Assessment of memory functioning over two years following severe childhood traumatic brain injury: results of the TGE cohort

Abstract

The aims of this study were (1) to prospectively measure memory functioning following severe childhood Traumatic Brain Injury (TBI), and its evolution over 2 years; (2) to assess demographic and medical factors associated with memory function and recovery; (3) to explore relations between memory and other TBI outcomes.Methods: Children (aged 0-15 years; n=65) consecutively admitted in a single trauma centre over a 3-year period, who survived severe non-inflicted TBI, were included in a prospective longitudinal study. Memory was assessed in 38 children aged 5-15 years at injury, using the Children's Memory Scale at 3, 12, and 24-months post-injury.Results: Mean general memory score was low at 3 months (M=90.2, SD=20.3) but within the normal range at 12 and 24 months (M=100.6, SD=23.1 and M=108.6, SD=24.1, respectively), with high variability. Improvement was stronger for immediate visual memory than for other memory indices. Lower general memory score was associated with higher injury severity, lower intellectual ability and functional status, higher overall disability, and ongoing education. Conclusion:Memory functioning is highly variable following severe childhood TBI, related to injury severity and functional, cognitive and educational outcomes; improvement is significant during the first-year post-injury, but varies according to the type of memory.

Memory functioning 7 years after severe childhood traumatic brain injury: Results of the Traumatisme Grave de l’Enfant study

“…Attention/concentration and verbal memory were significantly more impaired than visual memory. Memory outcome was associated with parental education and markers of initial TBI severity, and correlated with other outcomes, such as intellectual ability, overall functional outcome, and type of post-injury education [12]. Further, prospective memory (e.g.…”

“…Severe pediatric TBI, defined by a Pediatric Glasgow Coma Scale (Peds-GCS) score ≤ 8 [6], is associated with long-standing neurological, neuropsychological and behavioral impairments, such as sensory-motor deficits, including hemiparesis and cerebellar dysfunction [7], and deficits in language, visual-spatial skills, processing speed, memory, attention, working memory, executive functioning and behavior regulation [8][9][10][11][12][13]. Those deficits are associated with impaired educational achievement [12,[14][15][16][17], reduced participation, and impaired quality of life in the long term [18][19][20][21].…”

“…In a previous report of the TGE (Traumatisme Grave de l'Enfant, i.e. Severe Childhood Trauma) cohort (see description below), we presented memory outcomes over the first 2-years post-injury [12]. Memory impairment at 3-months post-injury was severe (mean one standard deviation below expected values), and improved significantly during the first two years post-injury.…”

Feasibility Randomized Trial for an Intensive Memory-Focused Training Program for School-Aged Children with Acquired Brain Injury

“…Memory has wide neurofunctional underpinnings, mainly involving the frontal and temporal lobes, and the basal ganglia [ 18 ]. Although neuropsychological studies support the effectiveness of memory training after TBI, the demonstration of neurofunctional modifications induced by specific treatments is much harder and largely unexplored in this field, due to the heterogeneous nature of each individual’s brain damage [ 19 ].…”

“…To the authors’ knowledge, this is the first study employing functional neuroimaging for the assessment of memory intervention efficacy in pediatric ABI. Based on present state-of-the art knowledge of the neural correlates of memory [ 18 ], and on the specific memory functions trained by IM-FTP, we expect frontal reorganization following training.…”