Cognitive recovery and predictors of functional outcome 1 year after traumatic brain injury

• Published in: Journal of the International Neuropsychological Society Vol. 15; no. 5; pp. 740 - 750
• Main Authors: SIGURDARDOTTIR, SOLRUN, ANDELIC, NADA, ROE, CECILIE, SCHANKE, ANNE-KRISTINE
• Format: Journal Article
• Language: English
• Published: New York, USA Cambridge University Press 01.09.2009
• Subjects: Adult; Brain Injuries - epidemiology; Brain Injuries - pathology; Brain Injuries - physiopathology; Brain Injuries - rehabilitation; Chi-Square Distribution; Cognition - physiology; Cohort Studies; Consciousness; Employment; Executive function; Fainting; Fatigue; Fatigue - epidemiology; Female; Glasgow Coma Scale; Glasgow Outcome Scale-Extended; Humans; Injury severity; Magnetic Resonance Imaging - methods; Male; Middle Aged; Neuropsychological Tests; Neuropsychology; Pathology; Predictive Value of Tests; Principal Component Analysis; Recovery of Function - physiology; Reproducibility of Results; Retrospective Studies; Substance-Related Disorders - epidemiology; Time Factors; Tomography Scanners, X-Ray Computed; Trauma; Trauma Severity Indices; Traumatic brain injury; Variables; Variance analysis; Young Adult; Norway; Glasgow Outcome Scale-Extended; Fatigue; Traumatic brain injury; Neuropsychology; Trauma; Injury severity
• ISSN: 1355-6177; 1469-7661; 1469-7661
• DOI: 10.1017/S1355617709990452

Outcome studies on traumatic brain injury (TBI) have shown that functional status can be predicted by demographic, injury severity, and trauma-related factors. Concurrent cognitive functions as one of the determinants of functional outcome is less documented. This study evaluated the effects of concurrent neuropsychological measures on functional outcome 1 year after injury. Neuropsychological data, employment status, self-reported fatigue, and the Glasgow Outcome Scale-Extended (GOSE) were collected from 115 persons with TBI (ranging from mild to severe) at 3 and 12 months postinjury. Principal components analysis was conducted with the neuropsychological measures and three components emerged. Multiple regression analysis, controlling for demographic and injury severity related factors, was used to test the effects of cognitive components at 12 months on functional outcome (GOSE). One year after injury, 64% were categorized as “good recovery” and 36% as “moderate disability” according to GOSE. Good functional recovery depended on shorter duration of posttraumatic amnesia, less fatigue, absence of intracranial pathology, higher education, and better performance on cognitive measures. The predictive values of Verbal/Reasoning and Visual/Perception components are supported; each added significantly and improved prediction of functional outcome. The Memory/Speed component showed a near-significant relationship to outcome. (JINS, 2009, 15, 740–750)