Research Reports - Neuropsychological recovery trajectories in traumatic brain injury

J Int Neuropsychol Soc. 2017 Oct 16:1-10. doi: 10.1017/S1355617717000996. [Epub
ahead of print]

Rabinowitz AR(1), Hart T(1), Whyte J(1), Kim J(1).

OBJECTIVES: The goal of the present study was to elucidate the influence of
demographic and neuropathological moderators on the longitudinal trajectory
neuropsychological functions during the first year after moderate to severe
traumatic brain injury (TBI). In addition to examining demographic moderators
such as age and education, we included a measure of whole-brain diffuse axonal
injury (DAI), and examined measures of processing speed (PS), executive function
(EF), and verbal learning (VL) separately.
METHODS: Forty-six adults with moderate to severe TBI were examined at 3, 6, and
12 months post-injury. Participants underwent neuropsychological evaluation and
neuroimaging including diffusion tensor imaging. Using linear mixed effects
modeling, we examined longitudinal trajectories and moderating factors of
cognitive outcomes separately for three domains: PS, VL, and EF.
RESULTS: VL and EF showed linear improvements, whereas PS exhibited a curvilinear
trend characterized by initial improvements that plateaued or declined, depending
on age. Age moderated the recovery trajectories of EF and PS. Education and DAI
did not influence trajectory but were related to initial level of functioning for
PS and EF in the case of DAI, and all three cognitive domains in the case of
education.
CONCLUSIONS: We found disparate recovery trajectories across cognitive domains.
Younger age was associated with more favorable recovery of EF and PS. These
findings have both clinical and theoretical implications. Future research with a
larger sample followed over a longer time period is needed to further elucidate
the factors that may influence cognitive change over the acute to chronic period
after TBI.  

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