Evolution of the cognitive profile in school-aged patients with severe TBI during the first 2 years of neurorehabilitation

Brain Inj. 2013;27(12):1395-401. doi: 10.3109/02699052.2013.823652. Epub 2013 Oct 8.

Abstract

Objective: Persistent post-injury cognitive, academic and behavioural deficits have been documented in children who sustained severe TBI during the school-age years. The major aim of this study was to examine and follow-up for 2 years the cognitive profile of a sample of post-injured patients (aged 6-16.11), in order to verify to what extent they recovered their intellectual functions after rehabilitation.

Method: Twenty-six patients who received a specific neuropsychological treatment and three cognitive evaluations with WISC-III were selected from a pool of 77.

Results: This group of patients showed a mild cognitive deficit at baseline, which improved over the 2 years to a borderline level. Despite the improvement in intellectual quotients and single sub-test scores achieved through rehabilitation, different recovery times were seen according to the function under study. The most common deficits are in processing speed, inferential and lexical-semantic skills.

Conclusions: Detailed analysis of the WISC-III sub-tests allows for an accurate description of single cognitive functions after TBI. This allows one to make differential diagnoses between functional profiles and plan individualized rehabilitation treatments. Post-injured school-aged patients should receive rehabilitation for a period of at least 2 years, which is the time necessary for an at-least partial reorganization of basic cognitive functions.

MeSH terms

  • Achievement
  • Adolescent
  • Age of Onset
  • Analysis of Variance
  • Brain Injuries / epidemiology
  • Brain Injuries / physiopathology
  • Brain Injuries / rehabilitation*
  • Child
  • Cognition
  • Cognition Disorders / epidemiology
  • Cognition Disorders / physiopathology
  • Cognition Disorders / rehabilitation*
  • Female
  • Follow-Up Studies
  • Humans
  • Injury Severity Score
  • Intelligence Tests
  • Italy / epidemiology
  • Male
  • Memory, Short-Term*
  • Predictive Value of Tests
  • Problem Solving*
  • Recovery of Function*
  • Semantics*
  • Task Performance and Analysis
  • Time Factors