Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-27T09:21:17.477Z Has data issue: false hasContentIssue false
  • English
  • Français

The UCLA study of Predictors of Cognitive Functioning Following Moderate/Severe Pediatric Traumatic Brain Injury

Published online by Cambridge University Press:  28 March 2016

Lisa M. Moran ,
Talin Babikian ,
Larissa Del Piero ,
Monica U. Ellis ,
Claudia L. Kernan ,
Nina Newman ,
Christopher C. Giza ,
Richard Mink ,
Jeffrey Johnson  and
Christopher Babbitt
...Show all authors
Lisa M. Moran
Affiliation:
Department of Psychiatry and Biobehavioral Health, University of California, Los Angeles, California
Talin Babikian*
Affiliation:
Department of Psychiatry and Biobehavioral Health, University of California, Los Angeles, California Department of Pediatrics, University of California, Los Angeles, California
Larissa Del Piero
Affiliation:
Department of Psychology, University of Southern California, Los Angeles, California
Monica U. Ellis
Affiliation:
Department of Psychiatry and Biobehavioral Health, University of California, Los Angeles, California Department of Psychology, Fuller Theological Seminary, Pasadena, California
Claudia L. Kernan
Affiliation:
Department of Psychiatry and Biobehavioral Health, University of California, Los Angeles, California
Nina Newman
Affiliation:
Department of Psychiatry and Biobehavioral Health, University of California, Los Angeles, California
Christopher C. Giza
Affiliation:
Department of Pediatrics, University of California, Los Angeles, California Brain Injury Research Center, University of California, Los Angeles, California Department of Neurosurgery and Division of Pediatric Neurology, Mattel Children’s Hospital, Los Angeles, California
Richard Mink
Affiliation:
Department of Pediatrics, Los Angeles County & Harbor University of California, Los Angeles, California
Jeffrey Johnson
Affiliation:
Department of Pediatrics, Los Angeles County & University of Southern California Medical Center, Los Angeles, California
Christopher Babbitt
Affiliation:
Department of Pediatrics, Miller Children’s Hospital, Long Beach, California
Robert Asarnow
Affiliation:
Department of Psychiatry and Biobehavioral Health, University of California, Los Angeles, California Department of Psychology, University of California, Los Angeles, California Brain Research Institute, University of California, Los Angeles, California
*
Correspondence and reprint requests to: Talin Babikian, Division of Child and Adolescent Psychiatry, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095. E-mail: tbabikian@mednet.ucla.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: Following pediatric moderate-to-severe traumatic brain injury (msTBI), few predictors have been identified that can reliably identify which individuals are at risk for long-term cognitive difficulties. This study sought to determine the relative contribution of detailed descriptors of injury severity as well as demographic and psychosocial factors to long-term cognitive outcomes after pediatric msTBI. Methods: Participants included 8- to 19-year-olds, 46 with msTBI and 53 uninjured healthy controls (HC). Assessments were conducted in the post-acute and chronic stages of recovery. Medical record review provided details regarding acute injury severity. Parents also completed a measure of premorbid functioning and behavioral problems. The outcome of interest was four neurocognitive measures sensitive to msTBI combined to create an index of cognitive performance. Results: Results indicated that none of the detailed descriptors of acute injury severity predicted cognitive performance. Only the occurrence of injury, parental education, and premorbid academic competence predicted post-acute cognitive functioning. Long-term cognitive outcomes were best predicted by post-acute cognitive functioning. Discussion: The findings suggest that premorbid factors influence cognitive outcomes nearly as much as the occurrence of a msTBI. Furthermore, of youth with msTBI who initially recover to a level of moderate disability or better, a brief cognitive battery administered within several months after injury can best predict which individuals will experience poor long-term cognitive outcomes and require additional services. (JINS, 2016, 22, 1–8)

Keywords

Cognitive SymptomsLongitudinal StudiesNeuropsychological TestsPsychometricsChildrenAdolescentsBrain Injury
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 22 , Issue 5 , May 2016 , pp. 512 - 519
Copyright
Copyright © The International Neuropsychological Society 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, V.A., Catroppa, C., Haritou, F., Morse, S., Pentland, L., Rosenfeld, J., && Stargatt, R. (2001). Predictors of acute child and family outcome following traumatic brain injury in children. Pediatric Neurosurgery, 34(3), 138–148.CrossRefGoogle ScholarPubMed
Anderson, V.A., Catroppa, C., Haritou, F., Morse, S., & Rosenfeld, J.V. (2005). Identifying factors contributing to child and family outcome 30 months after traumatic brain injury in children. Journal of Neurology, Neurosurgery & Psychiatry, 76(3), 401–408.CrossRefGoogle ScholarPubMed
Anderson, V.A., Catroppa, C., Morse, S., Haritou, F., & Rosenfeld, J. (2000). Recovery of intellectual ability following traumatic brain injury in childhood: Impact of injury severity and age at injury. Pediatric Neurosurgery, 32(6), 282–290.CrossRefGoogle ScholarPubMed
Anderson, V.A., Godfrey, C., Rosenfeld, J.V., & Catroppa, C. (2012). Predictors of cognitive function and recovery 10 years after traumatic brain injury in young children. Pediatrics, 129(2), E254–E261.CrossRefGoogle ScholarPubMed
Babikian, T., & Asarnow, R. (2009). Neurocognitive outcomes and recovery after pediatric TBI: Meta-analytic review of the literature. Neuropsychology, 23(3), 283–296.CrossRefGoogle ScholarPubMed
Babikian, T., Merkley, T, Savage, R.C., Giza, C.C., & Levin, H. (2015). Chronic aspects of pediatric traumatic brain injury, review of the literature. Journal of Neurotrauma, 32, 1849–1860.CrossRefGoogle ScholarPubMed
Brown, R.L. (2010). Epidemiology of injury and the impact of health disparities. Current Opinion in Pediatrics, 22(3), 321–325.CrossRefGoogle ScholarPubMed
Donders, J., & Nesbit-Greene, K. (2004). Predictors of neuropsychological test performance after pediatric traumatic brain injury. Assessment, 11(4), 275–284.CrossRefGoogle ScholarPubMed
Ewing-Cobbs, L., Barnes, M., Fletcher, J.M., Levin, H.S., Swank, P.R., & Song, J. (2004). Modeling of longitudinal academic achievement scores after pediatric traumatic brain injury. Developmental Neuropsychology, 25(1-2), 107–133.CrossRefGoogle ScholarPubMed
Ewing-Cobbs, L., Fletcher, J.M., Levin, H.S., Francis, D.J., Davidson, K., & Miner, M.E. (1997). Longitudinal neuropsychological outcome in infants and preschoolers with traumatic brain injury. Journal of the International Neuropsychological Society, 3(06), 581–591.CrossRefGoogle ScholarPubMed
Faul, M., Xu, L., Wald, M.M., & Coronado, V.G. (2010). Traumatic brain injury in the United States: Emergency department visits, hospitalizations, and deaths 2002-2006. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.CrossRefGoogle Scholar
Fay, T.B., Yeates, K.O., Wade, S.L., Drotar, D., Stancin, T., & Taylor, H.G. (2009). Predicting longitudinal patterns of functional deficits in children with traumatic brain injury. Neuropsychology, 23(3), 271–282.CrossRefGoogle ScholarPubMed
Hoofien, D., Vakil, E., Gilboa, A., Donovick, P.J., & Barak, O. (2002). Comparison of the predictive power of socio-economic variables, severity of injury and age on long-term outcome of traumatic brain injury: Sample-specific variables versus factors as predictors. Brain Injury, 16(1), 9–27.CrossRefGoogle ScholarPubMed
Howard, I., Joseph, J.G., & Natale, J.E. (2005). Pediatric traumatic brain injury: Do racial/ethnic disparities exist in brain injury severity, mortality, or medical disposition? Ethnicity & Disease, 15(4 Suppl 5), S5–51–6.Google ScholarPubMed
Jaffe, K.M., Polissar, N.L., Fay, G.C., & Liao, S. (1995). Recovery trends over three years following pediatric traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 76(1), 17–26.CrossRefGoogle ScholarPubMed
Kraus, J.F. (1995). Epidemiological features of brain injury in children: Occurrence, children at risk, causes and manner of injury, severity, and outcomes. In S.H. Broman & M.E. Michel (Eds.), Traumatic head injury in children (pp. 22–39). New York: Oxford University Press.Google Scholar
Langlois, J.A., Rutland-Brown, W., & Thomas, K.E. (2005). The incidence of traumatic brain injury among children in the United States: Differences by race. The Journal of Head Trauma Rehabilitation, 20(3), 229–238.CrossRefGoogle ScholarPubMed
Max, J.E., Roberts, M.A., Koele, S.L., Lindgren, S.D., Robin, D.A., Arndt, S., & Sato, Y. (1999). Cognitive outcome in children and adolescents following severe traumatic brain injury: Influence of psychosocial, psychiatric, and injury-related variables. Journal of the International Neuropsychological Society, 5(1), 58–68.CrossRefGoogle ScholarPubMed
Max, J.E., Schachar, R.J., Levin, H.S., Ewing-Cobbs, L., Chapman, S.B., Dennis, M., & Landis, J. (2005). Predictors of attention-deficit/hyperactivity disorder within 6 months after pediatric traumatic brain injury. Journal of the American Academy of Child and Adolescent Psychiatry, 44(10), 1032–1040.CrossRefGoogle ScholarPubMed
McCabe, D.P., Roediger, H.L., McDaniel, M.A., Balota, D.A., & Hambrick, D.Z. (2010). The relationship between working memory capacity and executive functioning: Evidence for a common executive attention construct. Neuropsychology, 24(2), 222–243.CrossRefGoogle ScholarPubMed
McKinlay, A., Kyonka, E.G.E., Grace, R.C., Horwood, L.J., Fergusson, D.M., & MacFarlane, M.R. (2010). An investigation of the pre-injury risk factors associated with children who experience traumatic brain injury. Injury Prevention, 16(1), 31–35.CrossRefGoogle ScholarPubMed
Ryan, N.P., Anderson, V., Godfrey, C., Beauchamp, M.H., Coleman, L., Eren, S., & Catroppa, C. (2014). Predictors of very-long-term sociocognitive function after pediatric traumatic brain injury: Evidence for the vulnerability of the immature “social brain”. Journal of Neurotrauma, 31(7), 649–657.CrossRefGoogle ScholarPubMed
Schneier, A.J., Shields, B.J., Hostetler, S.G., Xiang, H., & Smith, G.A. (2006). Incidence of pediatric traumatic brain injury and associated hospital resource utilization in the United States. Pediatrics, 118, 483–492.CrossRefGoogle ScholarPubMed
Taylor, H.G., Yeates, K.O., Wade, S.L., Drotar, D., Klein, S.K., & Stancin, T. (1999). Influences on first-year recovery from traumatic brain injury in children. Neuropsychology, 13(1), 76–89.CrossRefGoogle ScholarPubMed
Yeates, K.O., Taylor, H.G., Drotar, D., Wade, S.L., Klein, S., Stancin, T., & Schatschneider, C. (1997). Preinjury family environment as a determinant of recovery from traumatic brain injuries in school-age children. Journal of the International Neuropsychological Society, 3(6), 617–630.CrossRefGoogle ScholarPubMed
Yeates, K.O., Taylor, H.G., Wade, S.L., Drotar, D., Stancin, T., & Minich, N. (2002). A prospective study of short- and long-term neuropsychological outcomes after traumatic brain injury in children. Neuropsychology, 16(4), 514–523.CrossRefGoogle Scholar
Yeates, K.O., Taylor, H.G., Walz, N.C., Stancin, T., & Wade, S.L. (2010). The family environment as a moderator of psychosocial outcomes following traumatic brain injury in young children. Neuropsychology, 24, 345–356.CrossRefGoogle ScholarPubMed