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Cognitive reserve as a moderator of postconcussive symptoms in children with complicated and uncomplicated mild traumatic brain injury

Published online by Cambridge University Press:  19 October 2009

TARYN B. FAY ,
KEITH OWEN YEATES ,
H. GERRY TAYLOR ,
BARBARA BANGERT ,
ANN DIETRICH ,
KATHRYN E. NUSS ,
JEROME RUSIN  and
MARTHA WRIGHT
TARYN B. FAY
Affiliation:
Department of Psychology, Ohio State University, Columbus, Ohio Department of Pediatrics, Ohio State University College of Medicine, Columbus, Ohio
KEITH OWEN YEATES*
Affiliation:
Department of Pediatrics, Ohio State University College of Medicine, Columbus, Ohio The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio
H. GERRY TAYLOR
Affiliation:
Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio Rainbow Babies and Children’s Hospital, Cleveland, Ohio
BARBARA BANGERT
Affiliation:
Departments of Radiology and Neurosurgery, University Hospitals Health System, Cleveland, Ohio
ANN DIETRICH
Affiliation:
Department of Pediatrics, Ohio State University College of Medicine, Columbus, Ohio Department of Emergency Medicine, Nationwide Children’s Hospital, Columbus, Ohio
KATHRYN E. NUSS
Affiliation:
Department of Pediatrics, Ohio State University College of Medicine, Columbus, Ohio Department of Emergency Medicine, Nationwide Children’s Hospital, Columbus, Ohio
JEROME RUSIN
Affiliation:
Department of Radiology, Nationwide Children’s Hospital, Columbus, Ohio
MARTHA WRIGHT
Affiliation:
Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio Rainbow Babies and Children’s Hospital, Cleveland, Ohio
*
*Correspondence and reprint requests to: Keith Owen Yeates, Ph.D., Department of Psychology, Nationwide Children’s Hospital, 700 Children’s Dr., Columbus, OH 43205. E-mail: keith.yeates@nationwidechildrens.org
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Abstract

The occurrence of postconcussive symptoms (PCS) following mild traumatic brain injury (TBI) in children may depend on cognitive reserve capacity. This prospective, longitudinal study examined whether the relationship between mild TBI and PCS is moderated by cognitive ability, which served as a proxy for cognitive reserve. Participants included 182 children with mild TBI and 99 children with orthopedic injuries (OI), ranging from 8 to 15 years of age when injured. Mild TBI were classified as complicated (n = 32) or uncomplicated (n = 150) depending on whether they were associated with trauma-related intracranial abnormalities on magnetic resonance imaging. PCS were assessed initially within 3 weeks of injury, and again at 1, 3, and 12 months post injury. The initial assessment also included standardized tests of children’s cognitive skills and retrospective parent ratings of pre-injury symptoms. Hierarchical linear modeling indicated that ratings of PCS were moderated jointly by cognitive ability and injury severity. Children of lower cognitive ability with a complicated mild TBI were especially prone to cognitive symptoms across time according to parents and to high acute levels of PCS according to children’s self-ratings. Cognitive reserve is an important moderator of the outcomes of mild TBI in children and adolescents. (JINS, 2010, 16, 94–105.)

Keywords

Nervous system traumaPediatricProspective studiesHead injuryConcussionHead traumaCognitive ability
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 16 , Issue 1 , January 2010 , pp. 94 - 105
Copyright
Copyright © The International Neuropsychological Society 2009

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