A Systematic Review and Meta-Analysis on the Association Between Driving Ability and Neuropsychological Test Performances after Moderate to Severe Traumatic Brain Injury

2019 ◽  
Vol 25 (08) ◽  
pp. 868-877 ◽  
Author(s):  
Peter Egeto ◽  
Shaylea D. Badovinac ◽  
Michael G. Hutchison ◽  
Tisha J. Ornstein ◽  
Tom A. Schweizer

Abstract Objectives: Guidelines on return-to-driving after traumatic brain injury (TBI) are scarce. Since driving requires the coordination of multiple cognitive, perceptual, and psychomotor functions, neuropsychological testing may offer an estimate of driving ability. To examine this, a meta-analysis of the relationship between neuropsychological testing and driving ability after TBI was performed. Methods: Hedge’s g and 95% confidence intervals were calculated using a random effects model. Analyses were performed on cognitive domains and individual tests. Meta-regressions examined the influence of study design, demographic, and clinical factors on effect sizes. Results: Eleven studies were included in the meta-analysis. Executive functions had the largest effect size (g = 0.60 [0.39–0.80]), followed by verbal memory (g = 0.49 [0.27–0.71]), processing speed/attention (g = 0.48 [0.29–0.67]), and visual memory (g = 0.43 [0.14–0.71]). Of the individual tests, Useful Field of Vision (UFOV) divided attention (g = 1.12 [0.52–1.72]), Trail Making Test B (g = 0.75 [0.42–1.08]), and UFOV selective attention (g = 0.67 [0.22–1.12]) had the largest effects. The effect sizes for Choice Reaction Time test and Trail Making Test A were g = 0.63 (0.09–1.16) and g = 0.58 (0.10–1.06), respectively. Years post injury (β = 0.11 [0.02–0.21] and age (β = 0.05 [0.009–0.09]) emerged as significant predictors of effect sizes (both p < .05). Conclusions: These results provide preliminary evidence of associations between neuropsychological test performance and driving ability after moderate to severe TBI and highlight moderating effects of demographic and clinical factors.

2005 ◽  
Vol 27 (7) ◽  
pp. 897-906 ◽  
Author(s):  
Rael T. Lange ◽  
Grant L. Iverson ◽  
Martin J. Zakrzewski ◽  
Patrick E. Ethel-King ◽  
Michael D. Franzen

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Matthew Mesley ◽  
Ross Puffer ◽  
Charles Laymon ◽  
Brian Lopresti ◽  
Kathryn Edelman ◽  
...  

Abstract INTRODUCTION TBI (traumatic brain injury) is associated with an increased risk of late neurodegeneration in chronic TBI survivors. The underlying pathophysiology of trauma-related neurodegeneration is hypothesized to involve a tauopathy, with p-tau deposited in beta-pleated sheets. Current research focuses on identifying strategies to detect trauma-related neurodegeneration in-Vivo. [F-18]AV-1451, a tau-specific PET radiotracer, may detect hyper-phosphorylated tau deposits in living patients. METHODS Participants with a history of TBI >6 mo prior with concern for cognitive decline with age-matched controls were recruited. Subjects were classified into three groups: few (=3 TBI exposures), intermediate (4–10 exposures), and numerous (>10 exposures). Participants underwent PET imaging with [F-18]AV-1451, and qualitative and semi-quantitative (SUVR) analyses of radiotracer retention were performed. Visual classification of tau positivity (+/−) was performed with absence of established positivity thresholds for [F-18]AV-1451 SUVR values. All subjects underwent neuropsychological evaluation, including measures of processing speed, executive function, and memory. RESULTS Twenty-seven TBI subjects and 7 controls were enrolled. A total of 9 participants were categorized as few, 2 as intermediate, 7 as numerous. All TBI subjects demonstrated impairment on at least one neurocognitive measure, while control subjects had normal neuropsychological test results. Analysis of [F-18]AV-1451 uptake patterns demonstrated evidence of tauopathy in 3 subjects, based on visual reads. Significantly increased [F-18]AV-1451 retention was noted in occipital gray matter, posterior cingulate gyrus, and parietal cortex in these 3 tau (+) TBI subjects compared to 24 TBI subjects visually classified as tau (−) and also normal controls. CONCLUSION Evidence of tauopathy, indicative of trauma-related neurodegeneration, was noted in 3 chronic TBI subjects, all of whom were categorized as numerous (>10) TBI exposures and cognitive deficits on neuropsychological testing. No tau PET [F-18]AV-1451 uptake was noted in control participants or in participants categorized as few or intermediate. The data represent a possible [F-18]AV-1451 PET uptake pattern associated with a clinical neurodegeneration syndrome in repetitive TBI.


2012 ◽  
Vol 24 (3) ◽  
pp. 556-564 ◽  
Author(s):  
Daniel N. Allen ◽  
Nicholas S. Thaler ◽  
Erik N. Ringdahl ◽  
Sally J. Barney ◽  
Joan Mayfield

2012 ◽  
Vol 27 (4) ◽  
pp. 446-452 ◽  
Author(s):  
N. S. Thaler ◽  
D. N. Allen ◽  
J. S. Hart ◽  
J. R. Boucher ◽  
J. C. McMurray ◽  
...  

2020 ◽  
Vol 35 (6) ◽  
pp. 897-897
Author(s):  
Aita S ◽  
Knapp D ◽  
Demming C ◽  
Hill B

Abstract Objective Intra-individual variability (IIV) applied to cognition refers to scatter of performances at the individual level. This study meta-analyzed research that examined consistency (i.e., within-task) IIV in mild-traumatic brain injury (mTBI) and moderate/severe-traumatic brain injury (msTBI) compared to normal controls. Method Using PRISMA-guided search parameters, eight databases within the EBSCO network as well as ProQuest Dissertations & Theses were searched for studies comparing cognitive IIV between TBI and control samples. Random-effects modeling was used for all analyses. Hedge’s g was used as the index of combined effect size, and Q and I2 were evaluated for heterogeneity analyses. Results This study was a part of a broader meta-analysis looking at IIV across all clinical samples. The initial search strategy yielded 2,962 results, which were reduced to 87 studies for final inclusion. This meta-analysis included 12 studies (mTBI: k = 9, 64 effect sizes; msTBI: k = 5, 10 effect sizes). Meta-analysis resulted in a significant combined effect size across all TBI studies (g = 0.45, Q = 23.49, I2 = 53.17). When stratifying for TBI severity, msTBI samples yielded a greater combined effect size (g = 0.66, Q = 10.70, I2 = 62.61) than mTBI (g = 0.39, Q = 10.49, I2 = 23.74). Highest degree of between-study heterogeneity was noted in the msTBI studies. Conclussions Broad TBI as well as mTBI and msTBI studies yielded significant combined effect sizes, consistently showing elevated cognitive IIV in TBI samples compared to healthy controls. The combined effect size approximately doubled from mTBI to msTBI. This provides evidence that consistency-based IIV is sensitive and possibly specific to neurologic/pathologic burden. This supports prior literature framing IIV as an index of neurological health.


2007 ◽  
Vol 22 (4) ◽  
pp. 433-447 ◽  
Author(s):  
J PERIANEZ ◽  
M RIOSLAGO ◽  
J RODRIGUEZSANCHEZ ◽  
D ADROVERROIG ◽  
I SANCHEZCUBILLO ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document