Cognitive Reserve Moderates Cognitive Outcome After Mild Traumatic Brain Injury.

Autor:	Stenberg J; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Neurosurgery, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway., Håberg AK; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway., Follestad T; Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway., Olsen A; Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway., Iverson GL; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, United States; Spaulding Rehabilitation Hospital and Spaulding Research Institute, Boston, Massachusetts, United States; Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts, United States., Terry DP; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, United States; Spaulding Rehabilitation Hospital and Spaulding Research Institute, Boston, Massachusetts, United States; Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts, United States., Karlsen RH; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway., Saksvik SB; Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway., Karaliute M; Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway., Ek JAN; Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway., Skandsen T; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Electronic address: toril.skandsen@ntnu.no., Vik A; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Neurosurgery, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
Jazyk:	angličtina
Zdroj:	Archives of physical medicine and rehabilitation [Arch Phys Med Rehabil] 2020 Jan; Vol. 101 (1), pp. 72-80. Date of Electronic Publication: 2019 Sep 25.
DOI:	10.1016/j.apmr.2019.08.477
Abstrakt:	Objective: To investigate whether cognitive reserve moderates differences in cognitive functioning between patients with mild traumatic brain injury (MTBI) and controls without MTBI and to examine whether patients with postconcussion syndrome have lower cognitive functioning than patients without postconcussion syndrome at 2 weeks and 3 months after injury. Design: Trondheim MTBI follow-up study is a longitudinal controlled cohort study with cognitive assessments 2 weeks and 3 months after injury. Setting: Recruitment at a level 1 trauma center and at a general practitioner-run, outpatient clinic. Participants: Patients with MTBI (n=160) according to the World Health Organization criteria, trauma controls (n=71), and community controls (n=79) (N=310). Main Outcome Measures: A cognitive composite score was used as outcome measure. The Vocabulary subtest was used as a proxy of cognitive reserve. Postconcussion syndrome diagnosis was assessed at 3 months with the British Columbia Postconcussion Symptom Inventory. Results: Linear mixed models demonstrated that the effect of vocabulary scores on the cognitive composite scores was larger in patients with MTBI than in community controls at 2 weeks and at 3 months after injury (P=.001). Thus, group differences in the cognitive composite score varied as a function of vocabulary scores, with the biggest differences seen among participants with lower vocabulary scores. There were no significant differences in the cognitive composite score between patients with (n=29) and without (n=131) postconcussion syndrome at 2 weeks or 3 months after injury. Conclusion: Cognitive reserve, but not postconcussion syndrome, was associated with cognitive outcome after MTBI. This supports the cognitive reserve hypothesis in the MTBI context and suggests that persons with low cognitive reserve are more vulnerable to reduced cognitive functioning if they sustain an MTBI. (Copyright © 2019 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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