Cognitive functioning following traumatic brain injury: The first 5 years

Article type: Research Article

Authors: Marsh, Nigel V.

Affiliations: Department of Psychology, Sunway University, No. 5 Jalan Universiti, Bandar Sunway, 47500 Selangor Darul Ehsan, Malaysia. Tel.: +60 3 7491 8622; Fax: +60 3 5635 8633; E-mail: [email protected]

Abstract: OBJECTIVE:This study reports the results from a 5-year longitudinal investigation of the prevalence and severity of cognitive deficits following significant (i.e., ventilation required for > 24 hours) traumatic brain injury. The changes in performance, either improvement or decline, across five domains of cognitive functioning are described. METHOD:A group of 56 adults was assessed at approximately 6 months, 1 year, and 5 years following injury. RESULTS:Impairment was evident on all measures but prevalence and rate of improvement varied. Overall, by 5 years post-injury over 85% of patients were not impaired on measures of general intelligence, simple attention, and visual perception. However, 28% of patients continued to show some degree of impairment on complex attention and verbal fluency, and performance on verbal memory remained impaired for 60% of patients. There was also evidence for deterioration in complex attention and verbal memory between 1 year and 5 years. ANOVAs showed that improvement occurred on most measures between 6 months and 1 year, but there was both improvement and decline on some measures between 1 year and 5 years. CONCLUSIONS:The findings show that there is considerable heterogeneity in cognitive outcome following TBI, with some deterioration evident over the long term.

Keywords: Cognition, head injury, outcome, longitudinal design, neuropsychological assessment, long-term follow-up

DOI: 10.3233/NRE-182457

Journal: NeuroRehabilitation, vol. 43, no. 4, pp. 377-386, 2018