Does brain damage caused by stroke versus trauma have different neuropsychological outcomes? A lesion-matched multiple case study

Abstract

Traumatic brain injury (TBI) and stroke both have the potential to cause significant damage to the brain, with resultant neuropsychological impairments. How these different mechanisms of injury influence cognitive and behavioral changes associated with brain damage, however, is not well understood. Moreover, previous research directly comparing TBI and stroke has not accounted carefully for lesion location and size. Here, using a detailed lesion-matching approach that was used previously to compare neuropsychological outcomes in stroke versus tumor, we compared the neuropsychological profiles of 14 patients with focal lesions caused by TBI to those of 27 lesion-matched patients with stroke. Each patient with TBI was matched to two patients with stroke, based on lesion location and size (except 1 TBI case where only 1 stroke match was available). Demographic attributes (age, gender, handedness, education) were also matched in the TBI: stroke triplets, as much as possible. The patients with TBI versus stroke had similar performances across all cognitive and behavioral measures, with no significant or clinically meaningful differences. A supplemental analysis on developmental- versus adult-onset TBI cases (with their respective stroke matches) also yielded non-significant results, with TBI and stroke groups being statistically indistinguishable. Our results suggest that focal lesions caused by TBI versus stroke have similar neuropsychological outcomes in the chronic recovery phase, when location and size of lesion are comparable across TBI versus stroke mechanisms of injury.

Keywords:

• TBI
• stroke
• cognitive profile
• lesion
• assessment

Acknowledgments

We would like to thank all of the participants for their participation and the clinicians and students for their contributions in data collection and establishment of the Iowa Patient Registry. A portion of this research was previously presented at the Big Ten and Ivy League 9th annual TBI Summit in Chicago, Illinois, USA.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported in part by the National Institute of Health T32 pre-doctoral training [grant: T32GM108540 (S.H)], and by grants from the National Institutes of Mental Health [P50 MH094258 to DT) and the Kiwanis Neuroscience Research Foundation (to DT).