Research Reports - Neuropsychological predictors of outcome following traumatic brain injury in adults

Neuropsychol Rev. 2017 Jul 5. doi: 10.1007/s11065-017-9353-5. [Epub ahead of

Allanson F(1), Pestell C(1), Gignac GE(1), Yeo YX(1), Weinborn M(2).

Several neuropsychological dimensions are correlated with functional outcome
(e.g., ability to return to family and community roles) following traumatic brain
injury (TBI). Commonly investigated neuropsychological dimensions include verbal
memory, visuo-spatial construction, set-shifting, generativity, and processing
speed. Unfortunately, small sample sizes across relevant studies have contributed
to inconsistent results. Furthermore, no studies have concurrently measured all
of the candidate neuropsychological predictors, most of which are known to be
inter-correlated. Thus, the unique predictive effects associated with the
candidate predictors in TBI recovery have never been investigated. Consequently,
this study used both meta-analysis and multiple regression to statistically
evaluate neuropsychological candidate predictors across two outcome variables (1)
the Glasgow Outcome Scale-Extended (GOS-E) and (2) the Disability Rating Scale
(DRS). Seven studies met inclusion criteria. Based on the meta-analyses, the
following neuropsychological dimensions were found to be correlated with the
GOS-E: immediate verbal memory (r = .43, 95% CI [.27, .58]), delayed verbal
memory (r = .43, 95% CI [.21, .61]), visuo-spatial construction (r = .29, 95% CI
[.15, .53]), set-shifting (r = -.31, 95% CI [-.45, -.15], and generativity
(r = .44, 95% CI [.32, .54]). By contrast, only one neuropsychological dimension
was found to be significantly related to the DRS (generativity: r = -.21, 95% CI
[-.39, -.01]). Multiple regression on the GOS-E relevant meta-analytically
derived correlation matrix determined that all neuropsychological dimensions were
significant predictors of the GOS-E (multiple R (2) = .31) with the exception of
immediate verbal memory or learning. However, due to analytic characteristics,
these findings must be interpreted with caution. Results were consistent with the
need to consider multiple neuropsychological abilities in recovery and
rehabilitation following TBI. 

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