Article

Cognitive reserve as a moderator of postconcussive symptoms in children with complicated and uncomplicated mild traumatic brain injury

Department of Psychology, Ohio State University, Columbus, OH 43205, USA.
Journal of the International Neuropsychological Society (Impact Factor: 3.01). 10/2009; 16(1):94-105. DOI: 10.1017/S1355617709991007
Source: PubMed

ABSTRACT The occurrence of postconcussive symptoms (PCS) following mild traumatic brain injury (TBI) in children may depend on cognitive reserve capacity. This prospective, longitudinal study examined whether the relationship between mild TBI and PCS is moderated by cognitive ability, which served as a proxy for cognitive reserve. Participants included 182 children with mild TBI and 99 children with orthopedic injuries (OI), ranging from 8 to 15 years of age when injured. Mild TBI were classified as complicated (n = 32) or uncomplicated (n = 150) depending on whether they were associated with trauma-related intracranial abnormalities on magnetic resonance imaging. PCS were assessed initially within 3 weeks of injury, and again at 1, 3, and 12 months post injury. The initial assessment also included standardized tests of children's cognitive skills and retrospective parent ratings of pre-injury symptoms. Hierarchical linear modeling indicated that ratings of PCS were moderated jointly by cognitive ability and injury severity. Children of lower cognitive ability with a complicated mild TBI were especially prone to cognitive symptoms across time according to parents and to high acute levels of PCS according to children's self-ratings. Cognitive reserve is an important moderator of the outcomes of mild TBI in children and adolescents.

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    • "In support of the concept of CR, many studies have shown that higher levels of educational and occupational attainment, as well as greater premorbid intelligence are associated with better clinical outcomes across a variety of conditions, such as a reduced risk of mild cognitive impairment or dementia (Soldan et al., 2013; Wilson et al., 2002; Pettigrew et al., 2013), better recovery from traumatic brain injury (Fay et al., 2010; Levi et al., 2013), and less cognitive impairment in multiple sclerosis (Sumowski et al., 2013) or Parkinson's disease (Perneczky et al., 2008). Despite the strong evidence for the beneficial effects of CR, the neural mechanisms by which it operates are poorly understood. "
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    ABSTRACT: Apolipoprotein E (APOE) genotype influences onset age of Alzheimer's disease but effects on disease progression are less clear. We investigated amyloid-β (Aβ) levels and change in relationship to APOE genotype, using 2 different measures of Aβ in 2 different longitudinal cohorts. Aβ accumulation was measured using positron emission tomography (PET) imaging and (11)C-Pittsburgh compound-B (PiB) in 113 Baltimore Longitudinal Study of Aging participants (mean age 77.3 years; 107 normal, 6 cognitively impaired) and cerebral spinal fluid (CSF) Aβ1-42 assays in 207 BIOCARD study participants (mean age 62 years; 195 normal, 12 cognitively impaired). Participants in both cohorts had up to 7 serial assessments (mean 2.3-2.4). PET-PiB retention increased and CSF Aβ1-42 declined longitudinally. APOE ε4 was significantly associated with higher PET-PiB retention and lower CSF Aβ1-42, independent of age and sex, but APOE genotype did not significantly affect Aβ change over time. APOE ε4 carriers may be further along in the disease process, consistent with earlier brain Aβ deposition and providing a biological basis for APOE genotype effects on onset age of Alzheimer's disease. Copyright © 2015 Elsevier Inc. All rights reserved.
    Neurobiology of aging 04/2015; 36(8). DOI:10.1016/j.neurobiolaging.2015.04.001 · 4.85 Impact Factor
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    • "In support of the concept of CR, many studies have shown that higher levels of educational and occupational attainment, as well as greater premorbid intelligence are associated with better clinical outcomes across a variety of conditions, such as a reduced risk of mild cognitive impairment or dementia (Soldan et al., 2013; Wilson et al., 2002; Pettigrew et al., 2013), better recovery from traumatic brain injury (Fay et al., 2010; Levi et al., 2013), and less cognitive impairment in multiple sclerosis (Sumowski et al., 2013) or Parkinson's disease (Perneczky et al., 2008). Despite the strong evidence for the beneficial effects of CR, the neural mechanisms by which it operates are poorly understood. "
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    ABSTRACT: Although many epidemiological studies suggest the beneficial effects of higher cognitive reserve (CR) in reducing age-related cognitive decline and dementia risk, the neural basis of CR is poorly understood. To our knowledge, the present study represents the first electrophysiological investigation of the relationship between CR and neural reserve (i.e., neural efficiency and capacity). Specifically, we examined whether CR modulates event-related potentials associated with performance on a verbal recognition memory task with 3 set sizes (1, 4, or 7 letters) in healthy younger and older adults. Neural data showed that as task difficulty increased, the amplitude of the parietal P3b component during the probe phase decreased and its latency increased. Notably, the degree of these neural changes was negatively correlated with CR in both age groups, such that individuals with higher CR showed smaller changes in P3b amplitude and less slowing in P3b latency (i.e., smaller changes in the speed of neural processing) with increasing task difficulty, suggesting greater neural efficiency. These CR-related differences in neural efficiency may underlie reserve against neuropathology and age-related burden. Copyright © 2015 Elsevier Inc. All rights reserved.
    Neurobiology of Aging 12/2014; 36(3). DOI:10.1016/j.neurobiolaging.2014.12.025 · 4.85 Impact Factor
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    • "Estos resultados encuentran apoyo en recientes investigaciones que han estudiado los efectos del traumatismo craneoencefálico en niños, concluyendo que el desempeño de los pacientes no depende necesariamente del grado de severidad del TCE, sino que puede estar relacionado con factores como las características premorbidas, el nivel de éxito escolar, el nivel educativo de los padres,etc. (Taryn, Yeats, Taylor, Bangert, Nuss, Rusin, yWright, 2010; Delgado, Quintanar, Solovieva, Machinskaya, 2011). Estos resultados no coinciden con lo planteado por autores como Rodríguez Murillo (2007), quien propone que la duración y el estado del coma (condiciones para el establecimiento de la severidad de la lesión) se correlacionan directamente con los resultados funcionales y cognoscitivos, esto medido a través de escalas de inteligencia. "
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    ABSTRACT: Perfil Neuropsicológico en niños de 5 a 7 años de edad con traumatismo craneoencefálico Profil neuropsychologique des enfants de 5-7 ans avec un traumatisme crânien Características Neuropsicológicas depois do traumatismo cranioencefálico em crianças de 5 a 7 anos de idade Neuropsychological Profile in children 5-7 Resumen El traumatismo craneoencefálico (TCE) es la principal causa de muerte entre niños y adolescentes. El trauma en general representa un verdadero problema de salud pública en cualquier país del mundo, con una tendencia ascendente cuyas causas responden a diferentes tópicos en dependencia de la edad de ocurrencia de la lesión. Las características neuropsicológicas que aparecen después de un traumatismo craneoencefálico son múltiples y algunas de ellas pueden interferir en el desempeño escolar presente y las demandas futuras. El objetivo del presente estudio es analizar el estado funcional de los diferentes factores neuropsicológicos después de un trauma craneoencefálico en la edad infantil, teniendo en cuenta las variables localización (unidad cerebral afectada y hemisferio) y tipo de lesión (leve, moderada o severa). En el estudio participaron 26 niños de 5 a 7 años de edad, con diagnóstico de TCE. Todos los niños fueron evaluados con la prueba "Screening neuropsicológico infantil Puebla-Sevilla". Los resultados sugieren cuadros neuropsicológicos dependientes de la localización de la lesión más que de la severidad o tipo de lesión sufrida. Se discuten los hallazgos en términos de síndromes neuropsicológicos y sus posibles efectos en el desempeño posterior en la población infantil. Palabras clave: Trauma cráneoencefálico, factor neuropsicológico, localización, severidad, funciones psicológicas. Résumé Une lésion cérébrale traumatique (TBI) est la principale cause de décès chez les enfants et les adolescents. Le traumatisme en général est un problème de santé publique réel dans n'importe quel pays dans le monde, avec une tendance à la hausse dont les causes aborder différents sujets en fonction de l'âge de survenue de la blessure. Caractéristiques neuropsychologiques qui apparaissent après un traumatisme crâne -cerveau sont nombreux et certains d'entre eux peuvent interférer avec la performance scolaire en cours et les demandes futures. Le but de cette étude est d'analyser l'état de fonctionnement des différents facteurs neuropsychologiques après un traumatisme crânien dans l'enfance, en tenant compte des variables de localisation (de l'hémisphère cérébral et de l'unité touchée) et le type de blessure (légère, modérée ou sévère). L'étude a porté sur 26 enfants âgés de 5 à 7 ans, un diagnostic de TBI. Tous les enfants ont été évalués avec le test «enfant neuropsychologique de dépistage Puebla-Sevilla ". Les résultats suggèrent conditions neuropsychologiques liés à la situation de la lésion plutôt que la gravité ou le type de préjudice subi. Les résultats sont discutés en termes de syndromes neuropsychologiques et leurs effets possibles sur l'exécution ultérieure chez les enfants. Mot clefs: traumatisme crânien, facteurs neuropsychologiques, emplacement, gravité, fonctions psychologiques.
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