Executive Functions After Pediatric Mild Traumatic Brain Injury: A Prospective Short-Term Longitudinal Study

Abstract

Traumatic brain injuries (TBIs) occur frequently in childhood and entail broad cognitive deficits, particularly in the domain of executive functions (EF). Concerning mild TBI (mTBI), only little empirical evidence is available on acute and postacute performance in EF. Given that EF are linked to school adaptation and achievement, even subtle deficits in performance may affect children's academic careers. The present study assessed performance in the EF components of inhibition, working memory (WM), and switching in children after mTBI. Regarding both acute and postacute consequences, performance trajectories were measured in 13 patients aged between 5 and 10 years and 13 controls who were closely matched in terms of sex, age, and education. Performance in the EF components of inhibition, switching, and WM was assessed in a short-term longitudinal design at 2, 6, and 12 weeks after the mTBI. Results indicate subtle deficits after mTBI, which became apparent in the longitudinal trajectory in the EF components of switching and WM. Compared with controls, children who sustained mTBI displayed an inferior performance enhancement across testing sessions in the first 6 weeks after the injury in switching and WM, resulting in a delayed deficit in the EF component of WM 12 weeks after the injury. Results are interpreted as mTBI-related deficits that become evident in terms of an inability to profit from previous learning opportunities, a finding that is potentially important for children's mastery of their daily lives.

Key words:

• children
• executive functions
• inhibition
• mild traumatic brain injury
• prospective longitudinal study
• switching
• working memory

ACKNOWLEDGEMENTS

We would like to give thanks to participating children and their parents, to Dr. Glock, Dr. Bruhin-Feichter, Dr. Trötschler, Dr. Keller, Dr. Liniger, Dr. Bittel, to the administrative services who helped us to establish contact with patients, and to Martina Studer, and Manuela Spiess, who supported us in the data collection. Many thanks also to R. Bühlmann, to P. Cimeli, to N. Destan, and to R. Neuenschwander for helpful comments on the manuscript.

Notes

^a n = 12 for the flexibility task due to missing data from one patient.