Christian Oldenburg1, Anders Lundin2, Gunnar Edman3,4, Catharina Nygren-de Boussard1, Aniko Bartfai1. 1. a Department of Clinical Sciences , Karolinska Institute and Department of Rehabilitation Medicine Stockholm , Danderyd University Hospital , Stockholm , Sweden. 2. b Dizziness Center , Neuropsychiatry Section , Stockholm , Sweden. 3. c Department of Neurobiology , Care Sciences, and Society, Centre for Family Medicine (CeFAM), Karolinska Institutet , Stockholm , Sweden. 4. d Department of Psychiatry , Tiohundra AB , Norrtälje , Sweden.
Abstract
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.
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.
Authors: Christian Oldenburg; Anders Lundin; Gunnar Edman; Catharina Nygren Deboussard; Aniko Bartfai Journal: BMJ Open Date: 2018-07-06 Impact factor: 2.692
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