PREFACE to what traditional neuropsychological assessment got wrong about mild traumatic brain injury. A four-part opinion review

ABSTRACT

This Preface overviews a four-part opinion series on the role of tradtional neuropsychological tests in evaluating mild traumatic brain injury (mTBI), juxtaposed to all of the progress that has occurred with advanced neuroimaging and allied technologies. The four areas of review and critique are: I. Neuropathology; II: Limitations in Test Development, Statistical and Psychometric Issues; III. Implications of Advanced Neuroimaging Findings inn the Neuropsychological Assessment of the mTBI Patient, and IV: Clinical Applications and Future Directions. The example is made that since their inception in the early to mid-20th Century, traditional neuropsychological measures mostly have remained invariant, have been used as omnibus measures for assessing all types of neurological and neuropsychiatric conditions, and were never specifically designed to asses the effects of mTBI. Extensive discussion is provided across all four parts concerning the limits of traditional neuropsychological methods, especially in the absences of any integration with advanced neuroimaging and biomarker findings. Part IV provides an outline for future research and clinical application in the development of novel neuropsychological assessment mesasures specific to mTBI.

KEYWORDS:

• Mild traumatic brain injury
• traditional neuropsychological assessment
• neuroimaging
• network neuroscience
• concussion

Acknowledgments

Erin David Bigler is retired, professor emeritus of psychology and neuroscience, Brigham Young University. He does provide some forensic consultation on the topic of brain injury.

Disclosure statement

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

Notes

1. When used in a quote, post-concussion syndrome with be reproduced as per the original quote throughout the four critiques but more accurately it is the symptom constellation that accompanies a concussion brain injury, best referred to as post-concussive symptoms rather than a specific syndrome.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.