Exploratory Analysis of Comprehensive Neurocognitive Testing in Post-traumatic Brain Injury (TBI) Clinic Patients with Primary Cognitive Symptoms
Claire Joyner1, Amanda Fang1, Arunima Kapoor1, Alexis Conrad1, Bruce Albala1, Dahn Nguyen2, Michael Lopez1, Bernadette Boden-Albala3, Patrick Chen1
1Neurology Traumatic Brain Injury & Concussion (NTBIC) Program, Department of Neurology, University of California, Irvine, Orange, CA, 2Department of Medicine, University of California, Irvine, Orange, CA, 3Department of Health Society and Behavior, Joe C Wen School of Population and Public Health, University of California Irvine, Irvine, Ca Department of Epidemiology and Biostatistics, Joe C Wen School of Population and Public Health, University of California Irvine, Irvine, Ca Department of Neurology, School of Medicine, University of California Irvine, Irvine, Ca
Objective:
To assess differences in formal neurocognitive testing in traumatic brain injury (TBI) clinic patients reporting primary cognitive symptoms and analyze predictors of mild-moderate cognitive disorder diagnosis.
Background:
TBI is a prevalent condition, increasingly recognized as a chronic disease associated with cognitive symptoms and dementia. Screening for post-TBI cognitive disorders is limited in the clinic setting.
Design/Methods:
Retrospective cohort study of TBI-clinic visits in UCI-NTBIC database (9/2022-8/2024) receiving a standardized neuropsychological battery. Inclusion criteria: ≥18yo, self-reported TBI history (2023-ACRM criteria), cognition as primary symptom. Exclusion: dementia-diagnosis. Outcome is diagnosis of minor or major neurocognitive disorder by neuropsychologist. Descriptive statistics (Mann-Whitney/Fischer-test) and multivariable logistic-regression performed.
Results:
Of 24 patients with neuropsychology testing (mean age 46, 58% male, 30% non-white race, 83% mild-TBI, mean 31 months post-TBI), 6 (25%) patients were diagnosed with mild (n=5) or moderate (n=1) cognitive disorder secondary to TBI. There were no differences in education or previous TBI severity. Cognitive disorder TBI had higher BMI compared to TBI without cognitive disorder (34 kg/m² SD 9 vs 23 kg/m² SD 3, p=.003). Processing speed index percentile [PSI] (20 SD 35 vs. 58 SD 15 , p= .004) was lower in post-TBI cognitive disorders versus non-cognitive disorders. The trend was indicative of the Montreal Cognitive Assessment [MoCA] (23 SD 3 vs 27 SD .5, p = .013) being lower in cognitive disorder patients; a larger sample size is needed to confirm predictive value. In regression (adjusting for: Age/sex/race/education), time since TBI, PSI and BMI did not independently predict cognitive disorder diagnosis.
Conclusions:
In chronic TBI clinic patients with primarily cognitive complaints, 25% have a cognitive disorder. Neuropsychology batteries are feasible in a TBI clinic cohort. MoCA and PSI may be useful for cognitive screening and increased BMI may be risk factors for post-TBI cognitive disorder.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.