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Cognitive recovery and predictors of functional outcome 1 year after traumatic brain injury

Published online by Cambridge University Press:  01 September 2009

SOLRUN SIGURDARDOTTIR*
Affiliation:
Sunnaas Rehabilitation Hospital, University of Oslo, Nesoddtangen, Norway
NADA ANDELIC
Affiliation:
Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Norway
CECILIE ROE
Affiliation:
Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Norway Faculty of Medicine, University of Oslo, Oslo, Norway
ANNE-KRISTINE SCHANKE
Affiliation:
Sunnaas Rehabilitation Hospital, University of Oslo, Nesoddtangen, Norway
*
*Correspondence and reprint requests to: Solrun Sigurdardottir, Sunnaas Rehabilitation Hospital, 1450 Nesoddtangen, Norway. E-mail: [email protected]

Abstract

Outcome studies on traumatic brain injury (TBI) have shown that functional status can be predicted by demographic, injury severity, and trauma-related factors. Concurrent cognitive functions as one of the determinants of functional outcome is less documented. This study evaluated the effects of concurrent neuropsychological measures on functional outcome 1 year after injury. Neuropsychological data, employment status, self-reported fatigue, and the Glasgow Outcome Scale-Extended (GOSE) were collected from 115 persons with TBI (ranging from mild to severe) at 3 and 12 months postinjury. Principal components analysis was conducted with the neuropsychological measures and three components emerged. Multiple regression analysis, controlling for demographic and injury severity related factors, was used to test the effects of cognitive components at 12 months on functional outcome (GOSE). One year after injury, 64% were categorized as “good recovery” and 36% as “moderate disability” according to GOSE. Good functional recovery depended on shorter duration of posttraumatic amnesia, less fatigue, absence of intracranial pathology, higher education, and better performance on cognitive measures. The predictive values of Verbal/Reasoning and Visual/Perception components are supported; each added significantly and improved prediction of functional outcome. The Memory/Speed component showed a near-significant relationship to outcome. (JINS, 2009, 15, 740–750)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2009

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References

REFERENCES

Andelic, N., Hammergren, N., Bautz-Holter, E., Sveen, U., Brunborg, C., & Røe, C. (2009). Functional outcome and health-related quality of life 10 years after moderate-to-severe traumatic brain injury. Acta Neurologica Scandinavica, 120, 1623CrossRefGoogle ScholarPubMed
Andelic, N., Sigurdardottir, S., Brunborg, C., & Roe, C. (2008). Incidence of hospital-treated traumatic brain injury in the Oslo population. Neuroepidemiology, 30, 120128.CrossRefGoogle ScholarPubMed
Association for the Advancement of Automotive Medicine (1990). The Abbreviated Injury Scale, revision 1998. Des Plains, IL.Google Scholar
Atchison, T.B., Sander, A.M., Struchen, M.A., High, W.M. Jr, Roebuck, T.M., Contant, C.F., et al. . (2004). Relationship between neuropsychological test performance and productivity at 1-year following traumatic brain injury. The Clinical Neuropsychologist, 18, 249265.CrossRefGoogle ScholarPubMed
Baker, S.P., O’Neill, B., Haddon, W. Jr, & Long, W.B. (1974). The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. Journal of Trauma, 14, 187196.CrossRefGoogle ScholarPubMed
Belanger, H.G., Curtiss, G., Demery, J.A., Lebowitz, B.K., & Vanderploeg, R.D. (2005). Factors moderating neuropsychological outcomes following mild traumatic brain injury: A meta-analysis. Journal of the International Neuropsychological Society, 11, 215227.CrossRefGoogle ScholarPubMed
Benton, A.L., & Hamsher, K.D. (1976). Multilingual Aphasia Examination. Iowa City, IA: University of Iowa.Google Scholar
Boake, C., Millis, S.R., High, W.M. Jr, Delmonico, R.L., Kreutzer, J.S., Rosenthal, M., et al. . (2001). Using early neuropsychologic testing to predict long-term productivity outcome from traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 82, 761768.CrossRefGoogle ScholarPubMed
Bushnik, T., Englander, J., & Wright, J. (2008). Patterns of fatigue and its correlates over the first 2 years after traumatic brain injury. Journal of Head Trauma Rehabilitation, 23, 2532.CrossRefGoogle ScholarPubMed
Christensen, B.K., Colella, B., Inness, E., Hebert, D., Monette, G., Bayley, M., et al. . (2008). Recovery of cognitive function after traumatic brain injury: A multilevel modeling analysis of Canadian outcomes. Archives of Physical Medicine and Rehabilitation, 89, S3S15.CrossRefGoogle ScholarPubMed
Delis, D., Kaplan, E., & Kramer, J. (2001). Delis-Kaplan Executive Function System. San Antonio, TX: The Psychological Corporation.Google Scholar
Delis, D., Kaplan, E., Kramer, J., & Ober, B. (2000). California Verbal Learning Test-second edition. San Antonio, TX: The Psychological Corporation.Google Scholar
Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175191.CrossRefGoogle ScholarPubMed
Foreman, B.P., Caesar, R.R., Parks, J., Madden, C., Gentilello, L.M., Shafi, S., et al. . (2007). Usefulness of the abbreviated injury score and the injury severity score in comparison to the Glasgow Coma Scale in predicting outcome after traumatic brain injury. Journal of Trauma, 62, 946950.Google Scholar
Green, S.B. (1991). How many subjects does it take to do a regression analysis? Multivariate Behavioural Research, 26, 499510.CrossRefGoogle Scholar
Hammond, F.M., Hart, T., Bushnik, T., Corrigan, J.D., & Sasser, H. (2004). Change and predictors of change in communication, cognition, and social function between 1 and 5 years after traumatic brain injury. Journal of Head Trauma Rehabilitation, 19, 314328.CrossRefGoogle ScholarPubMed
Hanlon, R.E., Demery, J.A., Martinovich, Z., & Kelly, J.P. (1999). Effects of acute injury characteristics on neuropsychological status and vocational outcome following mild traumatic brain injury. Brain Injury, 13, 873887.Google ScholarPubMed
Iverson, G.L. (2006). Complicated vs uncomplicated mild traumatic brain injury: Acute neuropsychological outcome. Brain Injury, 20, 13351344.CrossRefGoogle ScholarPubMed
Kennedy, R.E., Livingston, L., Marwitz, J.H., Gueck, S., Kreutzer, J.S., & Sander, A.M. (2006). Complicated mild traumatic brain injury on the inpatient rehabilitation unit: A multicenter analysis. Journal of Head Trauma Rehabilitation, 21, 260271.CrossRefGoogle ScholarPubMed
Krupp, L.B., LaRocca, N.G., Muir-Nash, J., & Steinberg, A.D. (1989). The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology, 46, 11211123.CrossRefGoogle ScholarPubMed
Lehtonen, S., Stringer, A.Y., Millis, S., Boake, C., Englander, J., Hart, T., et al. . (2005). Neuropsychological outcome and community re-integration following traumatic brain injury: The impact of frontal and non-frontal lesions. Brain Injury, 19, 239256.CrossRefGoogle ScholarPubMed
Lerdal, A., Wahl, A., Rustoen, T., Hanestad, B.R., & Moum, T. (2005). Fatigue in the general population: A translation and test of the psychometric properties of the Norwegian version of the fatigue severity scale. Scandinavian Journal of Public Health, 33, 123130.CrossRefGoogle ScholarPubMed
Levin, H.S., O’Donnell, V.M., & Grossman, R.G. (1979). The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. Journal of Nervous and Mental Disease, 167, 675684.CrossRefGoogle Scholar
Machamer, J., Temkin, N., Fraser, R., Doctor, J.N., & Dikmen, S. (2005). Stability of employment after traumatic brain injury. Journal of the International Neuropsychological Society, 11, 807816.CrossRefGoogle ScholarPubMed
Meyers, J.E., & Meyers, K.R. (1995). Rey Complex Figure Test and Recognition Trial. Professional Manual. Odessa, FL: Psychological Assessment Resources, Inc.Google Scholar
Mittenberg, W., Patton, C., Canyock, E.M., & Condit, D.C. (2002). Base rates of malingering and symptom exaggeration. Journal of Clinical and Experimental Neuropsychology, 24, 10941102.CrossRefGoogle ScholarPubMed
Ownsworth, T., & McKenna, K. (2004). Investigation of factors related to employment outcome following traumatic brain injury: A critical review and conceptual model. Disability and Rehabilitation, 26, 765783.CrossRefGoogle ScholarPubMed
Ponsford, J., Draper, K., & Schonberger, M. (2008). Functional outcome 10 years after traumatic brain injury: Its relationship with demographic, injury severity, and cognitive and emotional status. Journal of the International Neuropsychological Society, 14, 233242.CrossRefGoogle ScholarPubMed
Ponsford, J.L., Olver, J.H., Curran, C., & Ng, K. (1995). Prediction of employment status 2 years after traumatic brain injury. Brain Injury, 9, 1120.CrossRefGoogle ScholarPubMed
Ponsford, J., Willmott, C., Rothwell, A., Cameron, P., Kelly, A.M., Nelms, R., et al. . (2000). Factors influencing outcome following mild traumatic brain injury in adults. Journal of the International Neuropsychological Society, 6, 568579.CrossRefGoogle ScholarPubMed
Reitan, R.M., & Wolfson, D. (1985). The Halstead-Reitan Neuropsychological Test Battery. Tucson, AZ: Neuropsychology Press.Google Scholar
Saunders, J.B., Aasland, O.G., Babor, T.F., de la Fuenta, J.R., & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction, 88, 791804.CrossRefGoogle ScholarPubMed
Scheibel, R.S., Levin, H.S., & Clifton, G.L. (1998). Completion rates and feasibility of outcome measures: Experience in a multicenter clinical trial of systemic hypothermia for severe head injury. Journal of Neurotrauma, 15, 685692.CrossRefGoogle Scholar
Sherer, M., Novack, T.A., Sander, A.M., Struchen, M.A., Alderson, A., & Thompson, R.N. (2002a). Neuropsychological assessment and employment outcome after traumatic brain injury: A review. The Clinical Neuropsychologist, 16, 157178.CrossRefGoogle ScholarPubMed
Sherer, M., Sander, A.M., Nick, T.G., High, W.M. Jr, Malec, J.F., & Rosenthal, M. (2002b). Early cognitive status and productivity outcome after traumatic brain injury: Findings from the TBI model systems. Archives of Physical Medicine and Rehabilitation, 83, 183192.CrossRefGoogle ScholarPubMed
Statistics Norway (2008). Statistical Yearbook of Norway 2008. Oslo: Statistics Norway.Google Scholar
Stulemeijer, M., Vos, P.E., Bleijenberg, G., & van der Werf, S.P. (2007). Cognitive complaints after mild traumatic brain injury: Things are not always what they seem. Journal of Psychosomatic Research, 63, 637645.CrossRefGoogle ScholarPubMed
Taylor, L.A., Kreutzer, J.S., & West, D.D. (2003). Evaluation of malingering cut-off scores for the Rey 15-Item Test: A brain injury case study series. Brain Injury, 17, 295308.CrossRefGoogle Scholar
Teasdale, G., & Jennett, B. (1974). Assessment of coma and impaired consciousness. A practical scale. Lancet, 2, 8184.CrossRefGoogle ScholarPubMed
Temkin, N.R., Machamer, J.E., & Dikmen, S.S. (2003). Correlates of functional status 3–5 years after traumatic brain injury with CT abnormalities. Journal of Neurotrauma, 20, 229241.CrossRefGoogle ScholarPubMed
Tombaugh, T.N. (1996). The Test of Memory Malingering. Toronto, Canada: Multi-Health Systems.Google Scholar
Wechsler, D. (1997). Wechsler Adult Intelligence Scale-third edition. San Antonio, TX: The Psychological Corporation.Google Scholar
Wehman, P., Targett, P., West, M., & Kregel, J. (2005). Productive work and employment for persons with traumatic brain injury: What have we learned after 20 years? Journal of Head Trauma Rehabilitation, 20, 115127.CrossRefGoogle Scholar
Whiteneck, G., Brooks, C.A., Mellick, D., Harrison-Felix, C., Terrill, M.S., & Noble, K. (2004). Population-based estimates of outcomes after hospitalization for traumatic brain injury in Colorado. Archives of Physical Medicine and Rehabilitation, 85, S73S81.CrossRefGoogle ScholarPubMed
Whitnall, L., McMillan, T.M., Murray, G.D., & Teasdale, G.M. (2006). Disability in young people and adults after head injury: 5–7 year follow up of a prospective cohort study. Journal of Neurology, Neurosurgery and Psychiatry, 77, 640645.CrossRefGoogle ScholarPubMed
Williams, D.H., Levin, H.S., & Eisenberg, H.M. (1990). Mild head injury classification. Neurosurgery, 27, 422428.CrossRefGoogle ScholarPubMed
Wilson, J.T., Pettigrew, L.E., & Teasdale, G.M. (1998). Structured interviews for the Glasgow Outcome Scale and the extended Glasgow Outcome Scale: Guidelines for their use. Journal of Neurotrauma, 15, 573585.CrossRefGoogle ScholarPubMed
Ziino, C., & Ponsford, J. (2005). Measurement and prediction of subjective fatigue following traumatic brain injury. Journal of the International Neuropsychological Society, 11, 416425.CrossRefGoogle ScholarPubMed