Possibility of rehabilitation of patients with cognitive dysfunction and impairment of critical thinking in mild traumatic brain injuries

Abstract

Abstract. Background. Studying the impact of mild traumatic brain injury (TBI) on cognitive functions and critical thinking is an important task in modern neurology and rehabilitation medicine. The aim of this study is to analyze the impact of mild TBI on cognitive functions and critical thinking, and to evaluate the possibilities of rehabilitation to restore these functions. Materials and methods. Clinical, neuropsychological and instrumental methods were used for assessing the state of cognitive functions in mild TBI. The study involved 36 patients aged 28 to 35 years, including 20 men (55.56 %) and 16 (44.44 %) women, maintaining gender equality. They had a diagnosis of mild TBI according to the International Statistical Classification of Diseases and Related Health Problems (10th revision) under the code S06.9X9, confirmed by medical documents. Results. The study showed that 29 people (80 %) with mild TBI had memory and attention impairments, which manifested themselves through a decrease in the ability to remember new information and concentrate. Patients with severe cognitive impairments were found to have structural changes in the brain on magnetic resonance imaging, such as hippocampal atrophy and enlargement of the cerebral ventricles. In 15 of 36 patients, these changes correlated with worse results on all neuropsychological tests (significance level p < 0.01). Conclusions. 1. Cognitive impairment: 29 patients (80 %) with mild TBI demonstrate significant memory and attention impairment, as evidenced by a 15% decrease on Wechsler Memory Scale scores compared to the control group (p < 0.05). 2. Slowed information processing: 23 patients (63.8 %) have a slow speed of information processing, as indicated by a 20% increase in the time to complete tasks of the Trail Making Test compared to the control group (p < 0.01). 3. Impaired critical thinking: 26 patients (72 %) with mild TBI demonstrated difficulties in critical thinking and executive functions, as evidenced by an 18% increase in the number of errors on the Wisconsin Card Sorting Test compared to the control group (p < 0.01). 4. Gender differences: women have more cognitive impairment than men, including a 12 % lower average score on the Wechsler Memory Scale (p < 0.05). 5. Age differences: older patients (32–35 years) show more significant cognitive deficits than younger ones (28–31 years), in particular, the average time to complete the Trail Making Test was 25 % longer in older individuals (p < 0.01). 6. Neuroimaging findings: 15 of 36 patients had structural brain changes on magnetic resonance imaging, such as hippocampal atrophy and enlargement of the cerebral ventricles, correlating with worse results of neuropsychological tests (p < 0.01). 7. Multidisciplinary approach combining cognitive rehabilitation, physical activity, potential pharmacological treatments, and psychological support offers promising opportunities for restoring cognitive functions and critical thinking abilities in individuals with mild traumatic brain injuries.