Effect of traumatic upper-limb injury on cognitive functions: A cross-sectional observational study

Abstract

Objectives: There is growing evidence of cognitive impairment after traumatic peripheral lesions. The purpose of this study was to explore the association between cognitive function and traumatic upper-limb injury. We assessed difference in cognitive function between participants with and without upper-limb injury, and explored the association between cognitive function and certain variables in injured individuals: gender, age, body mass index (BMI), educational level, and occupation. We sought to identify the factors associated with cognitive function in injured subjects: time since injury, injury side, nerve injury, hand function, pain, and finger sensation.

Material and methods: A cross-sectional observational study was conducted, with 2 groups: observational group (with traumatic upper-limb injury) and control group (uninjured). The 2 groups were matched for age, gender, BMI, educational level and occupation. Short-term memory and executive functions were assessed using the Rey Auditory and Verbal Learning Test (RAVLT) and Stroop Color and Word Test (SCWT), respectively.

Results: 104 participants with traumatic upper-limb injury and 104 uninjured control subjects were included. There was a significant inter-group difference only in RAVLT (p < 0.01; Cohen d, of 0.38). Regression analysis demonstrated an association of pain on VAS (beta = -0.16, p < 0.01) and touch-test (beta = 1.09, p < 0.05) with total RAVLT score (short-term memory) in injured subjects (R² = 0.19, F (2, 82) = 9.54, p < 0.001).

Conclusion: Traumatic upper-limb injury can impact short-term memory, which should be kept in mind during rehabilitation.

Keywords: Cognitive functions; Executive function; Fonction exécutive; Fonctions cognitives; Hand injury; Memory; Mémoire; Traumatisme de la main; Traumatisme du membre supérieur; Upper-limb injury.