Functional recovery after moderate/severe traumatic brain injury

Schneider, Eric B.; Sur, Sandeepa; Raymont, Vanessa; Duckworth, Josh; Kowalski, Robert G.; Efron, David T.; Hui, Xuan; Selvarajah, Shalini; Hambridge, Hali L.; Stevens, Robert

doi:10.1212/wnl.0000000000000379

Cited by 105 publications

(62 citation statements)

References 22 publications

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“…Yet even after adjusting for these effects found in the normed data, age and education were still significant predictors of cognitive composite score in our multivariable models, suggesting these demographic variables have an amplified injury-specific effect on cognitive performance. Education may be a correlate for post-TBI cognitive reserve that could likely impact an individual's cognitive recovery trajectory post-TBI 49,66 . Given the detrimental effects of age on other TBI pathology/recovery domains 67–70 , age enhanced vulnerability to cognitive dysfunction post-TBI likely also occurs.…”

Section: Discussionmentioning

confidence: 99%

Posttraumatic Brain Injury Cognitive Performance Is Moderated by Variation Within ANKK1 and DRD2 Genes

Failla

Ricker

et al. 2015

Journal of Head Trauma Rehabilitation

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Objective As dopamine neurotransmission impacts cognition, we hypothesized variants in the linked dopamine D2 receptor (DRD2) and ankyrin repeat and kinase domain (ANKK1) genes might account for some individual variability in cognitive recovery post-TBI. Participants Prospective cohort of 108 survivors of severe TBI, recruited consecutively from a level 1 trauma center. Design We examined relationships between DRD2 genetic variation and functional recovery at 6 and 12 months post-TBI. Main Measures Cognitive performance was evaluated using 8 neuropsychological tests targeting different cognitive domains. An overall cognitive composite was developed based on normative data. We also assessed functional cognition, depression status, and global outcome. Subjects were genotyped for 6 DRD2 tagging single nucleotide polymorphisms and Taq1A within ANKK1. Results ANKK1 Taq1A heterozygotes performed better than homozygotes across several cognitive domains at both time-points post-injury. When adjusting for age, GCS, and education, the Taq1A (ANKK1) and rs6279 (DRD2) variants were associated with overall composite scores at 6 months post-TBI (p=0.0468, 0.0430, respectively). At 12 months, only Taq1A remained a significant genetic predictor of cognition (p=0.0128). Following multiple comparisons correction, there were no significant associations between examined genetic variants and functional cognition, depression status, and global outcome. Conclusion These data suggest genetic variation within DRD2 influences cognitive recovery post-TBI. Understanding genetic influences on dopaminergic systems post-TBI may impact current treatment paradigms.

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Section: Discussionmentioning

confidence: 99%

Posttraumatic Brain Injury Cognitive Performance Is Moderated by Variation Within ANKK1 and DRD2 Genes

Failla

Ricker

et al. 2015

Journal of Head Trauma Rehabilitation

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“…The concept of cognitive reserve, as an active brain mechanism to preserve cognitive function, emerged from the study of dementia but has subsequently been invoked as an explanation of the variability in outcome for other brain disorders such as multiple sclerosis [6] and acquired brain damage [7][8][9]. Cognitive reserve also has explanatory power for understanding prognosis in disorders thought to have their roots in abnormal or derailed brain development, such as schizophrenia and affective disorders [10].…”

Section: Introductionmentioning

confidence: 99%

Cognitive reserve and neuropsychiatric disorders

Watson

Joyce

2015

Current Opinion in Behavioral Sciences

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“…18-20 The integrity of the brain pre-injury adds to outcomes, with education often used as an indicator of one's “cognitive reserve”. 21,22 …”

mentioning

confidence: 99%

Effects of Patient Preinjury and Injury Characteristics on Acute Rehabilitation Outcomes for Traumatic Brain Injury

Corrigan

Horn

Barrett

et al. 2015

Archives of Physical Medicine and Rehabilitation

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Objective To examine associations of patient and injury characteristics with outcomes at inpatient rehabilitation discharge and 9 months post-discharge for patients with traumatic brain injury (TBI) Design Prospective, longitudinal observational study Setting 10 inpatient rehabilitation centers (9 US, 1 Canada) Participants Consecutive patients (n=2130) enrolled between 2008 and 2011, admitted for inpatient rehabilitation after index TBI injury, and divided into 5 subgroups based on rehabilitation admission FIM Cognitive score Interventions Not applicable Main Outcome Measures Rehabilitation length of stay, discharge to home, and FIM at discharge and 9 months post-discharge. Results Severity indices increased explained variation in outcomes beyond that accounted for by patient characteristics. FIM Motor scores were generally the most predictable. Higher functioning subgroups had more predictable outcomes then subgroups with lower cognitive function at admission. Age at injury, time from injury to rehabilitation admission, and functional independence at rehabilitation admission were the most consistent predictors across all outcomes and subgroups. Conclusions Findings from previous studies of the relationships among patient and injury characteristics and rehabilitation outcomes were largely replicated. Discharge outcomes were most strongly associated with injury severity characteristics; while predictors of functional independence at 9 months post-discharge included both patient and injury characteristics.

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Functional recovery after moderate/severe traumatic brain injury

Cited by 105 publications

References 22 publications

Posttraumatic Brain Injury Cognitive Performance Is Moderated by Variation Within ANKK1 and DRD2 Genes

Posttraumatic Brain Injury Cognitive Performance Is Moderated by Variation Within ANKK1 and DRD2 Genes

Cognitive reserve and neuropsychiatric disorders

Effects of Patient Preinjury and Injury Characteristics on Acute Rehabilitation Outcomes for Traumatic Brain Injury

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