Cognitive recovery after severe traumatic brain injury in children/adolescents and adults: similar positive outcome but different underlying pathways?

PRIMARY OBJECTIVE

Does younger age at the time of severe traumatic brain injury (STBI) protect from cognitive symptoms? To answer this question, the authors compared the neuropsychological profile of late school-age children/adolescents and young adult patients at mid- and long-term recovery periods (6 and 12 months post-STBI).

METHODS AND PROCEDURES

Twenty-eight children/adolescents and 26 clinically matched adults were tested on measures of general intelligence, attention, executive functions, visuoperceptual, visuospatial and visuoconstructive abilities. Coma duration and the post-acute Glasgow Outcome Scale (GOS) score were used as predictor variables in a series of regression analyses.

MAIN OUTCOMES AND RESULTS

Children/adolescents and adults similarly improved on most measures, except for visuospatial and visuoconstructive skills, which worsened in time for children/adolescents. Coma duration significantly predicted performance IQ and visuoperceptual scores in children/adolescents. The GOS score significantly predicted performance and verbal IQ, sustained attention, visuoconstructive and long-term memory skills. Coma duration predicted executive function skills in both age groups.

CONCLUSIONS

(1) No evidence was found for a neuroprotective effect of younger age at STBI; and (2) Coma duration and GOS score predicted neuropsychological recovery in children/adolescents and adults, respectively. This suggests the existence of underlying age-specific recovery processes after STBI.