Cognitive function and participation in children and youth with mild traumatic brain injury two years after injury

ABSTRACT

Background: 10–20% of children and youth with mild traumatic brain injury (mTBI) suffer from long-term cognitive impairments with, supposedly, a negative impact on most domains of functioning.

Objectives: To describe cognitive functioning and participation in children and youth two-years post-mTBI and to determine associated risk factors.

Methods: Cross-sectional study among 73 patients (aged 6–22 years), hospital diagnosed with mTBI. Linear regression modelling was used to investigate the effect of potential predictors on cognitive functioning as measured with a neuropsychological assessment (NPA), two-years post-injury. Extent of participation was assessed using the Child and Adolescent Scale of Participation and correlation analysis was conducted to examine its association with level of cognitive functioning.

Results: 7–15% of all participants had impaired cognitive functions, especially in the domains of processing speed, inhibitory control, cognitive flexibility, visuospatial constructional ability and visuospatial memory. Lower level of education and pre-injury cognitive problems were predictive for a lower level of long-term cognitive functioning. Slower inhibition speed, impaired visuospatial and verbal working memory were associated with reduced participation.

Discussion and conclusions: Persisting cognitive problems two years after mTBI were mostly related to the lower level of education and to pre-injury cognitive problems. Although participation of the patients was reported by parents to be relatively high, slower inhibition speed, impaired visuospatial and verbal working memory were associated with reduced participation.

KEYWORDS:

• Acquired Brain Injury
• adolescents
• young adults
• long-term

Acknowledgments

The authors would like to thank the children, youth and parents participating in the present study.

The following members of the YOUBIN Study Group (YOUth with aquired Brain Injury Netherlands) contributed to this study: Erasmus MC University Medical Centre, Dept. of Rehabilitation Medicine and Rijndam Rehabilitation Institute, Rotterdam (M.E. Roebroeck, S.R. Hilberink), Erasmus MC University Medical Centre, Department of Pediatric Neurology, Rotterdam (C.E. Catsman-Berrevoets), Revant Rehabilitation Centre, Breda (S.A.M. Lambregts), The Hague University for applied sciences and Sophia Rehabilitation, The Hague (A.J. de Kloet, I.M.A.J. Verhoeven, M.A.M. Berger, M.J. Klippel), Haga Hospital and Medical Centre Haaglanden, Dept. of Pediatric Neurology, The Hague (E. Peeters).

Funding

The authors report no declarations of interest. This study was supported by the Revalidatiefonds (Grant 2010/0029), Johanna KinderFonds and Kinderrevalidatie Fonds Adriaanstichting (JKF/KFA Grant 2009/0075).