Research Reports - Cognitive impairment after traumatic brain injury, clinical course and impact on outcome

Behav Neurol. 2015;2015:680308. doi: 10.1155/2015/680308. Epub 2015 Dec 9.

Stenberg M(1), Godbolt AK(2), Nygren De Boussard C(2), Levi R(1), Stålnacke
BM(1).

Objective. To assess the clinical course of cognitive and emotional impairments
in patients with severe TBI (sTBI) from 3 weeks to 1 year after trauma and to
study associations with outcomes at 1 year. Methods. Prospective, multicenter,
observational study of sTBI in Sweden and Iceland. Patients aged 18-65 years with
acute Glasgow Coma Scale 3-8 were assessed with the Barrow Neurological Institute
Screen for Higher Cerebral Functions (BNIS) and the Hospital Anxiety and
Depression Scale (HADS). Outcome measures were Glasgow Outcome Scale Extended
(GOSE) and Rancho Los Amigos Cognitive Scale-Revised (RLAS-R). Results. Cognition
was assessed with the BNIS assessed for 42 patients out of 100 at 3 weeks, 75
patients at 3 months, and 78 patients at 1 year. Cognition improved over time,
especially from 3 weeks to 3 months. The BNIS subscales "orientation" and
"visuospatial and visual problem solving" were associated with the GOSE and
RLAS-R at 1 year. Conclusion. Cognition seemed to improve over time after sTBI
and appeared to be rather stable from 3 months to 1 year. Since cognitive
function was associated with outcomes, these results indicate that early
screening of cognitive function could be of importance for rehabilitation
planning in a clinical setting.

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