期刊
JOURNAL OF NEUROTRAUMA
卷 34, 期 2, 页码 353-362出版社
MARY ANN LIEBERT, INC
DOI: 10.1089/neu.2016.4476
关键词
cognitive function; neuropsychology; outcome measures; pediatric brain injury
资金
- Institutional Clinical and Translational Science Award, NIH/NCRR [1UL1RR026314]
- National Institute of Child Health and Human Development (NICHD) [R01 HD42729]
- Trauma Research grants from the State of Ohio Emergency Medical Services
The objectives of the study were to characterize long-term neuropsychological outcomes following traumatic brain injury (TBI) sustained during early childhood, and determine whether identified neuropsychological impairments mediated the effect of TBI on long-term adaptive functioning. Participants included 16 children with severe TBI, 42 children with moderate TBI, and 72 children with orthopedic injuries (OI) sustained between ages 3 and 7 years. Children completed neuropsychological tests and caregivers completed a structured interview of child adaptive functioning at 6.9 (+/- 1.10) years post-injury. Profile analysis and multiple mediator modeling were employed. Children with severe TBI demonstrated poorer fluid reasoning and inhibitory control than both children with moderate TBI and OI, as well as slower processing speed than the OI group. Both fluid reasoning and processing speed were significant independent mediators of the effect of severe TBI on adaptive functioning. No neuropsychological measure significantly mediated the effect of moderate TBI on adaptive functioning. Children sustaining early severe TBI demonstrate persisting neuropsychological impairments into adolescence and young adulthood. The impact of severe TBI on children's long-term adaptive functioning is mediated in part by its effects on fluid reasoning and processing speed.
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