Longitudinal neurocognitive trajectories and risk factors in the first three months following pediatric concussion

Daniel A.P. Geraghty, Vicki Anderson, Katherine Bray, Stephen J.C. Hearps, Fabian Fabiano, Franz E. Babl, Gavin A. Davis, Georgia M. Parkin, Vanessa C. Rausa, Nick Anderson, Vera Ignjatovic, Marc Seal, Michael Takagi

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To identify differential trajectories of neurocognitive outcomes following pediatric concussion and investigate predictors associated with patterns of recovery up to 3 months. Methods: 74 participants aged 8–17 years completed attention/working memory, processing speed, and executive function measures at 2 weeks, 1 month, and 3 months post-injury. We used principal component analysis to generate a composite of information processing. Group-based trajectory modeling identified latent trajectories. Multinominal logistic regression was used to examine associations between risk factors and trajectory groups. Results: We identified three trajectories of neurocognitive outcomes. The medium (54.6%) and high improving groups (35.8%) showed ongoing increase in information processing, while the low persistent group showed limited change 3 months post-injury. This group recorded below average scores on Digit Span Forward and Backward at 3 months. History of pre-injury headache was significantly associated with the persistent low scoring group, relative to the medium improving (p = 0.03) but not the high improving group (p = 0.09). Conclusions: This study indicates variability in neurocognitive outcomes according to three differential trajectories, with groups partially distinguished by preexisting child factors (history of frequent headaches). Modelling that accounts for heterogeneity in individual outcomes is essential to identify clinically meaningful indices that are indicative of children requiring intervention.

Original languageEnglish (US)
Pages (from-to)764-772
Number of pages9
JournalBrain Injury
Volume38
Issue number10
DOIs
StatePublished - 2024

Keywords

  • group-based trajectory modeling
  • mTBI
  • neurocognitive outcomes
  • pediatric concussion
  • principal component analysis

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Developmental and Educational Psychology
  • Clinical Neurology

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