Impact of physiological and neuropsychological function on quality of life in traumatic brain injury patients

Traumatic Brain Injury (TBI) leads to neuropsychological and social impairments, affecting quality of life (QoL). This study examines how heart rate variability (HRV) and neuropsychological functions under different cognitive task conditions influence TBI patients' QoL. The study adopted 20 healthy and 11 TBI participants. Measurements included the Montreal Cognitive Assessment (MoCA), Community Mental Status Examination (CMSE), Continuous Performance Test (CPT-3), Tower of London, Wisconsin Card Sorting Test, Rey Complex Figure Test, WAIS-4, Fatigue Severity Scale, the WHO QoL Taiwan Brief Version (WHOQOL) and Well-Being Index (WHO-5), Hierarchy of Care Required, Daily Executive Behavior Scale, Perceived Family Relationship Scale, Connor-Davidson Resilience Scale, and Center for Epidemiologic Studies Depression Scale (CESD). The HRV indexes were measured by biofeedback device. Statistical analyses include independent <i>t</i>-test, Chi-square, repeated measure ANOVA, Pearson correlation, and mediation analysis. TBI group showed lower scores in memory, attention, executive function, and psychosocial measures. HRV results revealed lower baseline LF and task-related interaction effects in LF, LF/HF, and RMSSD. Mediation analysis further showed that CPT-3 performance and LF mediated the group's impact on self-reported quality of life. TBI patients exhibit physiological, neuropsychological, and psychosocial impairments, which are closely related to their QoL. In particular, the preservation response in the CPT-3 and LF showed significant predictive effects on QoL.