The UCLA study of Predictors of Cognitive Functioning Following Moderate/Severe Pediatric Traumatic Brain Injury

• Published in: Journal of the International Neuropsychological Society Vol. 22; no. 5; pp. 512 - 519
• Main Authors: Moran, Lisa M., Babikian, Talin, Del Piero, Larissa, Ellis, Monica U., Kernan, Claudia L., Newman, Nina, Giza, Christopher C., Mink, Richard, Johnson, Jeffrey, Babbitt, Christopher, Asarnow, Robert
• Format: Journal Article
• Language: English
• Published: New York, USA Cambridge University Press 01.05.2016
• Subjects: Adolescent; Brain Injuries, Traumatic - complications; Brain research; Child; Children & youth; Cognition Disorders - etiology; Female; Glasgow Coma Scale; Hispanic Americans; Hospitals, University; Humans; Longitudinal Studies; Male; Medical imaging; Medical records; Mental disorders; Neuroimaging; Neuropsychological Tests; Neuropsychology; Pediatrics; Psychological aspects; Psychometrics; ROC Curve; Trauma Severity Indices; Traumatic brain injury; Young Adult; United States > US; Neuropsychological Tests; Brain Injury; Cognitive Symptoms; Psychometrics; Children; Adolescents; Longitudinal Studies
• ISSN: 1355-6177; 1469-7661
• DOI: 10.1017/S1355617716000175

Objectives: Following pediatric moderate-to-severe traumatic brain injury (msTBI), few predictors have been identified that can reliably identify which individuals are at risk for long-term cognitive difficulties. This study sought to determine the relative contribution of detailed descriptors of injury severity as well as demographic and psychosocial factors to long-term cognitive outcomes after pediatric msTBI. Methods: Participants included 8- to 19-year-olds, 46 with msTBI and 53 uninjured healthy controls (HC). Assessments were conducted in the post-acute and chronic stages of recovery. Medical record review provided details regarding acute injury severity. Parents also completed a measure of premorbid functioning and behavioral problems. The outcome of interest was four neurocognitive measures sensitive to msTBI combined to create an index of cognitive performance. Results: Results indicated that none of the detailed descriptors of acute injury severity predicted cognitive performance. Only the occurrence of injury, parental education, and premorbid academic competence predicted post-acute cognitive functioning. Long-term cognitive outcomes were best predicted by post-acute cognitive functioning. Discussion: The findings suggest that premorbid factors influence cognitive outcomes nearly as much as the occurrence of a msTBI. Furthermore, of youth with msTBI who initially recover to a level of moderate disability or better, a brief cognitive battery administered within several months after injury can best predict which individuals will experience poor long-term cognitive outcomes and require additional services. (JINS, 2016, 22, 1–8)