Skip to main content Accessibility help
×
Home
Hostname: page-component-559fc8cf4f-dxfhg Total loading time: 3.689 Render date: 2021-03-03T02:20:46.601Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": false, "newCiteModal": false, "newCitedByModal": true }

Three methods for examining trajectories in neuropsychological performance across the first 4 years after mild Traumatic Brain Injury

Published online by Cambridge University Press:  23 December 2019

Suzanne Barker-Collo
Affiliation:
School of Psychology, University of Auckland, Auckland, New Zealand
Alice Theadom
Affiliation:
National Institute for Stroke and Applied Neuroscience, School of Public health & Psychosocial Studies, Auckland University of Technology, New Zealand
Kelly Jones
Affiliation:
National Institute for Stroke and Applied Neuroscience, School of Public health & Psychosocial Studies, Auckland University of Technology, New Zealand
Nicola Starkey
Affiliation:
School of Psychology, University of Waikato, Hamilton, New Zealand
Kris Fernando
Affiliation:
Accident Claims Corporation, Clinical Services Director, Auckland, New Zealand
Michael Kahan
Affiliation:
Waikato Occupational Services, Hamilton, New Zealand.
Philip Prah
Affiliation:
National Institute for Stroke and Applied Neuroscience, School of Public health & Psychosocial Studies, Auckland University of Technology, New Zealand
Valery Feigin
Affiliation:
National Institute for Stroke and Applied Neuroscience, School of Public health & Psychosocial Studies, Auckland University of Technology, New Zealand
Corresponding

Abstract

Background:

Emerging data suggest that recovery from mild traumatic brain injury (mTBI) takes longer than previously thought. This paper examines trajectories for cognitive recovery up to 48 months post-mTBI, presenting these visually using a Sankey diagram and growth curve analysis.

Methods:

This sample (n = 301) represents adults (≥16 years) from a population-based Brain Injury Outcomes in the New Zealand Community study over a 4-year follow-up on the CNS-Vital Signs neuropsychological test. Data were collected within 2 weeks of injury, and then at 1, 6, 12 and 48 months post-injury.

Results:

Significant improvement in cognitive functioning was seen up to 6 months post-injury. Using growth curve modelling, we found significant improvements in overall neurocognition from baseline to 6 months, on average participants improved one point per month (0.9; 95% CI 0.42–1.39) p < 0.001. No change in neurocognition was found within the time periods 6–12 months or 12–48 months. The Sankey highlighted that at each time point, a small proportion of participants remained unchanged or declined. Proportionally, few show any improvement after the first 6 months.

Conclusion:

Most individuals remained stable or improved over time to 6 months post-injury. Summary statistics are informative regarding overall trends, but can mask differing trajectories for recovery. The Sankey diagram indicates that not all improve, as well as the potential impact of individuals moving in and out of the study. The Sankey diagram also indicated the level of functioning of those most likely to withdraw, allowing targeting of retention strategies.

Type
Articles
Copyright
© Australasian Society for the Study of Brain Impairment 2019

Access options

Get access to the full version of this content by using one of the access options below.

References

Arfanakisa, K., Haughtonb, V., Carewc, J., Rogersa, B., Dempseyd, R., & Meyeranda, M. (2003). Diffusion tensor MR imaging in diffuse axonal injury. American Journal of Neuroradiology, 23, 792804.Google Scholar
Barker-Collo, S., & Fernando, K. (2015). A survey of New Zealand psychologists’ practices with respect to the assessment of performance validity. New Zealand Journal of Psychology, 44(2), 3542.Google Scholar
Barker-Collo, S., Jones, K., Theadom, A., Starkey, N., Dowell, A., McPherson, K., … Group., B. R. (2015). Neuropsychological outcome and its correlates in the first year after adult mild traumatic brain injury: A population-based New Zealand study. Brain Injury, 29(13–14), 16041616.10.3109/02699052.2015.1075143CrossRefGoogle ScholarPubMed
Barker-Collo, S., Theadom, A., Jones, K., Starkey, N., Kahan, M., & Feigin, V. (2018). Depression and anxiety across the first 4 years after mild traumatic brain injury: Findings from a community-based study. Brain Injury, 32(13–14), 16511658.10.1080/02699052.2018.1540797CrossRefGoogle ScholarPubMed
Bjelland, I., Dahl, A., Haug, T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of Psychosomatic Research, 52(2), 6977.10.1016/S0022-3999(01)00296-3CrossRefGoogle ScholarPubMed
Bogdanova, Y., & Verfaellie, M. (2012). Cognitive sequelae of blast-induced traumatic brain injury: Recovery and rehabilitation. Neuropsychology Reviews, 22, 420.10.1007/s11065-012-9192-3CrossRefGoogle ScholarPubMed
Carroll, L., Cassidy, J., Holm, L., Kraus, J., & Coronado, V. (2004). WHO collaborating centre task force on mild traumatic brain injury. Methodological issues and research recommendations for mild traumatic brain injury: The WHO collaborating centre task force on mild traumatic brain injury. Journal of Rehabilitation Medicine, 43(Suppl.), 113125.10.1080/16501960410023877CrossRefGoogle Scholar
Carroll, L., Cassidy, J., Peloso, P., Bog, J., van Holst, H., Holm, L., … Pepin, M. (2004). Prognosis for mild traumatic brain injury: Results of the WHO collaborating centre task force on mild traumatic brain injury. Journal of Rehabilitation Medicine, 43(Suppl.), 84105.10.1080/16501960410023859CrossRefGoogle Scholar
Feigin, V., Theadom, A., Barker-Collo, S., Starkey, N., McPherson, K., Kahan, M., … Ametatunga, S. (2013). Incidence of traumatic brain injury across all ages and the full disease spectrum: A population-based study in New Zealand. The Lancet Neurology, 12(1), 5364.CrossRefGoogle Scholar
Giskiewicz, K. M., Marshall, S.W., & Bailes, J. (2007). Recurrent concussion and risk of depression in retired professional football players. Medical Science Sports and Exercise, 39, 903909.CrossRefGoogle Scholar
Gualtieri, C., & Johnson, L. (2006). Reliability and validity of a computerized neurocognitive test battery, CNS Vital Signs. Archives of Clinical Neuropsychology, 21, 623643.10.1016/j.acn.2006.05.007CrossRefGoogle ScholarPubMed
Gualtieri, C., & Johnson, L. (2008). Computerized test battery sensitive to mild and severe brain injury. Medscape Journal of Medicine, 10(4), 90.Google ScholarPubMed
Gualtieri, C., Johnson, L., & Benedict, K. (2004. Psychometric and clinical properties of a new, computerized neurocognitive assessment battery. Paper presented at the American Neuropsychiatric Association Annual Meeting, Bal Harbor, Florida, Bal Harbor, Florida.Google Scholar
Heilman, K. M., & Valenstein, E. (2003). Clinical neuropsychology (4th ed.). New York: Oxford University Press.Google Scholar
Holsinger, T., Steffens, D.C., Hillips, C., Helms, M. J., Havlik, R. J., Breitner, J. C., … Plassman, B. L. (2002). Head injury in early adulthood and the lifetime risk of depression. Archives of General Psychiatry, 59, 1722.CrossRefGoogle ScholarPubMed
Karr, J. E., Arechenkoff, C. N., & Garcia-Barrera, M. A. (2014). The neuropsychological outcomes of concussion: A systematic review of meta-analyses on the cognitive sequelae of mild traumatic brain injury. Neuropsychology, 28(3), 321336.CrossRefGoogle ScholarPubMed
Koponen, S., Taiminen, T., Portin, R., Himanen, L., Isoniemi, H., Heinonen, H., … Tenouvo, O. (2002). Axis I and II psychiatric disorders after traumatic brain injury: A 30-year follow-up study. American Journal of Psychiatry, 159, 13151321.CrossRefGoogle ScholarPubMed
Langley, J., Johnson, S., Slatyer, M., Skilback, C., & Thomas, M. (2010). Issues of loss to follow-up in a population study of traumatic brain injury (TBI) followed to 3 years post-trauma. Brain Injury, 24(7–8), 939947.10.3109/02699052.2010.491494CrossRefGoogle Scholar
Larabee, G. J. (2012). Performance validity and symptom validity in neuropsychological assessment. Journal of the International Neuropsychological Society, 18(4), 625630.CrossRefGoogle Scholar
Mathias, J. L., Beall, J. A., & Bigler, E. D. (2004). Neuropsychological and information processing deficits following mild traumatic brain injury. Journal of the International Neuropsychological Society, 10, 286297.CrossRefGoogle ScholarPubMed
McInnes, K., Friesen, C., MacKenzie, D., Westwood, D., & Boe, S. (2017). Mild traumatic brain injury (mTBI) and chronic cognitive impairment: A scoping review. PLoS ONE, 12(4), e174847.CrossRefGoogle ScholarPubMed
McMahon, P., Hricik, A., Yue, J., Puccio, A., Inoue, T., Lingsma, H., … Investigators, T.-T. (2014). Symptomatology and functional outcome in mild traumatic brain injury: Results from the prospective TRACK-TBI study. Journal of Neurotrauma, 31(1), 2633.10.1089/neu.2013.2984CrossRefGoogle ScholarPubMed
Mooney, G., & Speed, J. (2001). The asociation between mild traumatic brain injury and psychiatric condictions. Brain Injury, 15, 865877.CrossRefGoogle Scholar
Moore, E. L., Terryberry-Spohr, L., & Hope, D. A. (2006). Mild traumatic brain injury and anxiety sequelae: A review of the literature. Brain Injury, 20(2), 117132.10.1080/02699050500443558CrossRefGoogle ScholarPubMed
National Institute of Neurological Disorders and Stroke. (2002). Traumatic brain injury: Hope through research. Bethesda, MD: National Institues of Health.Google Scholar
Stulemeijer, M., van der Werf, S., Borm, G., & Vos, E. (2008). Early prediction of favourable recovery 6 months after mild traumatic brain injury. Journal of Neurology Neurosurgery and Psychiatry, 79, 936942.CrossRefGoogle ScholarPubMed
Suh, M., Kolster, R., Sarkar, R., McCandliss, B., & Ghajar, J. (2006). Deficits in predictive smooth pursuit after mild traumatic brain injury. Neuroscience Letters, 401, 108113.10.1016/j.neulet.2006.02.074CrossRefGoogle ScholarPubMed
Teasdale, G., & Jennett, B. (1974). Assessment of coma and impaired consciousness. A Practical scale. Lancet, 2(7872), 8184.Google Scholar
Theadom, A., Barker-Collo, S., Feigin, V., Starkey, N., Jones, K., Jones, A., … Barber, P. A. (2012). The spectrum captured: A methodological approach to studying incidence and outcomes of traumatic brain injury on a population level. Neuroepidemiology, 38(1), 1829.10.1159/000334746CrossRefGoogle ScholarPubMed
Theadom, A., Parag, V., Dowell, T., McPherson, K., Starkey, N., Barker-Collo, S., … Feigin, V. (2016). Persistent problems 1 year after mild traumatic brain injury: A longitudinal population study in New Zealand. British Journal of General Practice, 66(602), e16e23.CrossRefGoogle ScholarPubMed
Wood, R. L. (2004). Understanding the “miserable minority”: A diathesis-stress paradigm for postconcussional syndrome. Brain Injury, 18, 11351153.CrossRefGoogle Scholar
Zigmond, A., & Snaith, R. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361370.CrossRefGoogle ScholarPubMed

Altmetric attention score

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 22
Total number of PDF views: 54 *
View data table for this chart

* Views captured on Cambridge Core between 23rd December 2019 - 3rd March 2021. This data will be updated every 24 hours.

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Three methods for examining trajectories in neuropsychological performance across the first 4 years after mild Traumatic Brain Injury
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Three methods for examining trajectories in neuropsychological performance across the first 4 years after mild Traumatic Brain Injury
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Three methods for examining trajectories in neuropsychological performance across the first 4 years after mild Traumatic Brain Injury
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *