Evidence map›Paper›PMID 38124076›Full record

Observational studyBMC neurology2023

Investigating cognitive reserve, symptom resolution and brain connectivity in mild traumatic brain injury.

Natascha Ekdahl, Marika C Möller, Catharina Nygren Deboussard, Britt-Marie Stålnacke, Marianne Lannsjö, Love Engström Nordin

Registry-linked trialOpen access · goldAbstract readObservational Study
In one paragraph

Observational study in BMC neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05593172 (Different Courses of Change in Connectivity After mTBI Depending on Cognitive Reserve and How This is Related to Symptoms and Symptom Resolution?), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.1field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05593172 completednot on this map

Different Courses of Change in Connectivity After mTBI Depending on Cognitive Reserve and How This is Related to Symptoms and Symptom Resolution?

TypeobservationalSponsorDanderyd HospitalRan2015 to 2016Enrolled30ConditionsMild Traumatic Brain Injury
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Natascha EkdahlCentre for Research and Development, Uppsala University/ County Council of Gävleborg, Gävle, Sweden. natascha.ekdahl@ki.se.
Marika C MöllerDepartment of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden.
Catharina Nygren DeboussardDepartment of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden.
Britt-Marie StålnackeDepartment of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden.
Marianne LannsjöCentre for Research and Development, Uppsala University/ County Council of Gävleborg, Gävle, Sweden.
Love Engström NordinDepartment of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.
Danderyds sjukhus · SEUppsala University · SEKarolinska Institutet · SEUmeå University · SE

Funding

Stiftelsen Promobilia 19111
6 · The paper itself

Abstract

backgroundA proportion of patients with mild traumatic brain injury (mTBI) suffer long-term consequences, and the reasons behind this are still poorly understood. One factor that may affect outcomes is cognitive reserve, which is the brain's ability to maintain cognitive function despite injury. It is often assessed through educational level or premorbid IQ tests. This study aimed to explore whether there were differences in post-concussion symptoms and symptom resolution between patients with mTBI and minor orthopedic injuries one week and three months after injury. Additional aims were to explore the relationship between cognitive reserve and outcome, as well as functional connectivity according to resting state functional magnetic resonance imaging (rs-fMRI).

methodFifteen patients with mTBI and 15 controls with minor orthopedic injuries were recruited from the emergency department. Assessments, including Rivermead Post-Concussion Questionnaire (RPQ), neuropsychological testing, and rs-fMRI scans, were conducted on average 7 days (SD = 2) and 122 days (SD = 51) after injury.

resultsAt the first time point, significantly higher rates of post-concussion symptoms (U = 40.0, p = 0.003), state fatigue (U = 56.5, p = 0.014), and fatigability (U = 58.5, p = 0.025) were observed among the mTBI group than among the controls. However, after three months, only the difference in post-concussion symptoms remained significant (U = 27.0, p = 0.003). Improvement in post-concussion symptoms was found to be significantly correlated with cognitive reserve, but only in the mTBI group (Spearman's rho = -0.579, p = .038). Differences in the trajectory of recovery were also observed for fatigability between the two groups (U = 36.5, p = 0.015). Moreover, functional connectivity differences in the frontoparietal network were observed between the groups, and for mTBI patients, functional connectivity differences in an executive control network were observed over time.

conclusionThe findings of this pilot study suggest that mTBI, compared to minor orthopedic trauma, is associated to both functional connectivity changes in the brain and concussion-related symptoms. While there is improvement in these symptoms over time, a small subgroup with lower cognitive reserve appears to experience more persistent and possibly worsening symptoms over time. This, however, needs to be validated in larger studies.

trial registrationNCT05593172. Retrospectively registered.

Indexed as

Brain ConcussionCognitive ReservePost-Concussion SyndromeBrainHumansMagnetic Resonance ImagingPilot ProjectsCognitionFatigabilityFatigueImagingNeuropsychology

Identifiers

PMID38124076
PMCPMC10731820
OpenAlexW4390011071

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.