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Brain Inj. 2015;29(13-14):1604-16. doi: 10.3109/02699052.2015.1075143. Epub 2015 Sep 18.

Neuropsychological outcome and its correlates in the first year after adult mild traumatic brain injury: A population-based New Zealand study.

Author information

1
a School of Psychology, Faculty of Sciences, University of Auckland , New Zealand .
2
b National Institute for Stroke and Applied Neuroscience, School of Rehabilitation and Occupation Studies, Auckland University of Technology , Auckland , New Zealand .
3
c School of Psychology, Faculty of Arts and Social Sciences, University of Waikato , Hamilton , New Zealand .
4
d Department of Primary Health Care and General Practice , University of Otago , Wellington , New Zealand .
5
e Person Centered Research Centre, Health and Rehabilitation Research Institute, Auckland University of Technology , Auckland , New Zealand .
6
f School of Population Health, Faculty of Medical & Health Sciences, University of Auckland , New Zealand , and.
7
g School of Public Health & Psychosocial Studies, Auckland University of Technology , Auckland , New Zealand.

Abstract

OBJECTIVE:

The relationship between moderate/severe traumatic brain injury (TBI) and cognitive deficits is well known. The nature, duration and predictors of cognitive difficulties post-mild TBI remain unclear. This study examined cognitive, mood and post-concussion outcomes of mild TBI over 1-year post-injury.

METHOD:

Adults (>15 years) with mild TBI (n = 260) completed neuropsychological (CNS-Vital Signs, Behavioural Dyscontrol Scale), mood (Hospital Anxiety Depression Scale) and behavioural assessments (Cognitive Failures Questionnaire, Rivermead Post-Concussion Questionnaire) at baseline, 1-, 6- and 12-months post-injury.

RESULTS:

Over the 12-months post-injury self-reported cognition (p = 0.027), post-concussion symptoms (p < 0.001), depression (p < 0.001), anxiety (p < 0.001) and dyscontrol (p = 0.025) improved significantly. Assessments of memory, processing speed, executive function, psychomotor speed/reaction time, complex attention and flexibility also improved significantly. At baseline >20% of individuals produced very low scores on executive ability, complex attention and cognitive flexibility. At 1- and 6-month follow-ups >20% of participants were very low for complex attention, with 16.3% remaining so at 12-months. Executive abilities and speed were related to post-concussion symptoms, mood and self-reported cognition at 12-months.

CONCLUSIONS:

Whilst significant improvements were noted across measures over time, a significant proportion of individuals still perform poorly on neuropsychological measures 12-months after mild TBI; and these were linked to post-concussion symptoms, mood and self-reported cognitive outcomes. This implies a longer trajectory for recovery than has previously been suggested, which has implications for provision of assessment and rehabilitation services for more extended periods.

KEYWORDS:

Cognition; concussion; mild traumatic brain injury; mood; post-concussion

PMID:
26382561
DOI:
10.3109/02699052.2015.1075143
[Indexed for MEDLINE]

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