Research article summary (published 29 Nov 2008):

Postrecovery cognitive decline in adults with traumatic brain injury.

Full Abstract

OBJECTIVE: To assess prospectively the degree of postrecovery long-term cognitive decline after moderate to severe traumatic brain injury (TBI). DESIGN: Observational cohort. SETTING: Inpatient rehabilitation hospital. PARTICIPANTS: Adults (N=33) with moderate and severe TBI from a well characterized sample with low attrition. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Recovery of functioning was ascertained through repeat neuropsychological assessments over the first 5 years postinjury. Cognitive decline from a baseline of 12 months postinjury to a follow-up evaluation conducted on average +/- SD 2.1+/-0.99 years later. Change was calculated using the reliable change index (RCI) for 12 neuropsychological tests commonly used in the assessment of TBI. RESULTS: At the group level, negligible changes in cognitive function were observed over time. However, application of the RCI using 90% confidence intervals showed statistically significant cognitive decline on at least 2 neuropsychological measures in 27.3% of study participants. Decline was most commonly observed on a test of verbal fluency and the delayed recall portion of a test of verbal list learning (Rey Auditory Verbal Learning Test), although substantial variability existed across patients. Decline was significantly correlated with hours of therapy received at 5 months postinjury (P<.02). CONCLUSIONS: Consistent with a small number of previous studies, cognitive deterioration may follow an initial period of recovery. Overall, the pattern of decline across tests varied across individuals. Possible mechanisms of decline are discussed. Further research is needed to understand the stability of this finding and its functional implications.

Author information

Author/s: Till, Christine (C); Colella, Brenda (B); Verwegen, Joel (J); Green, Robin E (RE);

Affiliation: Toronto Rehabilitation Institute, University Centre, Toronto, ON, Canada. ctill(-atsign-)yorku.ca

Journal and publication information

Publication Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't

Journal: Archives of physical medicine and rehabilitation (Arch Phys Med Rehabil), published in United States. (Language: eng)

Reference: 2008-Dec; vol 89 (issue 12 Suppl) : pp S25-34

Dates: Created 2008/12/16; Completed 2009/01/08;

PMID: 19081438, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult Brain Injuries - complications; psychology; rehabilitation Cognition - physiology Cognition Disorders - etiology; physiopathology; rehabilitation Female Follow-Up Studies

Humans Male Prognosis Psychometrics - methods Recovery of Function - physiology Time Factors

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