Extended tests for evaluating post-traumatic brain injury deficits in resource-limited settings: methods and pilot...

Area of Science:

• Neuroscience
• Public Health
• Medical Technology

Background:

• Traumatic brain injury (TBI) is a major cause of death and disability globally, particularly in low to middle-income countries (LMICs).
• Limited funding in LMICs often results in inadequate diagnosis, monitoring, and treatment for TBI patients, leading to unaddressed deficits and potential secondary harm.
• Existing diagnostic tools may not be suitable for resource-limited settings.

Purpose of the Study:

• To develop and validate simple, scientifically-based practices leveraging technology for rapid and accurate identification of post-TBI deficits in LMICs.
• To circumvent economic limitations in LMICs by utilizing accessible testing strategies.
• To assess the feasibility and effectiveness of these methods in a real-world clinical setting.

Main Methods:

• Utilized a combination of paper-based tests (Montreal Cognitive Assessment - MoCA, line-bisection, Bell's test) and modified neuroscience computer tasks.
• Assessed peripheral vision, memory, and analytical accuracy.
• Collected data from 71 subjects (51 TBI patients and 20 controls) across 4 hospitals in Ethiopia, categorizing TBI severity (mild, moderate, severe).

Main Results:

• The developed neurophysiological methods are implementable in LMICs.
• These methods effectively test impairments common after TBI, including slowed processing speed, memory deficits, and impaired executive/cognitive control.
• The MoCA test, in particular, showed promise in identifying several deficits.

Conclusions:

• The implemented testing battery shows significant promise for evaluating TBI patients in resource-limited settings.
• These findings support the establishment of dedicated rehabilitation centers in LMICs.
• Future research will focus on expanding the cohort size and applying these tests in diverse settings.