Published online Jun 19, 2026. doi: 10.5498/wjp.v16.i6.116354
Revised: January 4, 2026
Accepted: January 30, 2026
Published online: June 19, 2026
Processing time: 176 Days and 23.5 Hours
Mental disorders often follow traumatic brain injury, significantly affecting quality of life and social functioning. Damage to the frontal lobe, which is a criti
To examine the association between the severity of frontal lobe injury and the incidence and prognostic outcomes of mental disorders.
A total of 218 patients with frontal lobe injuries were enrolled in the study retrospectively from Heping Hospital Affiliated to Changzhi Medical College. The severity of each injury was determined using both imaging findings and Glasgow Coma Scale scores. The primary outcome was the incidence of mental disorders at the three-month follow-up. The secondary outcome was functional recovery, which was evaluated using the Glasgow Outcome Scale six months after injury. Logistic regression analysis was employed to examine the association between frontal lobe injury severity and clinical outcomes.
Mental disorders were present in 50.9% (111/218) of patients. Mental disorder incidence rose with injury severity: Mild 38%, moderate 59%, severe 74%. Depression, anxiety, post-traumatic stress disorder, and cognitive dysfunction occurred in 32%, 35%, 25%, and 28% of patients, respectively, with 45% exhibiting comorbid disorders. After adjusting for confounders, patients with moderate and severe frontal lobe injury demonstrated 3.454-fold (95%CI: 1.650-7.231) and 8.034-fold (95%CI: 3.017-21.390) higher risks of mental disorders and 3.334-fold (95%CI: 1.256-8.853) and 14.626-fold (95%CI: 4.600-46.504) higher risks of poor prognosis, respectively. Subgroup analysis showed stable associations across age and sex (P value for interaction > 0.05), and prognosis worsened stepwise from mild, moderate, to severe injury (29.7% vs 61.9% vs 10.7%, P value for trend < 0.05).
Frontal lobe injury severity demonstrates a significant positive correlation with both the risk of mental disorders and poor prognosis.
Core Tip: This study identified a significant association between frontal lobe injury severity and the risk of mental disorders and early prognosis. The increasing severity of frontal lobe injury was progressively associated with elevated risks of mental disorders and poor prognosis. This relationship was observed consistently across various population subgroups, which provides strong evidence for the early clinical identification of high-risk patients.
- Citation: Bai J, Duan GW, Song Q, Ma TF. Correlation between frontal lobe injury severity caused by traumatic brain injury and mental disorders with early prognosis. World J Psychiatry 2026; 16(6): 116354
- URL: https://www.wjgnet.com/2220-3206/full/v16/i6/116354.htm
- DOI: https://dx.doi.org/10.5498/wjp.v16.i6.116354
Traumatic brain injury (TBI) is a common clinical condition that usually requires surgical treatment and is a principal cause of death and disability. Mortality rates of severe TBI may reach 50%[1]. About 70 million people suffer from TBI each year costing the economy a lot[2]. Although there is a reduction in the mortality as well as disability rate due to advances in technology but total repair of brain tissue damage by surgery is not possible. The injury’s pathological processes may result in sustained and perhaps irreversible neurodegenerative alterations as well as an augmented risk of traumatic encephalopathy[3]. Patients who do not receive this treatment are thought to be at risk of various mental disorders, such as anxiety, depression, personality changes, post-traumatic stress disorder (PTSD), cognitive dysfunction (CD), and other psychiatric symptoms[4]. Personality changes are especially prominent among others where nearly one-third of patients with TBI display antisocial or compulsive personality[5]. Complications significantly reduce the quality of life and the recovery of social functions[6]. Now, mental disorders related to TBI are considered common and a major contributor to post-injury disability and quality of life[7]. As a result, mental disorder prevention and management in TBI patients have emerged vital clinical and public health issues.
Traffic crashes, violent behavior, and sports activities produce TBI, which produces growing mental disorders in TBI patients[8]. TBIs are increasingly caused by growing traffic accidents as well as delinquency and sports. The trauma severity of a brain injury is evaluated with the Glasgow Coma Scale (GCS) scoring[9]. The area and severity of the injury to the brain determine the clinical manifestations of these disorders. The initial symptoms are often subtle, with the possibility for prolonged incubation periods. Direct injury can impair vital areas of the brain, with the frontal lobe being susceptible. The frontal lobe consists of a large number of associative fibers related to mental processes (e.g., judgment, memory, control of emotion and impulse)[10]. Studies have shown links between frontal lobe injury and many neuropsychiatric disorders such as depression, schizophrenia and Alzheimer’s disease[11-13]. The clinical evidence that supports this idea is limited: A patient with TBI who has frontal lobe damage may more easily develop mental disorders. Most studies about brain injuries have looked at the relationship between the first and the appearance of mental disorders. They do not look at specific brain regions. In particular, the degree of frontal lobe injury and the appearance of mental disorders and early functional recovery. The purpose of this study was to determine the correlation between frontal lobe injury severity with the incidence of mental disorder and their early prognosis among TBI patients. This will be helpful in understanding the complexities of TBI related to the frontal lobe in a better way. The results may be useful for clinical interventions to improve prognosis and quality of life.
Patients with TBI involving predominantly frontal lobe damage, admitted to Heping Hospital Affiliated to Changzhi Medical College between January 2019 and June 2025, were retrospectively enrolled in the study.
Inclusion criteria were as follows: (1) Documented history of TBI with primary frontal lobe involvement, confirmed by cranial computed tomography (CT) or magnetic resonance imaging (MRI), and meeting the TBI diagnostic criteria in ICD-11[14]; (2) GCS score recorded within 24 hours of admission; (3) Age ≥ 18 years; and (4) Complete medical records.
Exclusion criteria include: (1) In-hospital mortality; (2) Congenital intellectual disability; or (3) Concurrent end-stage malignancy. A total of 218 patients met the inclusion criteria (Figure 1).
The study protocol was approved by the Institutional Review Board of Heping Hospital Affiliated to Changzhi Medical College.
The severity of frontal lobe injury following craniocerebral trauma was the primary exposure factor. Injury localization was confirmed by cranial CT or MRI within 72 hours of admission, with assessments performed by two senior neuroradiologists, blinded to the study protocol (Kappa consistency > 0.8). Eligible injuries involved the frontal cortex, frontal white matter, or frontal lobe-adjacent basal ganglia, comprising > 50% of the total lesion volume. Injury severity was classified using the GCS score at admission: Severe (≤ 8), moderate (9-12), and mild (13-15)[15].
The primary outcome was the incidence of mental disorders, defined as anxiety, depression, PTSD, and CD, which were diagnosed via structured clinical interviews (SCIDI) according to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM5) criteria during a 3-month post-injury follow-up period. The diagnosis of any single condition qualified as a mental disorder. Diagnoses were established through SCID-I interviews administered by trained psychiatrists. Quantitative assessments were performed using the Hamilton Anxiety Scale (HAMA), Hamilton Depression Rating Scale (HAMD), PTSD Checklist for DSM-5 (PCL-5), and Montreal Cognitive Assessment (MoCA). The HAMA is a 14-item scale assessing anxiety symptom severity, with each item rated on a scale of 0-4 (0 = no symptoms; 4 = extremely severe); a total score < 7 indicates no anxiety symptoms, 7-13 suggests possible anxiety, and > 13 denotes clinically significant anxiety[16]. The HAMD-17 is a 17-item clinician-administered scale evaluating depressive symptoms; a total score < 7 indicates no depression, 17-23 (17 ≤ total score < 24) indicates mild-to-moderate depression, and ≥ 24 indicates severe depression[17]. The PCL-5 is a 20-item self-report measure. Each item is scored from 0 to 4 (0 = not at all, 4 = extremely). A total score of 33 or higher suggests probable PTSD[18]. The MoCA is an 11-item screening tool for global cognition. It is scored from 0 to 30, and a score of at least 26 indicates normal cognition[19].
The secondary outcomes included early prognosis, which was defined in this study as early neurological recovery. More specifically, it was defined as the functional recovery status assessed by the Glasgow Outcome Scale (GOS) at six months post-injury. Functional recovery was categorized as 1 point (death), 2 points (vegetative state), 3 points (severe disability), 4 points (mild disability), and 5 points (good recovery). A GOS score > 3 indicated a favorable prognosis, whereas ≤ 3 denoted poor prognosis[20].
Patient-related clinical data were extracted from the hospital’s electronic medical record system, including: (1) Demographic factors: Age, gender, education level, smoking history, alcohol misuse history, pre-injury substance abuse, pre-existing mental illness, and basic diseases (hypertension or diabetes); (2) Trauma-related factors: Craniocerebral trauma mechanisms (e.g., traffic accidents, falls, violent assaults, other), time from injury to first aid, Marshall CT classification, polytrauma, hypotension (systolic blood pressure < 90 mmHg), hypoxia (SaO2 < 90%), and surgical treatment status; and (3) Admission blood biomarkers: Activated partial thromboplastin time (APTT), procalcitonin (PCT), serum creatinine (Cr), and serum neuron-specific enolase (NSE).
Mental status was assessed at the 3-month post-injury follow-up using the HAMA, HAMD, PCL-5, and MoCA through either face-to-face interviews or remote video consultations. Two independent psychiatrists determined the presence of clinically significant mental disorders based on the criteria outlined in the DSM-5. Discrepancies in assessments were resolved by a third senior psychiatrist. Additionally, the GOS was administered at the 6-month post-injury follow-up to evaluate early neurological recovery.
Data were independently extracted by two trained researchers and entered into an electronic database using a double-blind approach. Discrepancies were resolved by cross-referencing the data with the original medical records. EpiData 3.1 software was employed to identify data inconsistencies, resulting in a final consistency rate of 95%.
Statistical analyses were performed using SPSS 27.0. Continuous variables were presented as means ± SD and compared between groups using one-way ANOVA. Non-normally distributed variables were presented as medians (25th, 75th percentiles) and analyzed using the Kruskal-Wallis H test. Post hoc pairwise comparisons for significant group differences (P < 0.05) were conducted using the Mann-Whitney U test with Bonferroni correction to adjust for multiple comparisons. Categorical variables were expressed as n (%) and compared using the χ2 test. When expected frequencies were < 5, Fisher’s exact test was applied. Pearson’s correlation analysis was conducted to examine the relationships between GCS scores and other scale metrics. Logistic regression analysis was used to explore the associations between frontal lobe injury severity and both mental disorders and poor prognosis, with interaction analysis assessing subgroup effect heterogeneity. Statistical significance was set at P < 0.05.
Among 218 patients with TBI involving the frontal lobe, 145 (66.5%) were male, and 73 (33.5%) were female. The age range was 25-86 years, with a mean age of 55.22 ± 12.05 years. The GCS score was averaged to 11.30 ± 3.43. Based on GCS scores, patients were categorized as follows: 112 (51.4%) with mild injury (GCS: 14.07 ± 0.81), 64 (29.4%) with moderate injury (GCS: 10.16 ± 1.01), and 42 (19.2%) with severe injury (GCS: 5.64 ± 1.71). Compared with patients with mild injury, those with moderate injury exhibited higher incidences of hypotension and hypoxia, as well as elevated levels of APTT, PCT, Cr, and NSE (P < 0.05). Biomarker levels were significantly higher in patients with severe injury compared to those with mild injury. Additionally, the prevalence of alcohol misuse, multiple traumatic injuries, Marshall CT classification > IV, and post-traumatic surgery was also elevated (Table 1).
| Mild injury (n = 112) | Moderate injury (n = 64) | Severe injury (n = 42) | F or H or χ2 | P value | |
| Age (year) | 54.13 ± 13.05 | 55.83 ± 11.01 | 57.21 ± 10.64 | 1.120 | 0.328 |
| Sex | 1.066 | 0.587 | |||
| Male | 78 (69.64) | 41 (64.06) | 26 (61.90) | ||
| Female | 34 (30.36) | 23 (35.94) | 16 (38.10) | ||
| Education | 0.501 | 0.779 | |||
| ≤ High school | 90 (80.36) | 54 (83.38) | 35 (83.33) | ||
| ≥ College | 22 (19.64) | 10 (15.62) | 7 (16.67) | ||
| Smoking history | 30 (26.79) | 16 (25.00) | 10 (23.81) | 0.164 | 0.921 |
| Alcohol misuse history | 26 (23.21) | 20 (31.25) | 20 (47.62)a | 8.659 | 0.013 |
| Pre-injury substance abuse | 8 (7.14) | 4 (6.25) | 1 (2.38) | 1.044 | 0.688 |
| Pre-existing mental illness | 13 (11.61) | 6 (9.38) | 5 (11.90) | 0.296 | 0.880 |
| Basic diseases | 31 (27.68) | 13 (20.31) | 13 (30.95) | 1.767 | 0.413 |
| Cause of trauma | 2.700 | 0.855 | |||
| Traffic accident | 54 (48.21) | 28 (43.75) | 21 (50.00) | ||
| Fall accident | 28 (25.00) | 15 (23.44) | 8 (19.05) | ||
| Violent assaults | 11 (9.82) | 9 (14.06) | 3 (7.14) | ||
| Other | 19 (16.97) | 12 (18.75) | 10 (23.81) | ||
| Time from injury to first aid (hour) | 1.231 | 0.540 | |||
| < 6 | 89 (79.46) | 48 (75.00) | 30 (71.43) | ||
| ≥ 6 | 23 (20.54) | 16 (25.00) | 12 (28.57) | ||
| Multiple traumatic injuries | 52 (46.43) | 33 (51.56) | 31 (73.81)a,b | 9.297 | 0.010 |
| Marshall CT classification | 9.705 | 0.008 | |||
| ≤ IV | 94 (83.93) | 53 (82.81) | 26 (61.90)a,b | ||
| > IV | 18 (16.07) | 11 (17.19) | 16 (38.10) | ||
| Post-traumatic surgery | 43 (38.39) | 29 (45.31) | 32 (76.19)a,b | 17.701 | < 0.001 |
| Hypotension | 36 (32.14) | 37 (57.81)a | 32 (76.19)a | 27.115 | < 0.001 |
| Hypoxia | 15 (13.39) | 19 (29.69)a | 21 (50.00)a,b | 22.654 | < 0.001 |
| Laboratory results | |||||
| APTT (second) | 30.57 ± 5.11 | 35.25 ± 5.52a | 44.65 ± 7.51a,b | 105.622 | < 0.001 |
| PCT (ng/L) | 1.84 (1.00, 2.93) | 3.64 (1.65, 5.12)a | 9.54 (7.84, 13.96)a,b | 98.919 | < 0.001 |
| Cre (mmol/L) | 45.68 ± 2.76 | 49.38 ± 3.24a | 53.62 ± 2.16a,b | 128.369 | < 0.001 |
| NSE (ng/mL) | 16.74 (12.83, 19.47) | 23.94 (15.52, 34.19)a | 31.59 (22.79, 39.84)a,b | 66.829 | < 0.001 |
| Admission GCS score | 14.07 ± 0.81 | 10.16 ± 1.01a | 5.64 ± 1.71a,b | 955.197 | < 0.001 |
The scores of HAMA, HAMD, and PCL-5 in patients with moderate and severe injuries were significantly higher than those in patients with mild injury. In contrast, the scores of MoCA and GOS were lower in patients with moderate and severe injuries than those with mild injury (P < 0.05; Table 2). The greater the severity of frontal lobe injury, the higher the incidence of anxiety, depression, PTSD, and CD (P value for trend < 0.001). During the 3-month follow-up period, any of the above symptoms were considered mental disorders. The overall incidence of mental disorders was 50.9% (111/218). Among them, the incidence of depressive disorder was 32.1%, anxiety disorder was 34.9%, PTSD was 25.2%, CD was 28.4%, and 44.5% (97/218) of patients showed mixed mental symptoms (meeting two or more diagnostic criteria). The incidence of mental disorders in patients with mild, moderate, and severe trauma was 37.5% (42/112), 59.4% (38/64), and 73.8% (31/42), respectively. The overall incidences of poor prognosis were 26.1% (57/218), 10.7% (12/112), 29.7% (19/64), and 61.9% (26/42) in patients with mild, moderate, and severe trauma, respectively (Figure 2).
In patients with moderate and severe frontal lobe injury, the scores on the HAMA, HAMD, and PCL-5 were significantly higher (P < 0.05), while the MoCA and GOS scores were significantly lower than those in patients with mild injury (Table 2). A positive dose-response relationship was observed between frontal lobe injury severity and the incidence of anxiety, depression, PTSD, and CD (P value for trend < 0.001). During the 3-month follow-up period, the presence of any of these symptoms (anxiety, depression, PTSD, or CD) was considered a mental disorder, yielding an overall incidence of 50.9% (111/218). Specifically, the incidence rates were 32.1% for depressive disorder, 34.9% for anxiety, 25.2% for PTSD, and 28.4% for CD, with 44.5% (97/218) of patients exhibiting mixed symptoms (meeting ≥ 2 diagnostic criteria). The incidence of mental disorders, stratified by injury severity, was 37.5% (42/112) for mild injury, 59.4% (38/64) for moderate, and 73.8% (31/42) for severe injury. Similarly, the overall incidence of poor prognosis was 10.7% (12/112), 29.7% (19/64), and 61.9% (26/42) for mild, moderate, and severe injury, respectively (Figure 2).
Pearson correlation analysis revealed a significant negative correlation between GCS score and HAMA (r = -0.535, P < 0.001), HAMD (r = -0.490, P < 0.001), and PCL-5 (r = -0.380, P < 0.001). Additionally, GCS score showed a significant positive correlation with MoCA (r = 0.290, P < 0.001) and GOS (r = 0.529, P < 0.001) scores (Figure 3).
After adjusting for relevant confounding factors, the risk of mental disorders and poor prognosis was found to be 3.454 times higher in patients with moderate injury and 8.034 times higher in those with severe injury compared to patients with mild injury. Similarly, the risk of poor prognosis was 3.334 times higher in the moderate injury group and 14.626 times higher in the severe injury group relative to the mild injury group (P value for trend < 0.001; Tables 3 and 4).
| Model 1 | Model 2 | Model 3 | ||||
| OR (95%CI) | P value | OR (95%CI) | P value | OR (95%CI) | P value | |
| Mild | Reference | Reference | Reference | |||
| Moderate | 2.436 (1.299-4.567) | 0.006 | 2.383 (1.260-4.509) | 0.008 | 3.454 (1.650-7.231) | 0.001 |
| Severe | 4.697 (2.138-10.319) | < 0.001 | 4.477 (2.012-9.930) | < 0.001 | 8.034 (3.017-21.390) | < 0.001 |
| P value for trend | < 0.001 | < 0.001 | < 0.001 | |||
| Model 1 | Model 2 | Model 3 | ||||
| OR (95%CI) | P value | OR (95%CI) | P value | OR (95%CI) | P value | |
| Mild | Reference | Reference | Reference | |||
| Moderate | 3.519 (1.575-7.860) | 0.002 | 3.553 (1.560-8.091) | 0.003 | 3.334 (1.256-8.853) | 0.016 |
| Severe | 13.542 (5.708-32.127) | < 0.001 | 13.794 (5.663-33.597) | < 0.001 | 14.626 (4.600-46.504) | < 0.001 |
| P value for trend | < 0.001 | < 0.001 | < 0.001 | |||
Subgroup analyses showed consistent associations between injury severity and mental disorder risk across age and gender groups: Severe injury increased risk in patients < 60 years, while moderate and severe injuries did so in those ≥ 60 years. In males, both moderate and severe injuries were risk factors, whereas in females only severe injury was significant. No significant interactions were found (all P > 0.05; Figure 4).
Subgroup analyses demonstrated a consistent increase in poor prognosis risk with greater injury severity across age, gender, and mental disorder groups. Severe injury was associated with increased risk in patients < 60 years, while moderate and severe injuries were significant in those ≥ 60 years. In males, both moderate and severe injuries were risk factors, whereas in females only severe injury was significant. Similar associations were observed in patients with mental disorders, and severe injury remained significant in those without. No significant interactions were found (all P for interaction > 0.05; Figure 5).
TBI is one of the most widespread global public health problems. The incidence of TBI, which is frequently seen as an acute neurological emergency, has been progressively increasing due to rapid urbanization and increasing use of motor vehicles[21]. TBI as compared to other diseases, is associated with significantly higher mortality and morbidity. It also adds a huge economic burden to society and families[22]. The multi-organ system disorder TBI can give rise to a variety of complications, among them neuropsychiatric sequelae are increasingly being seen as one of the topmost complications of TBI[23]. According to reports, the occurrence of post-traumatic mental disorders in TBI survivors ranges from 45.9% to 74.48%[24]. A total of 218 patients were re-evaluated at the 3-month follow-up. Overall, 50.9% (111/218) had a mental disorder. Of these, anxiety was the most common (34.9%), depression (32.1%), CD (28.4%) and PTSD (25.2%). Moreover, 44.5% of patients (97/218) exhibited mixed psychiatric symptoms. Mental disorders have a multidimensional effect on patient rehabilitation that includes recovery of cognitive functions, modulation of emotional states, and reconstruction of social adaptability. Thus, identifying and intervening early significantly enhances the functional outcome and prognosis[25].
Mental disorders caused by trauma to the skull and brain are essentially due to such secondary injuries occurring in the brain as bleeding in the brain, swelling, necrosis, rise in pressure inside the cranial cavity and rise in pressure of blood both in the brain and in general circulation. When the brain regions responsible for sentiment, cognition and behavior are affected by these secondary injuries, it can cause mental disorders[26]. The frontal lobe is the main brain area for complex cognitive function, emotion regulation, and social function. It is the most common site of injury in TBI. Motor-car accidents are particularly responsible for the moderate-to-severe form of TBI. Furthermore, it is also responsible for secondary injuries of a more constant kind. The rehabilitation and long-term functional recovery of the person gets severely compromised along with mental and behavior abnormalities being prominent[27]. Research indicates that personality changes after TBI are common. Approximately one in three are reported to have antisocial personality and compulsive personality. Such personality changes have often been linked to frontal lobe damage[28]. Frontal lobe injury was noted as a critical risk factor of mental disorder following TBI by Liu and Yi[29]. Moreover, there have been reports of regional differences in frontal lobe involvement. For example, left and bilateral frontal lobe injuries have been associated with depression and schizophrenia while right frontal lobe injuries have been associated with mania. In addition, orbitofrontal lobe dysfunction has been associated with compulsive behaviors[30]. The current studies mainly focus on the connection between TBI and mental disorders[29]. Besides that, few studies examine the individual areas of the brain. In particular, the classification of frontal lobe injury and the correlation with types of mental disorders. The GCS is commonly employed to gauge a patient’s neurological activity and works opposite to impairment. Lower scores indicate more significant neurological deficits[31]. However, in isolation, GCS is inadequate to assess the degree of frontal lobe structural damage. Aims of the study to overcome this limitation, the present study combined GCS with neuroimaging for a better assessment. According to findings, there was a consistent association between severity of frontal lobe injury and risk of mental disorder. Patients suffering from moderate and severe injury have a 3.454-fold and 8.034-fold higher risk of mental disorder, respectively, as compared to the mild injury. Hence, there is a positive dose-response relationship between injury severity and mental disorder risk. Importantly, the association was constant across age and sex subgroups, with no significant interaction between the demographic factors and injury severity.
The frontal lobe is the centre of the human brain activity from the point of view of neuroanatomy and functioning. Damage to this region creates susceptibility for emotional dysregulation and cellular dysfunction[32]. A frontal lobe injury becomes more severe, and the neuronal damage and death, as well as the breaking of neural conduction pathways, become more significant. Not only this but it also impeded the working of frontal lobe which further increases the risk of mental disorder and others. Injury to the prefrontal cortex and its white matter connections with the limbic system (including the cingulate gyrus and amygdala) has the potential to disrupt emotion-cognition integration and conveys relatively high vulnerability. Injury to these regions is thought to significantly raise the risk of psychiatric morbidity[33].
Prognostic analysis reveals that frontal lobe injury is not only a risk factor for development of mental disorders but also a determinant of clinical prognosis. Patients with moderate and severe injuries have a significantly poorer prognosis than patients with mild injury, and the risk increases after adjusting for mental disorder comorbidity, with poorer prognosis correlating with injury severity. These prognosis largely depend on GOS scores 6 months after the injury. Since the GOS determines overall clinical outcome by assessing patient functioning post-injury, it is the gold-standard for TBI prognosis[34]. According to an early prognostic study, the 6-month post-injury period is commonly utilized because patients typically achieve relative clinical stability and reach a functional recovery plateau at this time[35]. Patients with a slight injury to the frontal lobe will have minimal damage to the neural structures and the person will still get partial activation of the self-repair and compensatory mechanisms of the brain. Thus, such patients will have a relatively good prognosis. On the other hand, moderate and severe injuries have substantial loss of neurons paired with significant axonal damage that substantially detract from functional recovery during rehabilitation.
The severity of frontal lobe injury was significantly positively correlated with the risk of mental disorders and poor prognosis. Our results are mainly based on patients with traumatic focal frontal lesions caused by traffic trauma in urban areas, so it is necessary to be cautious when extending the results to other causes or diffuse brain injury. Accurate assessment of frontal lobe injury plays an important role in optimizing the clinical management and improving the prognosis of patients with traumatic brain injury TBI.
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