The Association of Cognitive Reserve in Chronic-Phase Functional and Neuropsychological Outcomes Following Traumatic Brain Injury

Leary, Jacob B.; Kim, Grace Y.; Bradley, Catherine; Hussain, Uzma; Sacco, Maryanne; Bernad, Martha; Collins, John P.; Dsurney, John; Chan, Leighton

doi:10.1097/htr.0000000000000329

Cited by 46 publications

(37 citation statements)

References 29 publications

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“…However, these results are confounded by participants with longer duration of PTA having lower estimated longstanding intellectual functioning than those with short duration PTA. Because intellectual functioning is known to be correlated with neuropsychological test performance ( 51 – 53 ), and with the composite scores in the present study ( Tables 8 , 9 ), the findings are likely in part related to premorbid differences in intelligence.…”

Section: Discussionmentioning

confidence: 63%

Developing Cognition Endpoints for the CENTER-TBI Neuropsychological Test Battery

et al. 2020

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Background: Measuring cognitive functioning is common in traumatic brain injury (TBI) research, but no universally accepted method for combining several neuropsychological test scores into composite, or summary, scores exists. This study examined several possible composite scores for the test battery used in the large-scale study Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI). Methods: Participants with mild traumatic brain injury (MTBI; n = 140), orthopedic trauma (n = 72), and healthy community controls (n = 70) from the Trondheim MTBI follow-up study completed the CENTER-TBI test battery at 2 weeks after injury, which includes both traditional paper-and-pencil tests and tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Seven composite scores were calculated for the paper and pencil tests, the CANTAB tests, and all tests combined (i.e., 21 composites): the overall test battery mean (OTBM); global deficit score (GDS); neuropsychological deficit score-weighted (NDS-W); low score composite (LSC); and the number of scores ≤5th percentile, ≤16th percentile, or <50th percentile. Results: The OTBM and the number of scores <50th percentile composites had distributional characteristics approaching a normal distribution. The other composites were in general highly skewed and zero-inflated. When the MTBI group, the trauma control group, and the community control group were compared, effect sizes were negligible to small for all composites. Subgroups with vs. without loss of consciousness at the time of injury did not differ on the composite scores and neither did subgroups with complicated vs. uncomplicated MTBIs. Intercorrelations were high within the paper-and-pencil composites, the CANTAB composites, and the combined composites and lower between the paper-and-pencil composites and the CANTAB composites. Conclusion: None of the composites revealed significant differences between participants with MTBI and the two control groups. Some of the composite scores Stenberg et al. Cognition Endpoints were highly correlated and may be redundant. Additional research on patients with moderate to severe TBIs is needed to determine which scores are most appropriate for TBI clinical trials.

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Section: Discussionmentioning

confidence: 63%

Developing Cognition Endpoints for the CENTER-TBI Neuropsychological Test Battery

et al. 2020

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“…Greater cognitive reserve may be the reason for better improvement which must be showing some degree of resilience to the impact of injury. 11 Moderate degree DAI patients have significant deficits of episodic memory including immediate and delayed verbal memory recall, verbal recognition, immediate and delayed visual memory recall, naming, verbal fluency, and information processing speed. The comprehensive neuropsychological assessments in all cases of TBI are important.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Impairment in Moderate Degree Diffuse Axonal Head Injuries: Analysis of 84 Cases Using MMSE

Jaleel

Ramesh

Raju

et al. 2020

Indian Journal of Neurotrauma

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Background Cognitive impairment is commonly seen in traumatic brain injury survivors. Posttraumatic cognitive sequelae may be more devastating than focal motor and focal sensory deficits, and are usually left unattended. Aim and Objective Aim of this study was to assess cognitive impairment in patients who had sustained moderate degree diffuse axonal injuries and having good outcome (Glasgow Outcome Score of 5). Methods and Materials Prospective observational study was done from 2011 to 2015 on the patients who had sustained moderated degree diffuse brain injuries. Eighty-four cases fulfilling the inclusion criteria were studied. Patients were assessed with Mini-Mental Status Examination at discharge, end of 1 month, and at 3 months. Result Seventy-six were males and 8 were females. Age ranged from 16 to 49 years. Note that 4.76% (4) patients had hypotension at presentation, 32.14% (27) patients had associated injuries, and 19.04% (16) patients had hyponatremia at presentation. Diabetes mellitus was seen in 34.52% (29) patients, while hypertension was seen in 14.28% (12). At 3 months’ follow-up, 19.06% (16) patients had cognitive impairment. The present study revealed that hypotension and presence of associated injuries at presentation raises the odds of having cognitive impairment by 8 and 5 times, respectively. Conclusion Routine assessment of cognitive impairment in head injury survivors is essential as it may help in identifying cognitive deficits. Early intervention of neurorehabilitation to such patients results in better neurocognitive outcome. Hypotension and associated injuries are associated with poor cognitive outcome.

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“…Earlier studies support the fact that number of years of education is associated with better cognitive performance in domains like memory, learning and executive functions. 23,24 Based on their occupation, housewives were found to be more affected in cognitive performance following mTBI compared to those in other professions. 57.1% of them exhibited severe dysfunction in learning and storing new information (X 2 =20.063, df=8, p<.05) and 42.9% had mild deficit in mental balance (X 2 =21.255, df=8, p<.05).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Risk Factors of Neuropsychological Issues Following Acute Mild Traumatic Brain Injury

Kannan¹,

Kannan²,

Stalin³

2019

jemds

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BACKGROUND Traumatic brain injury (TBI) is one of the major causes of neurological disability in India 1 , 80-90% of TBIs are mild 2,3. Mild traumatic brain injury (mTBI) participants may present with post concussive symptoms especially deficits in cognition which is commonly ignored. Unidentified cognitive deficits in the acute phase of mTBI may result in long term functional problems and poor quality of life. Aim of the present study is to determine the prevalence and risk factors of neuropsychological issues in mild traumatic brain injury. METHODS Ninety persons with mild traumatic brain injury admitted to the emergency unit of neurosciences in a Chennai based tertiary care hospital aged between 20 and 60 years with Glasgow Coma Scale Score of 13-15 were assessed with PGI battery of brain dysfunctions within 48 hours of admission. Impairment in memory, verbal intelligence, performance intelligence, visual acuity and visuospatial functions were assessed using the battery. Cognitive dysfunction was evaluated using dysfunction rating scale scores in each test. RESULTS Data were analysed using IBM SPSS Version 21. Cognitive dysfunction was found to be higher in memory such as delayed recall, visual and verbal retention of new information, mental balance and constructional ability. Male participants (30%) between 50-60 years (70%) with lower educational qualification (44.4%) had severe cognitive impairment compared to others. Housewives (57.1%) had severe dysfunction in learning and retaining new information. Abnormality in CT report (35.9%) was found to have significant effect on visual retention. CONCLUSIONS There is significant cognitive impairment in various domains of memory and constructional abilities in the acute phase of single mTBI. Factors such as age, gender, years of education, occupation and structural abnormality were found to be risk factors for individual vulnerabilities. Younger age, higher educational qualifications and good occupational skills with uncomplicated CT reports were found to play protective roles as cognitive reserves in preventing cognitive dysfunction after traumatic brain injury.

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The Association of Cognitive Reserve in Chronic-Phase Functional and Neuropsychological Outcomes Following Traumatic Brain Injury

Abstract: Cognitive reserve factors may be associated with outcomes following TBI. Additional alternatives to TBI severity are needed to help guide rehabilitative planning postinjury.

Cited by 46 publications

References 29 publications

Developing Cognition Endpoints for the CENTER-TBI Neuropsychological Test Battery

Developing Cognition Endpoints for the CENTER-TBI Neuropsychological Test Battery

Cognitive Impairment in Moderate Degree Diffuse Axonal Head Injuries: Analysis of 84 Cases Using MMSE

Prevalence and Risk Factors of Neuropsychological Issues Following Acute Mild Traumatic Brain Injury

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