Research Reports - Cognitive reserve and persistent post-concussion symptoms-A prospective mild traumatic brain injury

Brain Inj. 2015 Nov 30:1-10. [Epub ahead of print]

Oldenburg C(1), Lundin A(2), Edman G(3,)(4), Nygren-de Boussard C(1), Bartfai
A(1).

PRIMARY OBJECTIVE: Having three or more persisting (i.e. > 3 months)
post-concussion symptoms (PCS) affects a significant number of patients after a
mild traumatic brain injury (mTBI). A common complaint is cognitive deficits.
However, several meta-analyses have found no evidence of long-term cognitive
impairment in mTBI patients. The study sought to answer two questions: first, is
there a difference in cognitive performance between PCS and recovered mTBI
patients? Second, is lower cognitive reserve a risk factor for developing PCS?
RESEARCH DESIGN: Prospective inception cohort study.
METHODS AND PROCEDURE: One hundred and twenty-two adult patients were recruited
from emergency departments within 24 hours of an mTBI. Three months post-injury,
participants completed the Rivermead Post Concussion Symptoms Questionnaire and a
neuropsychological assessment. A healthy control group (n = 35) were recruited.
The estimate of cognitive reserve was based upon sub-test Information from
Wechsler Adult Intelligence Scale and international classifications of
educational level and occupational skill level.
MAIN OUTCOME AND RESULTS: mTBI patients showed reduced memory performance.
Patients with lower cognitive reserve were 4.14-times more likely to suffer from
PCS.
CONCLUSIONS: mTBI may be linked to subtle executive memory deficits. Lower
cognitive reserve appears to be a risk factor for PCS and indicates individual
vulnerabilities. 

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