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J Spinal Cord Med. 2018 Dec 3:1-10. doi: 10.1080/10790268.2018.1543103. [Epub ahead of print]

Patterns of cognitive deficits in persons with spinal cord injury as compared with both age-matched and older individuals without spinal cord injury.

Author information

a Kessler Foundation, Traumatic Brain Injury Research , West Orange , New Jersey , USA.
b Kessler Foundation, Neuropsychology & Neuroscience Research , West Orange , New Jersey , USA.
c Department of Physical Medicine and Rehabilitation Medical School , Rutgers-NJ , Newark , New Jersey , USA.
d VA War Related Illness and Injury Study Center , East Orange , New Jersey , USA.
e Kessler Foundation, Spinal Cord Injury Research , West Orange , New Jersey , USA.
f VA RR&D National Center for the Medical Consequences of SCI, James J. Peters VAMC , Bronx , New York , USA.
g Department of Medicine and Rehabilitation Medicine , The Icahn School of Medicine, Mount Sinai , New York , New York , USA.



Cognitive deficits can impact as many as 60% of individuals with spinal cord injury (SCI). In an effort to identify the nature of cognitive deficits in SCI, we examined neuropsychological test performance in individuals with SCI, age matched healthy controls and older healthy controls.


Participants completed a motor-free neuropsychological test battery assessing attention, working memory, information processing speed, new learning /memory and executive control.


Outpatient rehabilitation research facility.


Participants included 60 individuals with chronic spinal cord injury [SCI; 32 with paraplegia (T2-T12) and 28 with tetraplegia (C3-T1)], 30 age-matched healthy controls (AMHC; 30-40 years old) and 20 older healthy controls (OHC; 50-60 years old).


Wechsler Intelligence Scale - 3rd edition (WAIS-III) Digit Span and Letter-Number Sequencing; Symbol Digit Modalities Test (SDMT) - oral version; California Verbal Learning Test-II; Paced Auditory Serial Addition Test (PASAT); Wechsler Abbreviated Scale of Intelligence (WASI); Delis-Kaplan Executive Function System; Verbal Fluency subtest.


Significant differences were noted between the SCI and AMHC groups on measures of information processing speed, new learning and memory, and verbal fluency. No significant differences were noted between the groups on tests of attention or working memory.


The current study documented differences in specific realms of cognitive functioning between a chronic SCI sample and AMHC. Implications for cognitive rehabilitation and overall quality of life are discussed. Additional research is needed utilizing a more comprehensive battery of motor-free neuropsychological tests that avoid the confound of upper limb motor limitations on cognitive performance.


Cognitive deficits; Executive functioning; Memory; Processing speed; Spinal cord injury

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