2026 American Academy of Neurology Abstract Website

Amanda Fang¹, Stephania Tovar-Vargas², Maral Sakayan¹, Maria Thereza Paulino¹, Alexis Conrad¹, Arunima Kapoor¹, Danh Nguyen³, Mark Mapstone⁴, Sigrid Burruss⁵, Jeffry Nahmias⁵, Michael Lopez¹, Bernadette Boden-Albala², Patrick Chen¹
¹Neurology Traumatic Brain Injury & Concussion (NTBIC) Program, Department of Neurology, University of California, Irvine, ²Joe C. Wen School of Population & Public Health, University of California, Irvine, ³Department of Medicine, University of California, Irvine, ⁴Department of Neurology, University of California, Irvine, ⁵Department of Surgery, University of California, Irvine

Objective:

To investigate the concordance of functional and patient-reported outcome measures (PROMs) compared to Glasgow Outcome Scale–Extended (GOSE) in subacute-chronic traumatic brain injury (TBI) clinic patients.

Background:

GOSE is the current gold standard for measuring functional outcome after TBI and emphasizes patients’ return to work and functional independence. However, the complete spectrum of recovery is not represented with GOSE and including PROMs such as social reintegration may better encapsulate a patient-centric recovery after TBI.

Design/Methods:

A retrospective (7/2024-8/2025) cohort study of a single-center TBI clinic was performed. Functional outcomes included: Modified Rankin Scale (mRS); Rivermead Post-Concussion Symptoms Questionnaire (RPQ); Montreal Cognitive Assessment (MoCA). PROMs included NIH PROMIS surveys: Psychosocial Illness Impact (PII); Self-Efficacy; Social Roles and Activities (SRA). Inclusion criteria: ≥ 18 years old, GOSE, TBI diagnosis per American-Congress-Rehabilitation-Medicine criteria, at least one functional outcome measure or PROM. mRS and RPQ are reverse-scored compared to GOSE. Kendall’s tau and Spearman’s correlation were performed.

Results:

183 TBI patients (mean age=46, 44.3% female, 76% mild TBI) were analyzed. There was moderate concordance between GOSE and mRS (tau=-0.617, p<.0001), SRA (tau=.467, p<.0001), and Self-Efficacy (tau=.401, p<.0001). Weaker concordance with GOSE was observed with RPQ (tau=-0.268, p<.0001), PII (tau=.202, p=.006), and MoCA (tau=.171, p=.039).

Moderate correlations with GOSE were observed with mRS (rho=-0.693, p<.0001), SRA (rho=.583, p<.0001), and Self-Efficacy (rho=.499, p<.0001), while weaker correlations with GOSE were seen with RPQ (rho=-0.349, p<.0001), PII (rho=.259, p=.007), and MoCA (rho=.226, p=.037).

Conclusions:

Though there was general concordance across all measures with GOSE, not all were strong concordant relationships, indicating some underrepresented considerations for recovery when using GOSE and the potential benefit of supplementing GOSE with specific PROMs such as social reintegration and self-efficacy to track TBI recovery.