Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.
Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.
J Int Neuropsychol Soc. 2022 Nov;28(10):1091-1103. doi: 10.1017/S1355617721001296. Epub 2021 Nov 26.
To examine the effects of pediatric traumatic brain injury (TBI) on verbal IQ by severity and over time.
A systematic review and subsequent meta-analysis of verbal IQ by TBI severity were conducted using a random effects model. Subgroup analysis included two epochs of time (e.g., <12 months postinjury and ≥12 months postinjury).
Nineteen articles met inclusion criteria after an extensive literature search in MEDLINE, PsycInfo, Embase, and CINAHL. Meta-analysis revealed negative effects of injury across severities for verbal IQ and at both time epochs except for mild TBI < 12 months postinjury. Statistical heterogeneity (i.e., between-study variability) stemmed from studies with inconsistent classification of mild TBI, small sample sizes, and in studies of mixed TBI severities, although not significant. Risk of bias on estimated effects was generally low ( = 15) except for studies with confounding bias (e.g., lack of group matching by socio-demographics; = 2) and measurement bias (e.g., outdated measure at time of original study, translated measure; = 2).
Children with TBI demonstrate long-term impairment in verbal IQ, regardless of severity. Future studies are encouraged to include scores from subtests within verbal IQ (e.g., vocabulary, similarities, comprehension) in addition to functional language measures (e.g., narrative discourse, reading comprehension, verbal reasoning) to elucidate higher-level language difficulties experienced in this population.
研究儿童创伤性脑损伤 (TBI) 严重程度和随时间推移对言语智商的影响。
使用随机效应模型对 TBI 严重程度的言语智商进行系统评价和随后的荟萃分析。亚组分析包括两个时间阶段（例如，伤后<12 个月和≥12 个月）。
在 MEDLINE、PsycInfo、Embase 和 CINAHL 进行广泛的文献检索后，有 19 篇文章符合纳入标准。荟萃分析显示，除了轻度 TBI<12 个月外，损伤对言语智商的影响在各严重程度和两个时间阶段均为负性。统计异质性（即研究间变异性）源于轻度 TBI 分类不一致、样本量小以及混合 TBI 严重程度研究的研究，尽管没有统计学意义。估计效应的偏倚风险通常较低（=15），但存在混杂偏倚（例如，缺乏社会人口统计学的组匹配；=2）和测量偏倚（例如，原始研究时使用过时的测量方法，翻译后的测量方法；=2）的研究除外。
无论严重程度如何，患有 TBI 的儿童在言语智商方面均表现出长期损害。鼓励未来的研究除了包括功能语言测量（例如，叙事话语、阅读理解、言语推理）之外，还包括言语智商（例如，词汇、相似性、理解）内的子测试分数，以阐明该人群中经历的更高层次的语言困难。
