Research Reports - Long-term effects of mild traumatic brain injury on cognitive performance

Front Hum Neurosci. 2013;7:30

Dean PJ, Sterr A

Although a proportion of individuals report chronic cognitive difficulties after
mild traumatic brain injury (mTBI), results from behavioral testing have been
inconsistent. In fact, the variability inherent to the mTBI population may be
masking subtle cognitive deficits. We hypothesized that this variability could be
reduced by accounting for post-concussion syndrome (PCS) in the sample.
Thirty-six participants with mTBI (>1 year post-injury) and 36 non-head injured
controls performed information processing speed (Paced Visual Serial Addition
Task, PVSAT) and working memory (n-Back) tasks. Both groups were split by PCS
diagnosis (4 groups, all n = 18), with categorization of controls based on
symptom report. Participants with mTBI and persistent PCS had significantly
greater error rates on both the n-Back and PVSAT, at every difficulty level
except 0-Back (used as a test of performance validity). There was no difference
between any of the other groups. Therefore, a cognitive deficit can be observed
in mTBI participants, even 1 year after injury. Correlations between cognitive
performance and symptoms were only observed for mTBI participants, with worse
performance correlating with lower sleep quality, in addition to a medium effect
size association (falling short of statistical significance) with higher PCS
symptoms, post-traumatic stress disorder (PTSD), and anxiety. These results
suggest that the reduction in cognitive performance is not due to greater symptom
report itself, but is associated to some extent with the initial injury.
Furthermore, the results validate the utility of our participant grouping, and
demonstrate its potential to reduce the variability observed in previous studies.

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