Research Reports - Intelligence after traumatic brain injury

Eur J Neurol. 2015 Apr 27

Königs M(1), Engenhorst PJ, Oosterlaan J

Worldwide, 54-60 million individuals sustain traumatic brain injury (TBI) each
year. This meta-analysis aimed to quantify intelligence impairments after TBI and
to determine the value of age and injury severity in the prognosis of TBI. An
electronic database search identified 81 relevant peer-reviewed articles
encompassing 3890 patients. Full-scale IQ (FSIQ), performance IQ (PIQ) and verbal
IQ (VIQ) impairments were quantified (Cohen's d) for patients with mild, moderate
and severe TBI in the subacute phase of recovery and the chronic phase.
Meta-regressions explored prognostic values of age and injury severity measures
for intelligence impairments. The results showed that, in the subacute phase,
FSIQ impairments were absent for patients with mild TBI, medium-sized for
patients with moderate TBI (d = -0.61, P < 0.001) and large for patients with
severe TBI (d = -1.09, P < 0.001). In the chronic phase, FSIQ impairments were
small for patients with mild or moderate TBI (d = -0.37 and -0.19, P ≤ 0.008) and
large for patients with severe TBI (d = -0.80, P < 0.001). Adults with mild TBI
had larger PIQ and VIQ impairments in the chronic phase than children (both
Q ≥ 5.21, P ≤ 0.02), whilst children with severe TBI had larger FSIQ and VIQ
impairments than adults (both Q ≥ 4.40, P ≤ 0.04). Glasgow Coma Scale score,
duration of loss of consciousness and post-traumatic amnesia duration moderately
to strongly predicted FSIQ, PIQ and VIQ impairments (0.41 ≤ r ≤ 0.82, P ≤ 0.02),
but no differences in predictive value were observed. In conclusion, TBI causes
persisting intelligence impairments, where children may have better recovery from
mild TBI and poorer recovery from severe TBI than adults. Injury severity
measures predict intelligence impairments and do not outperform one another.

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