Pediatric concussion working memory outcomes: a scoping review

ABSTRACT

Objective: Characterize the working memory (WM) profile of children and youth who have experienced concussion by systematically synthesizing existing literature on the neuropsychological outcomes of these injuries.

Methods: Implemented a peer-reviewed search strategy combining key concepts of concussion/mild traumatic brain injury (mTBI), WM, and pediatrics across MedLine, Embase, PsycINFO, and CINAHL. Included studies written in English with extractable results on a WM outcome measure in individuals aged 21 and under who experienced concussion. Applied narrative synthesis to identify trends in the literature. Assessed risk of bias and quality using the NHLBI’s Quality Assessment of Observational Cohort and Cross-Sectional Studies.

Results: 40 articles met inclusion criteria. 34/40 studies compared WM performance in children or youth with concussion to healthy controls, pre-injury performance, or normative values, of which 15 reported significantly lower WM performance in the concussion sample. Visual/spatial WM was more consistently impacted than verbal WM. Cognitive demanding dual-task conditions were also reliably impacted.

Conclusion: Literature indicated that WM is vulnerable to negative outcomes following pediatric concussion, yet the nature of outcomes is variable. Clinicians and researchers should implement comprehensive and theoretically motivated WM assessments to better understand the WM components impacted by injury.

KEYWORDS:

• Concussion
• post concussional syndrome
• pediatric
• memory
• cognitive rehabilitation
• mild brain injury

Acknowledgments

We thank medical research librarians Pui-Ying Wong and Erica Lenton for their assistance in developing the search strategy.

Disclosure Statement

The authors report no conflict of interest.

Additional information

Funding

Financial support for the execution of this scoping review was received from the Canadian Institutes of Health Research Canada Graduate Scholarships – Masters Awards (CGS-M) and the Holland Bloorview Kids Rehabilitation Hospital Kimel Family Graduate Student Scholarship in Paediatric Rehabilitation