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Severity of Ongoing Post-Concussive Symptoms as a Predictor of Cognitive Performance Following a Pediatric Mild Traumatic Brain Injury

Published online by Cambridge University Press:  27 November 2020

Veronik Sicard
Affiliation:
The Mind Research Network/Lovelace Biomedical Research Institute, Albuquerque, NM, USA
Danielle C. Hergert
Affiliation:
The Mind Research Network/Lovelace Biomedical Research Institute, Albuquerque, NM, USA
Sharvani Pabbathi Reddy
Affiliation:
The Mind Research Network/Lovelace Biomedical Research Institute, Albuquerque, NM, USA
Cidney R. Robertson-Benta
Affiliation:
The Mind Research Network/Lovelace Biomedical Research Institute, Albuquerque, NM, USA
Andrew B. Dodd
Affiliation:
The Mind Research Network/Lovelace Biomedical Research Institute, Albuquerque, NM, USA
Nicholas A. Shaff
Affiliation:
The Mind Research Network/Lovelace Biomedical Research Institute, Albuquerque, NM, USA
David D. Stephenson
Affiliation:
The Mind Research Network/Lovelace Biomedical Research Institute, Albuquerque, NM, USA
Keith Owen Yeates
Affiliation:
Department of Psychology, University of Calgary, Calgary, Alberta, Canada Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
Jason A. Cromer
Affiliation:
Child Study Center, Yale University, New Haven, CT, USA Cogstate Ltd, New Haven, CT, USA
Richard A. Campbell
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
John P. Phillips
Affiliation:
The Mind Research Network/Lovelace Biomedical Research Institute, Albuquerque, NM, USA Department of Neurology, University of New Mexico, Albuquerque, NM, USA
Robert E. Sapien
Affiliation:
Department of Emergency Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
Andrew R. Mayer*
Affiliation:
The Mind Research Network/Lovelace Biomedical Research Institute, Albuquerque, NM, USA Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA Department of Neurology, University of New Mexico, Albuquerque, NM, USA Department of Psychology, University of New Mexico, Albuquerque, NM, USA
*
*Correspondence and reprint requests to: Andrew R. Mayer, Ph.D., Mind Research Network, Pete and Nancy Domenici Hall, 1101 Yale Ave NE, Albuquerque, NM 87106, USA. Email: amayer@mrn.org

Abstract

Objective:

This study aimed to examine the predictors of cognitive performance in patients with pediatric mild traumatic brain injury (pmTBI) and to determine whether group differences in cognitive performance on a computerized test battery could be observed between pmTBI patients and healthy controls (HC) in the sub-acute (SA) and the early chronic (EC) phases of injury.

Method:

203 pmTBI patients recruited from emergency settings and 159 age- and sex-matched HC aged 8–18 rated their ongoing post-concussive symptoms (PCS) on the Post-Concussion Symptom Inventory and completed the Cogstate brief battery in the SA (1–11 days) phase of injury. A subset (156 pmTBI patients; 144 HC) completed testing in the EC (~4 months) phase.

Results:

Within the SA phase, a group difference was only observed for the visual learning task (One-Card Learning), with pmTBI patients being less accurate relative to HC. Follow-up analyses indicated higher ongoing PCS and higher 5P clinical risk scores were significant predictors of lower One-Card Learning accuracy within SA phase, while premorbid variables (estimates of intellectual functioning, parental education, and presence of learning disabilities or attention-deficit/hyperactivity disorder) were not.

Conclusions:

The absence of group differences at EC phase is supportive of cognitive recovery by 4 months post-injury. While the severity of ongoing PCS and the 5P score were better overall predictors of cognitive performance on the Cogstate at SA relative to premorbid variables, the full regression model explained only 4.1% of the variance, highlighting the need for future work on predictors of cognitive outcomes.

Type
Regular Research
Copyright
Copyright © INS. Published by Cambridge University Press, 2020

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Severity of Ongoing Post-Concussive Symptoms as a Predictor of Cognitive Performance Following a Pediatric Mild Traumatic Brain Injury
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