The course and prognostic factors of cognitive outcomes after traumatic brain injury: A systematic review and meta-analysis

Mollayeva, Tatyana; Mollayeva, Shirin; Pacheco, Nicole; D’Souza, Andrea; Colantonio, Angela

doi:10.1016/j.neubiorev.2019.01.011

Cited by 39 publications

(47 citation statements)

References 98 publications

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“…Our results show that TBI alone, or with SCI, differentially affects men and women of varying ages, with effect of severe TBI and concussions (e.g., unspecified injury severity S06.0 codes) decreasing with increasing age. Our results support the notion that the CNS is not a static entity and that its structure and function at the time of injury matters when it comes to reorganization of neural pathways in response to the damage [40] .…”

Section: Discussionsupporting

confidence: 85%

Sex‐specific incident dementia in patients with central nervous system trauma

Mollayeva

Hurst

Escobar

et al. 2019

Alz & Dem Diag Ass & Dis Mo

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Introduction Despite evidence that central nervous system (CNS) trauma, including traumatic brain injury and spinal cord injury, can cause sustained neurocognitive impairment, it remains unclear whether trauma-related variables are associated with incident dementia independently of other known risk factors. Methods All adults without dementia entering the health-care system with diagnoses of CNS trauma were examined for occurrence of dementia. All trauma-related variables were examined as predictors in sex-specific Cox regression models, controlling for other known risk factors. Results Over a median follow-up of 52 months, 32,834 of 712,708 patients (4.6%) developed dementia. Traumatic brain injury severity and spinal cord injury interacted with age to influence dementia onset; women were at a greater risk of developing dementia earlier than men, all other factors being equal. Discussion Risk stratification of patients with CNS trauma by sex is vital in identifying those most likely to develop dementia and in understanding the course and modifying factors.

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Section: Discussionsupporting

confidence: 85%

Sex‐specific incident dementia in patients with central nervous system trauma

Mollayeva

Hurst

Escobar

et al. 2019

Alz & Dem Diag Ass & Dis Mo

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“…These findings may have clinical value for a specific subgroup of patients, indicating the need for continual neurocognitive assessments and for seeking age-related changes including psychological (e.g., depression and anxiety) and medical (e.g., seizures, biomarkers, and neurodegenerative) mechanisms that may contribute to cognitive decline in chronic TBI. However, as the time since TBI progresses, the environmental, behavioral, structural, morphological, and physiological influences may become a scientific challenge in understanding the prognostic factors of cognitive outcomes (for review, see Mollayeva et al, 2019). The current findings suggest that premorbid relationship of education was a consistently significant predictor of the three neurocognitive trajectories, where individuals with a lower education (12 years or less) showed a trend in Reasoning decline after 5 years of brain trauma (e.g., see Figure 2).…”

Section: Discussionmentioning

confidence: 99%

“…A recent review by Mollayeva et al (2019) indicated that age as a determinant of cognitive outcome is inconsistent. In the current study, age was not found to be a significant predictor of neurocognitive trajectories.…”

Section: Discussionmentioning

confidence: 99%

Trajectory of 10-Year Neurocognitive Functioning After Moderate–Severe Traumatic Brain Injury: Early Associations and Clinical Application

Sigurðardóttir

Anđelić

Røe

et al. 2020

J Int Neuropsychol Soc

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Objective: This study aimed to explore the 10-year trajectories of neurocognitive domains after moderate–severe traumatic brain injury (TBI), to identify factors related to long-term neurocognitive functioning, and to investigate whether performance remained stable or changed over time. Method: Seventy-nine patients with moderate–severe TBI between the ages of 16 and 55 years were assessed at 3 months, 1, 5, and 10 years postinjury using neuropsychological tests and functional outcomes. Three hierarchical linear models were used to investigate the relationships of domain-specific neurocognitive trajectories (Memory, Executive function, and Reasoning) with injury severity, demographics, functional outcome at 3 months (Glasgow Outcome Scale-Extended) and emotional distress at 1 year (Symptom Checklist 90-Revised). Results: Education, injury severity measures, functional outcome, and emotional distress were significantly associated with both Memory and Executive function. Education and emotional distress were related to Reasoning. The interaction effects between time and these predictors in predicting neurocognitive trajectories were nonsignificant. Among patients with data at 1 and 10 year follow-ups (n = 47), 94–96% exhibited stable scores on Executive function and Reasoning tasks, and 83% demonstrated stable scores on Memory tasks. Significant memory decline was presented in 11% of patients. Conclusions: The findings highlight the differential contribution of variables in their relationships with long-term neurocognitive functioning after moderate–severe TBI. Injury severity was important for Memory outcomes, whereas emotional distress influenced all neurocognitive domains. Reasoning (intellectual) abilities were relatively robust after TBI. While the majority of patients appeared to be cognitively stable beyond the first year, a small subset demonstrated a significant memory decline over time.

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“…Indeed, often individuals with similar indicators of severity and early clinical trajectories experience different outcomes (Bigler et al, 2006;Lutkenhoff et al, 2019). Recovery and community reintegration is further complicated by a number of interacting premorbid, clinical, demographic, and genetic factors (Mollayeva et al, 2019).…”

Section: Leveraging Enigma To Address Challenges In Ams-tbi Researchmentioning

confidence: 99%

Toward a Global and Reproducible Science for Brain Imaging in Neurotrauma: The ENIGMA Adult Moderate/Severe Traumatic Brain Injury Working Group

Olsen¹,

Babikian²,

Bigler³

et al. 2019

Preprint

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The global burden of mortality and morbidity caused by traumatic brain injury (TBI) is significant and the heterogeneity of TBI patients and the relatively small sample sizes of most current neuroimaging studies is a major challenge for scientific advances and clinical translation. The ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) Adult moderate/severe TBI (AMS-TBI) working group aims to be a driving force for new discoveries in AMS-TBI by providing researchers world-wide with an effective framework and platform for large-scale cross-border collaboration and data sharing. Based on the principles of transparency, rigor, reproducibility and collaboration, we will facilitate the development and dissemination of multiscale and big data analysis pipelines for harmonized analyses in AMS-TBI using structural and functional neuroimaging in combination with nonimaging biomarkers, genetics, as well as clinical and behavioral measures. Ultimately, we will offer investigators an unprecedented opportunity to test important hypotheses about recovery and morbidity in AMS-TBI by taking advantage of our robust methods for largescale neuroimaging data analysis. In this consensus statement we outline the working group’s short-term, intermediate, and long-term goals.

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The course and prognostic factors of cognitive outcomes after traumatic brain injury: A systematic review and meta-analysis

Cited by 39 publications

References 98 publications

Sex‐specific incident dementia in patients with central nervous system trauma

Sex‐specific incident dementia in patients with central nervous system trauma

Trajectory of 10-Year Neurocognitive Functioning After Moderate–Severe Traumatic Brain Injury: Early Associations and Clinical Application

Toward a Global and Reproducible Science for Brain Imaging in Neurotrauma: The ENIGMA Adult Moderate/Severe Traumatic Brain Injury Working Group

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