ABSTRACT

Neuropsychologists are commonly asked practical questions about cognitive recovery in the first year following moderate-to-severe traumatic brain injury (TBI), however guiding evidence to provide answers is limited. The design of this longitudinal study rectifies methodological problems in the literature by taking serial assessments on a monthly basis from 3- to 12-months post-trauma in a severe TBI sample (n = 23), and using four alternate forms of a brief yet sensitive cognitive assessment battery. Fifteen variables sampling seven cognitive domains were used: orientation, attention, processing speed, executive function, memory, language and visuospatial function. A matched control group (n = 23) was used to establish equivalence of the four alternate forms (no statistically significant differences), document practice effects (no statistically significant differences), and provide a comparison standard of cognitive functioning against which to interpret the TBI recovery curves. Twenty-one of 23 consenting TBI participants continued with the serial assessments. Hierarchical growth model analyses typically revealed linear recovery trajectories over the first 12 months. However, by 12-months post-trauma, a significant proportion (up to 36%) had residual mild to severe impairments in various cognitive domains. These results provide detailed information about patterns of cognitive recovery that also have direct clinical application.

摘要

在中度至重度创伤性脑损伤 (TBI) 后的第一年，神经心理学家通常会被问及有关认知恢复的实际问题，但提供答案的指导性证据有限。这项纵向研究的设计通过在严重 TBI 样本 ( n  = 23) 的创伤后 3 至 12 个月内每月进行一系列评估，并使用四种替代形式的简短但敏感的认知评估电池。使用了七个认知领域的 15 个变量：定向、注意力、处理速度、执行功能、记忆、语言和视觉空间功能。一个匹配的对照组（n = 23）用于建立四种替代形式的等效性（无统计学显着差异），记录实践效果（无统计学显着差异），并提供认知功能的比较标准来解释 TBI 恢复曲线。23 名同意的 TBI 参与者中有 21 名继续进行系列评估。分层增长模型分析通常揭示了前 12 个月的线性恢复轨迹。然而，到创伤后 12 个月，很大一部分人（高达 36%）在各种认知领域都存在轻度至重度损伤。这些结果提供了有关认知恢复模式的详细信息，这些信息也具有直接的临床应用。