Insomnia, fragmented sleep, fatigue, and excessive daytime sleepiness
TBI disrupts sleep architecture through hypothalamic and brainstem damage, resulting in mixed sleep disorders including insomnia and hypersomnia.
Question 6: Which approach is used to manage agitation and aggression in TBI rehabilitation settings?
- Strict physical restraint as first-line intervention
- Environmental modification, structured routine, behavioral strategies, and judicious pharmacotherapy (Correct answer)
- Immediate psychiatric transfer
- Long-term isolation
Correct answer: Environmental modification, structured routine, behavioral strategies, and judicious pharmacotherapy
A low-stimulation environment, predictable routines, de-escalation techniques, and targeted medications form the evidence-based approach to TBI-related agitation.
TBI TBI Cognitive & Behavioral Outcomes 2
What is 'executive dysfunction' in the context of TBI, and which brain region is most associated with it?