Measuring Change Over Time: A Systematic Review of Evaluative Measures of Cognitive Functioning in Traumatic Brain Injury

D’Souza, Andrea; Mollayeva, Shirin; Pacheco, Nicole; Javed, Fiza; Colantonio, Angela; Mollayeva, Tatyana

doi:10.3389/fneur.2019.00353

Cited by 14 publications

(9 citation statements)

References 88 publications

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“…It may also be difficult to interpret the clinical relevance of a small but statistically significant individual decline in the mean values over time, and whether this negative result induces further cognitive evaluation and relevant treatment for the individual. A recent review of cognitive measures in TBI (D'Souza et al, 2019) revealed that there is insufficient evidence for the test-retest reliability and responsiveness of instruments for measuring longitudinal change in cognition in TBI samples. Unfortunately, this may apply for the majority of neuropsychological tests used in this study, and we can question if there was a decline or a period of stability in cognitive functioning.…”

Section: Discussionmentioning

confidence: 99%

Trajectory of 10-Year Neurocognitive Functioning After Moderate–Severe Traumatic Brain Injury: Early Associations and Clinical Application

Sigurðardóttir

Anđelić

Røe

et al. 2020

J Int Neuropsychol Soc

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Objective: This study aimed to explore the 10-year trajectories of neurocognitive domains after moderate–severe traumatic brain injury (TBI), to identify factors related to long-term neurocognitive functioning, and to investigate whether performance remained stable or changed over time. Method: Seventy-nine patients with moderate–severe TBI between the ages of 16 and 55 years were assessed at 3 months, 1, 5, and 10 years postinjury using neuropsychological tests and functional outcomes. Three hierarchical linear models were used to investigate the relationships of domain-specific neurocognitive trajectories (Memory, Executive function, and Reasoning) with injury severity, demographics, functional outcome at 3 months (Glasgow Outcome Scale-Extended) and emotional distress at 1 year (Symptom Checklist 90-Revised). Results: Education, injury severity measures, functional outcome, and emotional distress were significantly associated with both Memory and Executive function. Education and emotional distress were related to Reasoning. The interaction effects between time and these predictors in predicting neurocognitive trajectories were nonsignificant. Among patients with data at 1 and 10 year follow-ups (n = 47), 94–96% exhibited stable scores on Executive function and Reasoning tasks, and 83% demonstrated stable scores on Memory tasks. Significant memory decline was presented in 11% of patients. Conclusions: The findings highlight the differential contribution of variables in their relationships with long-term neurocognitive functioning after moderate–severe TBI. Injury severity was important for Memory outcomes, whereas emotional distress influenced all neurocognitive domains. Reasoning (intellectual) abilities were relatively robust after TBI. While the majority of patients appeared to be cognitively stable beyond the first year, a small subset demonstrated a significant memory decline over time.

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Section: Discussionmentioning

confidence: 99%

Trajectory of 10-Year Neurocognitive Functioning After Moderate–Severe Traumatic Brain Injury: Early Associations and Clinical Application

Sigurðardóttir

Anđelić

Røe

et al. 2020

J Int Neuropsychol Soc

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“…Working memory was assessed using the WAIS III–Inverse digits (T15) and verbal memory using the Rey Auditory Verbal Memory Test (RAVLT) ( 28 ), specifically RAVLT learning (T17), RAVLT free-recall memory (T18) and RAVLT recognition (T19) ( 29 ).…”

Section: Methodsmentioning

confidence: 99%

Neuropsychological Assessments of Patients With Acquired Brain Injury: A Cluster Analysis Approach to Address Heterogeneity in Web-Based Cognitive Rehabilitation

et al. 2021

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We aimed to (1) apply cluster analysis techniques to mixed-type data (numerical and categorical) from baseline neuropsychological standard and widely used assessments of patients with acquired brain injury (ABI) (2) apply state-of-the-art cluster validity indexes (CVI) to assess their internal validity (3) study their external validity considering relevant aspects of ABI rehabilitation such as functional independence measure (FIM) in activities of daily life assessment (4) characterize the identified profiles by using demographic and clinically relevant variables and (5) extend the external validation of the obtained clusters to all cognitive rehabilitation tasks executed by the participants in a web-based cognitive rehabilitation platform (GNPT). We analyzed 1,107 patients with ABI, 58.1% traumatic brain injury (TBI), 21.8% stroke and 20.1% other ABIs (e.g., brain tumors, anoxia, infections) that have undergone inpatient GNPT cognitive rehabilitation from September 2008 to January 2021. We applied the k-prototypes algorithm from the clustMixType R package. We optimized seven CVIs and applied bootstrap resampling to assess clusters stability (fpc R package). Clusters' post hoc comparisons were performed using the Wilcoxon ranked test, paired t-test or Chi-square test when appropriate. We identified a three-clusters optimal solution, with strong stability (>0.85) and structure (e.g., Silhouette > 0.60, Gamma > 0.83), characterized by distinctive level of performance in all neuropsychological tests, demographics, FIM, response to GNPT tasks and tests normative data (e.g., the 3 min cut-off in Trail Making Test-B). Cluster 1 was characterized by severe cognitive impairment (N = 254, 22.9%) the mean age was 47 years, 68.5% patients with TBI and 22% with stroke. Cluster 2 was characterized by mild cognitive impairment (N = 376, 33.9%) mean age 54 years, 53.5% patients with stroke and 27% other ABI. Cluster 3, moderate cognitive impairment (N = 477, 43.2%) mean age 33 years, 83% patients with TBI and 14% other ABI. Post hoc analysis on cognitive FIM supported a significant higher performance of Cluster 2 vs. Cluster 3 (p < 0.001), Cluster 2 vs. Cluster 1 (p < 0.001) and Cluster 3 vs. Cluster 1 (p < 0.001). All patients executed 286,798 GNPT tasks, with performance significantly higher in Cluster 2 and 3 vs. Cluster 1 (p < 0.001).

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“…It was piloted in Medline using medical subject headings (MeSH) and refined using key articles found in preliminary searches. 14 15 The Medline (Ovid interface) search strategy was consistent across all databases (online supplemental table 1). Strategic search terms included paediatric, child, adolescent, traumatic brain injury, head injury, cognition and neurocognitive disorder.…”

Section: Search Strategymentioning

confidence: 99%

The Impact of Traumatic Brain Injury on Neurocognitive Outcomes in Children: a Systematic Review and Meta-Analysis

Goh

Looi

Goh

et al. 2021

J Neurol Neurosurg Psychiatry

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ObjectiveTo assess the burden of paediatric traumatic brain injury (TBI) on neurocognition via a systematic review and meta-analysis.MethodsStudies that compared neurocognitive outcomes of paediatric patients with TBI and controls were searched using Medline, Embase, PsycINFO and Cochrane Central Register of Controlled Trials, between January 1988 and August 2019. We presented a random-effects model, stratified by TBI severity, time of assessment post injury and age.ResultsOf 5919 studies, 41 (patients=3717) and 33 (patients=3118) studies were included for the systematic review and meta-analysis, respectively. Studies mostly measured mild TBI (n=26, patients=2888) at 0–3 months postinjury (n=17, patients=2502). At 0–3 months postinjury, standardised mean differences between TBI and controls for executive function were −0.04 (95% CI −0.14 to 0.07; I2=0.00%), −0.18 (95% CI −0.29 to –0.06; I2=26.1%) and −0.95 (95% CI −1.12 to –0.77; I2=10.1%) for mild, moderate and severe TBI, respectively; a similar effect was demonstrated for learning and memory. Severe TBI had the worst outcomes across all domains and persisted >24 months postinjury. Commonly used domains differed largely from workgroup recommendations. Risk of bias was acceptable for all included studies.ConclusionA dose-dependent relationship between TBI severity and neurocognitive outcomes was evident in executive function and in learning and memory. Cognitive deficits were present for TBIs of all severity but persisted among children with severe TBI. The heterogeneity of neurocognitive scales makes direct comparison between studies difficult. Future research into lesser explored domains and a more detailed assessment of neurocognitive deficits in young children are required to better understand the true burden of paediatric TBI.

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Measuring Change Over Time: A Systematic Review of Evaluative Measures of Cognitive Functioning in Traumatic Brain Injury

Cited by 14 publications

References 88 publications

Trajectory of 10-Year Neurocognitive Functioning After Moderate–Severe Traumatic Brain Injury: Early Associations and Clinical Application

Trajectory of 10-Year Neurocognitive Functioning After Moderate–Severe Traumatic Brain Injury: Early Associations and Clinical Application

Neuropsychological Assessments of Patients With Acquired Brain Injury: A Cluster Analysis Approach to Address Heterogeneity in Web-Based Cognitive Rehabilitation

The Impact of Traumatic Brain Injury on Neurocognitive Outcomes in Children: a Systematic Review and Meta-Analysis

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