Cognitive recovery after severe traumatic brain injury in children/adolescents and adults: similar positive outcome but different underlying pathways?

Brain Inj. 2014;28(7):900-5. doi: 10.3109/02699052.2014.890742. Epub 2014 Mar 21.

Abstract

Primary objective: Does younger age at the time of severe traumatic brain injury (STBI) protect from cognitive symptoms? To answer this question, the authors compared the neuropsychological profile of late school-age children/adolescents and young adult patients at mid- and long-term recovery periods (6 and 12 months post-STBI).

Methods and procedures: Twenty-eight children/adolescents and 26 clinically matched adults were tested on measures of general intelligence, attention, executive functions, visuoperceptual, visuospatial and visuoconstructive abilities. Coma duration and the post-acute Glasgow Outcome Scale (GOS) score were used as predictor variables in a series of regression analyses.

Main outcomes and results: Children/adolescents and adults similarly improved on most measures, except for visuospatial and visuoconstructive skills, which worsened in time for children/adolescents. Coma duration significantly predicted performance IQ and visuoperceptual scores in children/adolescents. The GOS score significantly predicted performance and verbal IQ, sustained attention, visuoconstructive and long-term memory skills. Coma duration predicted executive function skills in both age groups.

Conclusions: (1) No evidence was found for a neuroprotective effect of younger age at STBI; and (2) Coma duration and GOS score predicted neuropsychological recovery in children/adolescents and adults, respectively. This suggests the existence of underlying age-specific recovery processes after STBI.

Keywords: Age; coma duration; glasgow outcome scale; neuropsychological recovery; reserve capacity effect.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Attention
  • Brain Injuries / epidemiology
  • Brain Injuries / physiopathology*
  • Child
  • Child, Preschool
  • Cognition
  • Executive Function*
  • Female
  • Follow-Up Studies
  • Glasgow Coma Scale
  • Glasgow Outcome Scale
  • Humans
  • Intelligence
  • Male
  • Memory, Long-Term*
  • Neuropsychological Tests
  • Predictive Value of Tests
  • Psychomotor Performance
  • Recovery of Function*
  • Time Factors
  • Trauma Severity Indices