Research Reports - Predictors of the recovery of cognitive functions in patients with traumatic brain injury
Rev Neurol. 2014 Apr 1;58(7):296-302
Solís-Marcos I, Castellano-Guerrero AM, Domínguez-Morales R, León-Carrión J(1)
INTRODUCTION: After a traumatic brain injury (TBI), cognitive functionality may
be severely altered. Some studies have aimed at identifying the best predictive
variables for cognitive recovery, however, results still remain unclear.
AIMS: To assess the recovery of cognitive functionality in TBI patients after a
rehabilitation programme, and to identify the variables that best predict the
PATIENTS AND METHODS: We conducted a retrospective pre-post study with 58 adult
TBI patients that underwent an intensive rehabilitation programme. All of them
were assessed using the cognitive functions sub-scale from the FIM+FAM scale, at
admission and discharge. Both scores were compared using non-parametric test
Wilcoxon. Cognitive functionality gain percentage was calculated and correlated
with all the collected data. A multiple linear regression analysis was carried
out to identify the best predictors of cognitive functionality gain percentage by
introducing all clinical, demographic and cognitive information.
RESULTS: The group's cognitive functionality increased significantly from 33,6%
to 85% (p < 0,01). Patients with higher cognitive functionality gain percentage
were those with younger age, shorter time post-TBI, and higher scores on
cognitive functions sub-scale, conditional attention and Luria's memory word
tests. The best predictors for cognitive functionality gain percentage were time
post-TBI and cognitive functions at admission (adjusted R(2) = 55,8%).
CONCLUSIONS: Patients who started rehabilitation sooner and had a higher
cognitive functionality at admission, showed the greatest increase in cognitive
functionality gain percentage. Other variables like age, or scores on cognitive
tests must also be considered in future studies.