Adult Cognitive Outcomes Following Childhood Mild Traumatic Brain Injury: A Scoping Review.

Abstract

This review aimed to (1) summarize the existing literature regarding cognitive outcomes in adults with a history of pediatric mild traumatic brain injury (mTBI) and (2) identify gaps in the literature to provide directions for future research. Participants sustained mTBI in childhood (0-17 years of age) and underwent cognitive assessment in adulthood (older than 18 years) at least 1 year postinjury. MEDLINE Ovid and PsycINFO Ovid databases were searched to identify original research studies that examined adult cognitive outcomes after childhood mTBI. Cognitive outcome measures assessed memory, attention, visuospatial abilities, processing speed, comprehension, reasoning, intellectual functioning, and executive functioning. Outcome measures ranged from self-reported cognitive symptoms to objective testing. A total of 4216 articles were screened, leading to the inclusion of 6 published studies for review (3 prospective cohort and 3 retrospective cohort), with 131 537 participants (mTBI = 6724; controls = 123 823). Review of the included articles suggests that adults with a history of childhood mTBI perform within the average range expected for adult cognitive functioning, although they may perform more poorly than non-head-injured comparison groups on a variety of cognitive measures. Injury-related factors, such as requiring electroencephalography within 24 hours of injury and posttraumatic amnesia lasting longer than 30 minutes, may be associated with variability in adult cognitive outcomes. The weight of the available evidence suggests that childhood mTBI does not have a significant impact on adult cognitive functioning. However, further research is needed to provide a more comprehensive understanding of the long-term cognitive outcomes of childhood mTBI and to identify predictors of those outcomes in adulthood.