Cognitive Reserve, Early Cognitive Screening, and Relationship to Long-Term Outcome after Severe Traumatic Brain Injury
The objective was to investigate the relationship between early global cognitive functioning using the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) and cognitive flexibility (Trail Making Test (TMT), TMT B-A), with long-term outcome assessed by the Mayo-Portland Adaptabi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/7/2046 |
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| author | Natascha Ekdahl Alison K. Godbolt Catharina Nygren Deboussard Marianne Lannsjö Britt-Marie Stålnacke Maud Stenberg Trandur Ulfarsson Marika C. Möller |
| author_facet | Natascha Ekdahl Alison K. Godbolt Catharina Nygren Deboussard Marianne Lannsjö Britt-Marie Stålnacke Maud Stenberg Trandur Ulfarsson Marika C. Möller |
| author_sort | Natascha Ekdahl |
| collection | DOAJ |
| description | The objective was to investigate the relationship between early global cognitive functioning using the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) and cognitive flexibility (Trail Making Test (TMT), TMT B-A), with long-term outcome assessed by the Mayo-Portland Adaptability Index (MPAI-4) in severe traumatic brain injury (sTBI) controlling for the influence of cognitive reserve, age, and injury severity. Of 114 patients aged 18–65 with acute Glasgow Coma Scale 3–8, 41 patients were able to complete (BNIS) at 3 months after injury and MPAI-4 5–8 years after injury. Of these, 33 patients also completed TMT at 3 months. Global cognition and cognitive flexibility correlated significantly with long-term outcome measured with MPAI-4 total score (r<sub>BNIS</sub> = 0.315; r<sub>TMT</sub> = 0.355). Global cognition correlated significantly with the participation subscale (r = 0.388), while cognitive flexibility correlated with the adjustment (r = 0.364) and ability (r = 0.364) subscales. Adjusting for cognitive reserve and acute injury severity did not alter these relationships. The effect size for education on BNIS and TMT scores was large (d ≈ 0.85). Early screenings with BNIS and TMT are related to long-term outcome after sTBI and seem to measure complementary aspects of outcome. As early as 3 months after sTBI, educational level influences the scores on neuropsychological screening instruments. |
| first_indexed | 2024-03-09T11:42:27Z |
| format | Article |
| id | doaj.art-5a92dc54734c48a9b7831ceea41bc65e |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T11:42:27Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-5a92dc54734c48a9b7831ceea41bc65e2023-11-30T23:30:31ZengMDPI AGJournal of Clinical Medicine2077-03832022-04-01117204610.3390/jcm11072046Cognitive Reserve, Early Cognitive Screening, and Relationship to Long-Term Outcome after Severe Traumatic Brain InjuryNatascha Ekdahl0Alison K. Godbolt1Catharina Nygren Deboussard2Marianne Lannsjö3Britt-Marie Stålnacke4Maud Stenberg5Trandur Ulfarsson6Marika C. Möller7Centre for Research and Development, Uppsala University/County Council of Gävleborg, 801 88 Gävle, SwedenDepartment of Clinical Sciences, Karolinska Institutet, 182 88 Stockholm, SwedenDepartment of Clinical Sciences, Karolinska Institutet, 182 88 Stockholm, SwedenCentre for Research and Development, Uppsala University/County Council of Gävleborg, 801 88 Gävle, SwedenDepartment of Community Medicine and Rehabilitation, Umeå University, 901 85 Umeå, SwedenDepartment of Community Medicine and Rehabilitation, Umeå University, 901 85 Umeå, SwedenDepartment of Rehabilitation Medicine, Sahlgrenska University Hospital, 405 30 Gothenburg, SwedenDepartment of Clinical Sciences, Karolinska Institutet, 182 88 Stockholm, SwedenThe objective was to investigate the relationship between early global cognitive functioning using the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) and cognitive flexibility (Trail Making Test (TMT), TMT B-A), with long-term outcome assessed by the Mayo-Portland Adaptability Index (MPAI-4) in severe traumatic brain injury (sTBI) controlling for the influence of cognitive reserve, age, and injury severity. Of 114 patients aged 18–65 with acute Glasgow Coma Scale 3–8, 41 patients were able to complete (BNIS) at 3 months after injury and MPAI-4 5–8 years after injury. Of these, 33 patients also completed TMT at 3 months. Global cognition and cognitive flexibility correlated significantly with long-term outcome measured with MPAI-4 total score (r<sub>BNIS</sub> = 0.315; r<sub>TMT</sub> = 0.355). Global cognition correlated significantly with the participation subscale (r = 0.388), while cognitive flexibility correlated with the adjustment (r = 0.364) and ability (r = 0.364) subscales. Adjusting for cognitive reserve and acute injury severity did not alter these relationships. The effect size for education on BNIS and TMT scores was large (d ≈ 0.85). Early screenings with BNIS and TMT are related to long-term outcome after sTBI and seem to measure complementary aspects of outcome. As early as 3 months after sTBI, educational level influences the scores on neuropsychological screening instruments.https://www.mdpi.com/2077-0383/11/7/2046traumatic brain injurycognitionneuropsychologypatient outcome assessmentexecutive functioneducation |
| spellingShingle | Natascha Ekdahl Alison K. Godbolt Catharina Nygren Deboussard Marianne Lannsjö Britt-Marie Stålnacke Maud Stenberg Trandur Ulfarsson Marika C. Möller Cognitive Reserve, Early Cognitive Screening, and Relationship to Long-Term Outcome after Severe Traumatic Brain Injury Journal of Clinical Medicine traumatic brain injury cognition neuropsychology patient outcome assessment executive function education |
| title | Cognitive Reserve, Early Cognitive Screening, and Relationship to Long-Term Outcome after Severe Traumatic Brain Injury |
| title_full | Cognitive Reserve, Early Cognitive Screening, and Relationship to Long-Term Outcome after Severe Traumatic Brain Injury |
| title_fullStr | Cognitive Reserve, Early Cognitive Screening, and Relationship to Long-Term Outcome after Severe Traumatic Brain Injury |
| title_full_unstemmed | Cognitive Reserve, Early Cognitive Screening, and Relationship to Long-Term Outcome after Severe Traumatic Brain Injury |
| title_short | Cognitive Reserve, Early Cognitive Screening, and Relationship to Long-Term Outcome after Severe Traumatic Brain Injury |
| title_sort | cognitive reserve early cognitive screening and relationship to long term outcome after severe traumatic brain injury |
| topic | traumatic brain injury cognition neuropsychology patient outcome assessment executive function education |
| url | https://www.mdpi.com/2077-0383/11/7/2046 |
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